Tommy Broughan (Dublin Bay North, Independent)
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43. To ask the Minister for Health if there will be a full audit of all cancer screening programmes; when these audits will be completed; when the results of such audits will be laid before Dáil Éireann; and if he will make a statement on the matter. [23144/18]

Tommy Broughan (Dublin Bay North, Independent)
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I will follow on from the Minister's last point on cervical testing. Will he accelerate that into 2018 to move towards the HPV testing? On the overall programme, we are approximately 12 years into the 2006 strategy for cancer control, including BreastCheck, CervicalCheck, BowelScreen and Diabetic RetinaScreen. What type of audits are the Government and Department ordering on the whole range of cancer screening services? How does the Minister plan to expand that?

Simon Harris (Wicklow, Fine Gael)
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On HPV testing, I asked the Health Information and Quality Authority, HIQA, to carry out a health technology assessment on this and it came back recommending HPV testing. I decided in February that we would move ahead with the introduction of that later this year. I have asked that that be accelerated. It is a big body of work. It will also provide the opportunity for the reconfiguration of the laboratories that we are using in Ireland. I have said on a number of occasions that this is nothing to do with safety or quality assurance. Instinctively, I would like to be able to use Irish laboratories and develop our own services here, should that be possible. I have asked officials to examine that.

Following on from the recent issues relating to the disclosure of the results of the CervicalCheck clinical audit, I have established the scoping inquiry being led by Dr. Gabriel Scally. He will review all aspects of CervicalCheck and examine the other screening programmes operated by the National Screening Service, particularly relating to quality assurance, clinical audit, open disclosure and governance. The Deputy's point is well-made. Screening has saved lives in this country, whether BreastCheck, BowelScreen or CervicalCheck. We know that it has saved lives. It is also important that we continue to see if there are areas in which we can do better and if we can learn from other countries. While we have somebody doing an external review of CervicalCheck, it seems sensible to me to ask that they would also look at the other screening programmes and examine them, particularly with regard to quality assurance, open disclosure and governance.

As the Deputy will also be aware, I have engaged on a cross-party basis about the terms of reference for this inquiry. It is fair to say that they are comprehensive and reflect the issues raised by all parties in this House. I gave the written submissions that were given to me by the Opposition to Dr. Scally and asked that not only does he act on the terms of reference, but considers all of this. The inquiry is expected to issue its first report at the beginning of next month and its final report by the end. A website has been established, scallyreview.ie, which provides a public-facing presence for the inquiry and will enable it to communicate progress with all interested parties.

Tommy Broughan (Dublin Bay North, Independent)
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I notice when one looks for statistics on various screening programmes that the last statistics for BreastCheck were from 2015, when 199,000 or so women were invited for screening. Of those, I think 146,000 attended, which was an uptake rate of almost 75%. It was the highest number ever screened by BreastCheck in a single year. Why do we not have the relevant statistics for BreastCheck, for example, for 2016 and 2017? Similarly, on the bowel-screening programme, the last figures I was able to look at were for 2012 to 2015. When will we get a more up to date report on that? For example, the uptake rate for bowel screening was just 40%, which seems very low. As the Minister rightly says, the screening programme has had a tremendously positive impact on our health, although we obviously still need to spend significant funding on prevention, especially with regard to obesity. Why do we not have more up to date reports? Will we get more feedback on the total screening programme for the next while?

Simon Harris (Wicklow, Fine Gael)
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I will ask that question of the HSE and revert to Deputy Broughan. I envisage that it is likely that Dr. Scally's report will signpost any areas identified as needing improvements, make recommendations and outline to us what further body of work needs to be done. I want to take the opportunity, on the record of the Dáil, to reiterate the point about screening not being a diagnostic tool. I am not suggesting the Deputy said it is but it is important that over the last weeks, we have all become very conscious of that. The difference between screening and diagnostic screening is important. Screening helps to save lives but it is not a diagnostic tool. I hope that we will have an opportunity shortly to work with stakeholders, whether the Irish Cancer Society, Patients' Association, the Marie Keating Foundation or our own health messaging within the health service, to take the opportunity to promote screening but also to explain and communicate to our public what screening is and is not. As part of its work, the HSE serious incident management team, SIMT, has examined whether a formal audit process as carried out by the CervicalCheck programme exists in BreastCheck or BowelScreen. The examination by the SIMT found that there is no comparable formal audit process in place with either BreastCheck or BowelScreen but we have asked Dr. Scally to look at all these matters.

Tommy Broughan (Dublin Bay North, Independent)
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When the Taoiseach was in Deputy Harris's Department, I remember asking three years ago on behalf of women constituents about mammogram machines. I think he told me there were 30 machines, they had an eight year lifespan and there were complaints about the kinds of machines that we were using. Has the replacement programme that the Taoiseach, Deputy Varadkar, referred to at that stage been completed? Are there further improvements in that regard to take account of the views of women in particular?

Simon Harris (Wicklow, Fine Gael)
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In the interests of providing accurate information, I will have to check that. I do not have a note available to me about that. I will check for the Deputy if the mammogram machines have been upgraded since he last asked the question of my predecessor and will revert to him directly.