Brian Lenihan Jnr (Dublin West, Fianna Fail)

The Minister for Health and Children and I thank the Senator for raising this important matter. The Senator's concerns relate to the restricted availability of smear kits in the South Eastern Health Board area. These kits are supplied by the board to smeartakers, predominantly GPs, in order to assist them in the provision of services in the case of women who present for opportunistic cervical smear tests in the region.

We raised the matter with the South Eastern Health Board, which has responsibility for the supply of such kits, and it has responded to the effect that because it has no cervical cytology laboratory, it relies on the services provided by St. Luke's Hospital, Rathgar. Given the demand on services in St. Luke's Hospital, it has been unable to supply the board with the level of service necessary to meet demand and this has resulted in restrictions in relation to the availability of smear kits.

The demand for smeartaking services has increased hugely in recent years. Information supplied by cervical cytology laboratories points to the annual throughput of smears increasing by approximately 24% to over 210,000 smears between 1997 and 2001. The increase is attributable to a number of factors including media interest in the area, notably the incorporation of a story-line involving cervical cancer in a popular TV programme last year. In addition, the commencement of phase one of the national cervical screening programme in the Mid-Western Health Board has also increased awareness among women outside the board's area of the importance of screening. This increase has manifested itself in particular in additional demand for cervical cytology laboratory services.

With a view to facilitating boards in meeting these extra demands, additional resources have been made available over the past few years. These resources have resulted in the employment of additional staff, purchase of new equipment and the introduction of new liquid-based technology in laboratories. The funding has also facilitated the development of colposcopy clinics, to which women who require treatment following a positive smear test result are referred. An additional €1.4 million has been allocated to health boards and the ERHA for 2003 for ongoing development of the services.

Cervical screening is a worthwhile preventive health measure when delivered as an organised screening programme. This was acknowledged in the 1996 report of the Department of Health cervical screening committee. That report also acknowledged that, based on an extensive literature review, it is difficult to quantify the effectiveness of opportunistic screening and that "it is generally agreed that opportunistic screening such as the current Irish screening service, is not effective in reducing overall mortality".