Richard Bruton (Dublin North Central, Fine Gael)
Link to this: Individually | In context

Question 39: To ask the Minister for Health and Children her plans to rationalise laboratory services here; when this process of rationalisation will commence; the estimated amount of money that will be saved from this rationalisation; and if she will make a statement on the matter. [45580/09]

Mary Harney (Dublin Mid West, Independent)
Link to this: Individually | In context

Approximately 77 million laboratory tests are undertaken annually across 44 public hospitals. At present, the annual cost of this service is approximately €470 million. The workload comprises both urgent and non-urgent tests, and a significant proportion of the activity originates in the primary care setting.

An external review of laboratory services was conducted for the HSE by Teamwork Management Services in 2007. The review highlighted limitations in the current organisation of laboratories which impact on quality, turnaround time and cost. In light of the review, the HSE announced plans earlier this year to modernise laboratory services and to introduce significant efficiencies in the configuration and operation of these services. The HSE has already had significant engagement with stakeholders in progressing this initiative. Groups such as the faculty of pathology and the Medical Laboratory Scientists Association will have an ongoing input into the process.

As part of this initiative, the HSE has recently commenced discussions with the National Development Finance Agency about the capital financing of a small number of dedicated "cold" laboratories to process the large volumes of routine patient tests currently undertaken in hospital laboratories. This will include a robust analysis of the cold laboratory business model from a value for money perspective.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Everyone supports the rationalisation of laboratory services. The Minister used the words "cold" and "hot" to define routine versus emergency. The issue is that there are plans to allow for international tendering so, once again, a company like Quest Diagnostics can take over laboratory services in this country and we end up with hundreds of medical laboratory scientists' jobs gone. They have already seen the cervical screening activity removed.

Invitation by letter has reduced the number of people attending for smears from 28,000 in August to 18,000 in September, as was anticipated, despite the denials on the other side of the table. Could the Minister tell us if she intends to tender this work outside the country and how many jobs will be lost? Does she believe this is a sensible use of Irish taxpayers' money in terms of retaining Irish jobs and a particular skill?

Mary Harney (Dublin Mid West, Independent)
Link to this: Individually | In context

The main issue is quality and cost. The Deputy knows from the report that our turn-around time is bad, our quality is poor and our cost is enormous. Clearly, from any perspective, that is not satisfactory. The intention is to go to tender and there has been discussion with stakeholders. One would hope that the public service would be successful in that tender but clearly it must compete on the basis of quality, turn-around time and cost. That must be the future because if we waste €200 million on this service that could be used in areas where we have deficiencies, be that in the child protection area or the many other areas where there are deficiencies, no one could defend that. Quest Diagnostics is in discussions about a public facility in Ireland with a view to putting facilities in place.

On the cervical screening, there was huge take up, there were 250,000 smears taken last year, with the number up this year. It is appropriate that we do it by way of letter so there are proper systems for recall. Given we only started cervical screening in September 2008, it has been highly successful and we want to see it develop further during 2010.

Jan O'Sullivan (Limerick East, Labour)
Link to this: Individually | In context

I understand the issue of the cold labs and the farming out of the work, possibly abroad, although I share Deputy Reilly's concern about the loss of jobs. One of the problems when Quest Diagnostics got the contract for cervical cancer screening was that many of the Irish laboratories had been neglected in terms of building up what they needed to be able to carry out the tests.

Can the Minister clarify if some of the cytology screening will be done in Ireland now that the two year contract has run out and is being renewed?

Mary Harney (Dublin Mid West, Independent)
Link to this: Individually | In context

Quest Diagnostics has announced its intention to establish a facility in Ireland and it is in active discussions with a public facility here. The issue is one of quality, turn-around time and cost. It is not appropriate, as everyone accepts, including the professional representatives and the College of Pathology, that there are 44 centres in Ireland. There cannot be a quality-driven, quick turn-around, cost effective laboratory service in that scenario. Everyone has signed up for rationalisation of that.

The challenge for the public sector is to be able to compete with others, and I believe it has the capacity to do that in a tender. The HSE is in active discussions with the national finance agency about a public private partnership model for the provision of this service which we hope to advance during 2010.