Seanad debates
Thursday, 12 December 2002
Adjournment Matters. - Cervical Smear Tests.
Fergal Browne (Fine Gael)
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I welcome the Minister of State who is becoming a regular fixture in the House.
In Carlow and the south-east at present there is a two month delay in doctors obtaining cervical smear test kits. It takes a further four months before they obtain the results from those tests, meaning that there is an overall delay of six months. I forwarded to the Minister a copy of the letter I received from a group of doctors in Carlow outlining the case and I would appreciate a reply.
Brian Lenihan Jnr (Dublin West, Fianna Fail)
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Does the Senator want to outline the position at greater length?
Brian Lenihan Jnr (Dublin West, Fianna Fail)
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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 â¬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".
Following on from the recommendations in this report, phase one of the national cervical screening programme commenced in the Mid-Western Health Board in October 2000. A key concern in relation to the development of phase one is that of ensuring a service which is underpinned by quality assurance and best practice. Under the programme, in the region of 67,000 women in the 25 to 60 age group will be screened at five yearly intervals free of charge. Under the national health strategy, a commitment has been given to the full extension of the programme to the rest of the country.
The process of planning and organising the national programme is a major undertaking, with significant logistical and resource implications that requires careful planning. The experience gained from phase one of the national programme should be of assistance in the context of implementing this commitment. As part of an examination of the feasibility and implications of a rollout of the national programme, I understand that the health boards executive is planning to have an external review of phase one carried out during 2003. Other issues relating to the management of the national programme, in particular in the sphere of governance, are also being examined by the chief executive officers of the health boards.