Noel Ahern (Dublin North West, Fianna Fail)

I am taking the Adjournment on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. Senators Doherty and Keaveney seem to be up to speed on what is happening, so I am not sure this reply will provide them with any additional information. I understand the ongoing discussions are about quality assurance standards and as Senator Keaveney said, further discussions are to take place this week.

The national cancer screening service, NCSS, is responsible for the implementation of CervicalCheck, the national cervical screening programme. Colposcopy services are an integral part of a population-based cervical screening programme, but a colposcopy service is not a cancer service. Colposcopy services are provided as a dedicated number of hours or sessions within the wider gynaecology clinic. Women who have pre-cancerous cell changes detected by their smear test are referred for colposcopy.

One of the reasons for establishing a national, population-based, cervical screening programme is to end the need for opportunistic screening and ensure women are screened at the appropriate intervals. To date, much screening has been carried out on an ad hoc basis and women have been offered varying structures and processes of care in addition to sometimes lengthy waiting times. The NCSS is responsible for the monitoring and audit of colposcopy services provided under the programme to ensure the quality assured standards, based on those defined by the Royal College of Obstetricians and Gynaecologists, are adhered to.

The roll-out of CervicalCheck has provided an opportunity to focus on the development and organisation of colposcopy services in Ireland. The NCSS is making a significant investment to enhance colposcopy services and this will ensure timely access to a quality assured colposcopy service for women who require further investigation. In preparation for the launch of the national cervical screening programme, the NCSS, in co-operation with the National Hospitals Office of the HSE, completed a baseline analysis of existing colposcopy services in Ireland. This service-by-service analysis examined facilities, staffing, systems management, information management, information technology and governance.

It is important to ensure that as part of CervicalCheck, women can access colposcopy services within international best practice timeframes based on adherence to quality assured clinical practice and the achievement of best clinical outcomes for women. The purpose of identifying and investing in these colposcopy services is to ensure this is the case for all women, regardless of which location they are referred to.

Existing services are at different stages of operational development. Using the baseline analysis, the NCSS has identified 11 colposcopy services to support CervicalCheck initially. The colposcopy service at Letterkenny General Hospital has not been identified for initial referrals of women. However, in the interim, Letterkenny will continue to provide colposcopy services to women already attending or awaiting colposcopy.

The provision of additional colposcopy services to women in the north west is being examined. The colposcopy service at Letterkenny General Hospital requires a number of enhancements to meet the quality assurance standards defined by the NCSS. The National Cancer Screening Service is working with the hospital on this issue. The question of the hospital's future participation in the colposcopy service for CervicalCheck will be considered in this context. Discussions between the hospital and the NCSS are due to take place this week.

This is an answer to the question of what the discussions are about. I hope the discussions taking place this week will move matters on and that the service will be organised in a way that offers the best outcomes for all women, including those in the north west.