Róisín Shortall (Dublin North West, Social Democrats)
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175. To ask the Minister for Health the waiting times for cervical smear test results; the number of tests which have timed out; and the steps he is taking to address the backlog. [2187/19]

Simon Harris (Wicklow, Fine Gael)
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In May 2018, I asked CervicalCheck to make the necessary arrangements to provide that any woman who had had a CervicalCheck smear test, and whose GP considered that they should have a further test, to access such a further test without charge. This decision was made in good faith to address the considerable fears of the many anxious women in Ireland as a result of significant media coverage of the issues that emerged in late April.

In the months since then, there has been a significant increase in the volume of women presenting for smear tests. This includes women who have availed of the out of cycle tests, but also a greater number of women presenting for scheduled screening.

This increased level of engagement with the programme is very welcome. However, the increased demand has undoubtedly put immense pressure on lab capacity and the HSE has advised that, currently, results of smear tests may take up to 20 weeks from the time of the test, and that it may take longer in a small number of cases.

The HSE has been working actively with the labs to manage this issue and to improve turnaround times for smear tests. The HSE reports that laboratories have agreed to undertake additional recruitment, provide for overtime and manage annual leave in an effort to minimise the backlog. In addition, the HSE is aiming to source additional screening capacity, which would improve the turnaround time of results. However, sourcing capacity and resources is a global challenge as countries start to move to primary HPV screening, which vastly reduces the requirement for cytology screening staff.

The HSE is currently developing a capacity plan to take account of available capacity and expected demand, with the aim of bringing the programme into stabilisation this year.

While the provision of out of cycle smears ceased on the 31 December 2018, it is important to be clear that this backlog will take some time to resolve. It remains a priority concern for me, for my Department and for the HSE.

Smear test samples must be sent to the laboratory and made into slides within six weeks of the smear test date. After six weeks, the sample is deemed expired and cannot be processed. Transferring slides to samples in this timeframe was being achieved by the laboratories used by CervicalCheck until they experienced a high demand on resources following the announcement of free repeat smear tests in April. In some cases, the increased volume resulted in a delay transferring samples to slides.

However, as of 30 July 2018, the HSE has advised that the majority of smear test samples are now transferred to slides within the six week timeframe. There may be a small number of cases where the vial used to contain the sample expires before the laboratory has an opportunity to carry out the analysis of the sample and in some cases a sample may be insufficient. Although every effort is made to avoid these situations from happening, it is inevitable that cervical screening programmes will sometimes encounter these issues. In such cases, a woman and her GP are advised of the need for a repeat test in three months’ time by letter from CervicalCheck.

From April to October 2018 the rate of expired samples and vials was 0.29%. This compares with 0.25% for the same period in 2017.

In relation to the specific number of tests which have expired, this is a matter for the HSE and accordingly I have asked the HSE to respond directly to the Deputy on this issue.