Michael Harty (Clare, Independent) | Oireachtas source

I thank the Minister for giving us the opportunity to discuss the subject this morning. Cervical screening is not a diagnostic test and this is where a lot of the issues have arisen. No screening programme can identify 100% of the abnormality that it is looking for. In this case the screening programme looks for pre-cancerous changes, which have a huge spectrum of change from zero to invasive cancer. The programme attempts to deliver population health versus individual health. Up to 2008 it was random screening of cervical smears and then the population health directorate introduced the national screening programme, which has delivered a huge amount of success in identifying women who had pre-cancerous changes. Unfortunately, because the programme has inherent difficulties - all screening programmes have inherent difficulties - the judgment that was delivered last week on absolute confidence really misunderstands what screening programmes are all about. It is not attainable or available to any screening programme to achieve 100% success. Right across the world this is not possible. Medicine is an uncertain business and one tries to confirm in an area of uncertainty. Screening tries to improve population health. Will the Minister tell the House if the judgment will put other screening programmes in doubt, has it put other diagnostic tests in doubt and has it put the future of cervical screening in doubt? I understand there was a high-level meeting between CervicalCheck and departmental officials some days ago to discuss this very issue. Has the judgment really damaged the future of all screening? I believe there will be an appeal of the judgment. Will the Minister comment on that?

HPV testing has been promised for a year. It was to come in last October and it is now promised for before the end of this year. What are the barriers to introducing HPV testing before the end of this year? Is it dependent on clearing the backlog or is it dependent on finding a laboratory that will provide the new level of testing?

My third question relates to MedLab's coverage. The smears that are sent to MedLab are usually from the regions outside the Dublin area. I believe that MedLab is no longer accepting new smears since 1 July. Those smears are now being stored pending access to new laboratory capacity, which has not been attained yet. Will the Minister confirm if this is true?

Earlier I made a suggestion for dealing with the substantial backlog, for which the last figure we had was 80,000 smears. Is there some merit in suspending the screening element of CervicalCheck until that backlog is cleared?

Women are now being asked to attend for smears but they might not get a result for up to 33 weeks, which negates the benefit of getting an early result from screening and undermines confidence in the screening programme. Has the Minister or CervicalCheck considered a temporary suspension of the screening arm of CervicalCheck to allow for the backlog to be cleared?

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