James Reilly (Dublin North, Fine Gael)
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Question 11: To ask the Minister for Health and Children if, in view of the reported plans to outsource the reading of all 300,000 cervical smears outside this State to another continent, causing the closure of all cervical smear laboratories here and the consequent loss of more than 100 highly skilled specialised jobs involved in the teaching and reading of cervical smears at a time of economic downturn, she will confirm that the accuracy rate of the non-Irish tender was only 85% compared to 95% in the Irish laboratory at University College Hospital, Galway; her views on whether it is untenable to leave Ireland in a position where we will have no laboratories for cytology screening, and that Ireland will be at the mercy of the vagaries of the international commercial laboratory operators; if she will reconsider the path she is taking and instead properly resource, update and fund adequately the screening laboratories here as formerly agreed by her Department and all the stakeholders in Limerick in 2005 as per the Dr. McGoogan report on cervical screening services; and if she will make a statement on the matter. [16776/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I confirm the planned roll-out of a national cervical screening programme. The absolute priority in the roll-out of this programme is to provide a quality-assured service for women availing of the service. This includes an acceptable turnaround time for cytology results.

The national cancer screening service is in the process of procuring cytology providers as part of the planned roll-out of the screening programme. It commenced in December 2007 and was open to laboratories in Ireland and internationally. The procurement process is being run in accordance with national and EU procurement requirements. The necessary entry criteria in choosing a cytology partner included accreditation status and a laboratory dealing with a volume of a minimum of 25,000 smears per annum. These criteria were chosen in line with international acceptable criteria for cervical screening programmes. The initial contractual period with laboratories will be for a two-year period. As this process is ongoing, it is not appropriate for me to comment on the specific aspects of the competition such as those referred to by the Deputy. However, in more general terms, taxpayers are entitled to expect the best value for money in terms of the cost of the service being provided.

The Dr. McGoogan report recommended that cervical screening be managed as a national call and recall programme via effective governance structures that provide overall leadership and direction in terms of policy, quality assurance, accountability and value for money. This report, among others, was taken into account by the national cancer screening service in determining the process for roll-out of the cervical screening programme nationally.

The HSE has undertaken a review of its laboratory medicine services. I welcome steps being taken by certain HSE-funded laboratories to secure accreditation. If all those involved work together in partnership, there is scope to provide high quality and cost effective services within HSE-funded laboratories.

James Reilly (Dublin North, Fine Gael)
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The Minister's reply is incredible. A cervical cancer screening programme was piloted in the mid-west in 1999. Either the Department of Health and Children or the Health Service Executive engineered the tender for this contract. Why was action not taken in recent years to encourage, assist and resource the laboratories in this State to be in a position to tender for the contract?

Some important facts must be put before this House. The data arising from the smear tests undertaken in the United States will be available in that jurisdiction and may come under the remit of the Patriot Act. Information relating to Irish women will be in the hands of the Department of Homeland Security to do with as it wishes.

Under the national screening programme, women are to undergo smear tests every three to five years. Given the way in which this Government has been funding the health service, it will be every five years. In the United States, where women are offered smear tests every year, an 85% efficiency rate is tolerable as opposed to the 95% efficiency rate required here. This means we are putting patients at risk by outsourcing smear tests to a jurisdiction in which women undergo tests yearly and where a greater margin of error is therefore allowed.

Deputy Harney observed that several of the State's laboratories expect to achieve accreditation in the near future. Many of these laboratories have leased expensive new equipment but no advice was offered to them on how to tender for this contract. They are not accustomed to this type of approach.

Brendan Howlin (Wexford, Labour)
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I am sure there is a question among Deputy Reilly's statements.

James Reilly (Dublin North, Fine Gael)
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Will the Minister reconsider this tendering process, particularly in light of the patient safety issues, to which I referred? In addition, smear tests are reported in a different manner in the United States. We are building into the system more room for human error that may impact on the patient in a negative fashion.

Mary Harney (Dublin Mid West, Progressive Democrats)
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It is extraordinary that the Deputy who has been screaming at the Government to introduce the cervical screening programme, a Deputy who understands that we do not currently have the capacity in this State to provide quality-assured cytology services, is now screaming at me because we are proceeding to introduce that programme this year. I am also surprised that Deputy Reilly is raising the prospect of private patient data being made widely available in the United States. I do not understand his concern. Others may have something to say about it

Our tests will meet the standards laid down by the British Society for Colposcopy and Cervical Pathology. That is the most important issue. It is our intention to bring the laboratories in this State up to the standard required and to achieve accreditation. However, we will not be in a position to do so between now and the summer.

James Reilly (Dublin North, Fine Gael)
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The Minister and the Government of which she is a member have had ten years of economic boom to achieve this. It is difficult to accept her undertaking to do so in the coming years as we face into an economic downturn. The public will not swallow that.

Mary Harney (Dublin Mid West, Progressive Democrats)
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We are providing the service. That is what is important.

James Reilly (Dublin North, Fine Gael)
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It is my understanding that one of the main United States tenderers for this contract is currently taking ten weeks to turn around results.

Mary Harney (Dublin Mid West, Progressive Democrats)
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I have already told the Deputy what is required under the terms of the tender. The specified turnaround time must be met. The quality control standard in the United States is similar to the high standard set by the British society. That standard will be met. There is no point in having cytology without accuracy.

James Reilly (Dublin North, Fine Gael)
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What about the 85% efficiency rate versus the 95% efficiency rate?

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Deputy knows that much of the opportunistic screening that took place here was not reliable because the quality-assured facilities were not in place.