Seán Haughey (Dublin North Central, Fianna Fail)

I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney.

The national cancer screening service is responsible for implementation of CervicalCheck, the national cervical screening programme, which commenced last September. Colposcopy services are an integral part of a cervical screening programme. Women who have pre-cancerous cell changes detected by a smear test are referred for colposcopy. Prior to the commencement of CervicalCheck, much screening was carried out on an ad hoc basis and women were offered varying structures and processes of care, in addition to sometimes lengthy waiting times for colposcopy, where necessary. The roll-out of CervicalCheck has provided an opportunity to focus on the development and organisation of colposcopy services in Ireland.

The NCSS is responsible for the monitoring and audit of colposcopy services provided under the programme to ensure quality assured standards, based on those defined by the Royal College of Obstetricians and Gynaecologists, are adhered to. 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.

In preparation for the launch of the screening programme the NCSS, in co-operation with the Health Service Executive, completed an analysis of existing colposcopy services. This examined facilities, staffing, systems management, information management, information technology and governance. Based on this analysis, the NCSS initially identified 11 colposcopy services as being most prepared to receive referrals from CervicalCheck. A further four colposcopy services have since been identified to support the CervicalCheck programme, following a wide range of service enhancements. The NCSS is making a significant investment to enhance these services to ensure best outcomes for all women, regardless of location.

The colposcopy service at the Midland Regional Hospital Mullingar is not among the services identified as suitable to receive referrals from CervicalCheck. Historically, there has been a multiplicity of small-scale services in the midlands which do not meet quality assurance requirements. For clinics to become part of the programme, there is a requirement to demonstrate capacity for a minimum of 500 new referrals. For the midlands region as a whole, the projected total number of new colposcopy referrals is 868, based on Central Statistics Office figures and an 80% uptake rate of screening. The NCSS recognises the need for a colposcopy service in the midlands that can meet the quality assurance demands of the programme. The local hospital network manager is working actively with clinicians on the ground to ensure colposcopy services are delivered in the midlands. If a service in the midlands is identified in terms of scalable capacity, sustainable quality assurance and geographical location, the NCSS will assess its ability to provide support to enhance the resources, information technology facilities and equipment of such a service. In the meantime, women from the midlands region who require a colposcopy following screening through the CervicalCheck programme will be referred to one of the 15 quality assured services supported by the programme. The aim is to ensure best outcomes for all women, including those living in the midlands area.