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Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Stephen Donnelly: I thank the witnesses for their time today and for the opening statements. The HPV test was spoken of with much interest last year. It represents a higher level of detection and, therefore, patient safety. The Minister sought to have the HPV test implemented last September. When that deadline was missed, I believe the Minister suggested having it live in January. It is now February. I...

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Mr. Damien McCallion: That is a slightly different question because it is historical. The current contracts are geared to bridge us through to HPV and sustain the programme until then. The recommendations Dr. Scally made on the procurement side are being implemented. Those recommendations were in his report. In this context, we will see them as part of the HPV tender and that is where...

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

...an ongoing basis and the position was changing by the week. The challenges the programme was facing were changing by the week. The potential work involved in dealing with factors other than the HPV test was changing by the week. There was an ongoing flow as the crisis - it was a crisis - evolved to take stock of where we were and what it meant for the HPV test. This and the backlog...

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Ms Anne O'Connor: With regard to the HPV vaccine, the uptake by girls is 65% and increasing. It is continuing to increase and we are one of the few countries in the world that has seen such a reversal. The boys' programme is outside of this programme but it is being worked up through public health and the national immunisation office. Based on the success of the girls' programme, we will...

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Kate O'Connell: ...on track to eradicate cervical cancer within ten years from when they started, how we are we doing with our target? I know it was discussed here and that the witnesses could not give a date for HPV testing technically superseding, although not getting rid of, cervical screening. While the witnesses cannot give a date, I am very conscious that on 10 October, Dr. Denton, the lady from...

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

...of screeners, there are challenges around the world whereby those who work in cytopathology are moving away from the field. This is because of the general trend away from cytopathology and into HPV testing. Dr. McKenna may want to comment on this as well. Having said that, we will offer more opportunities in terms of the Coombe - the public system. What most countries have done is try...

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Stephen Donnelly: ...trying to get this across the line as quickly as possible - the Minister set expectations in May or June last year, or whenever it was, when he said in the Chamber that he was aiming to have the HPV test go live in September 2018. We are hearing there is no guarantee, in spite of best efforts, that it will be live in 2019. In making the statement that he was aiming to have the HPV test...

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Kate O'Connell: On the issue of HPV herd immunity, we went down to a rate of 52% immunisation with girls. Where are we now with percentages of HPV vaccine uptake after all of the catch-up programmes? Are we still going up the graph as opposed to down the graph for uptake of the vaccine among young girls? Although I am very supportive of boys also getting the vaccine in September, it is very important to...

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

...the Deputy. The wait times for colposcopy testing are significantly shorter. The numbers are relatively small, but the cases are important in terms of priority. In addition, we have sanctioned HPV prioritisation for laboratories experiencing particular challenges. That process triages the outstanding slides and smears to ensure that those which may have the high-risk types of HPV...

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

...the European guidelines, and look at those in other jurisdictions as well. That is also being done from two perspectives. The first is the current programme and the second is another process for HPV testing which is now under way and which will require a new QA model. The standard turnaround for tests before the crisis was 17 days, and covered the period from when the slide went to...

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Mr. Damien McCallion: On HPV testing, there are two key things we need to move on in order to move to primary HPV screening. One relates to the selection of a partner to work with us. I mentioned earlier we had a pre-tender market engagement before Christmas. I told Deputy Durkan we had positive input from that because, obviously, one of our concerns was whether we would get a partner to...

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Stephen Donnelly: Is it possible that the HPV test will not be live in 2019?

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Bernard Durkan: What progress is being made on the changeover to HPV testing?

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Mr. Damien McCallion: HPV primary screening is undoubtedly the way to go. HIQA approved it.

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Mr. Jim Breslin: Prior to the decision being made - the decision was made prior to the controversy - HIQA conducted a health technology assessment of the HPV. We can also make that available to the committee.

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Bernard Durkan: Will there also be a look-back at the HPV tests? For instance in some cases they are not entirely accurate - we cannot get 100%. What protection will there be for the ones that may not be accurate and fall off the shelf, as it were, in that test?

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

...Damien McCallion: On the learnings, Dr Scally's report had a number of recommendations regarding procurement, the balance of contracts, emphasises and criteria. We will be building those into the HPV procurement process. The contracts we extended were clearly for the purpose of trying to sustain the programme for a period-----

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Mr. Damien McCallion: -----so that is slightly separate in respect of what is there. On the learnings identified by Dr. Scally on the procurement side, those will be built into the HPV process-----

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Alan Kelly: Those contracts will have to be examined as soon as Dr. Scally's report comes out. Mr. McCallion addressed this question earlier, but when are we going to have HPV? Are we going to have it this year?

Joint Oireachtas Committee on Health: CervicalCheck Screening Programme Update: Discussion (13 Feb 2019)

Alan Kelly: ...the concept of herd immunity, I am on the record of the Dáil as being a strong advocate of boys having this vaccination. Where do we stand regarding herd immunity and getting boys and girls the HPV vaccination?

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