Richard Bruton
Question:53 Mr. R. Bruton asked the Minister for Health whether he intends to introduce anonymous HIV testing in accident and emergency departments; and if he will make a statement on the matter.
Ceisteanna — Questions. Oral Answers. - HIV Testing.
Paul Connaughton
Question:92 Mr. Connaughton asked the Minister for Health whether he intends to introduce anonymous HIV testing in accident and emergency departments; and if he will make a statement on the matter.
I propose to take Questions Nos. 53 and 92 together.
AIDS was identified as a clinical entity in 1981. Diagnosed cases have been reported to the Department since 1982. Serological surveillance of the disease became possible in 1985 and was initiated in Ireland on a voluntary linked basis in September 1985. Under this programme, tests are confirmed for their HIV — positivity by the Virus Reference Laboratory in UCD.
There is a general acceptance that the present surveillance of the disease needs to be improved and that it is necessary to have more detailed information in relation to the spread of infection as a basis for programme planning and evaluation.
This is particularly important in view of the bias inherent in current surveillance mechanisms where persons at greatest risk of infection may choose not to be tested individually. This non-participation biases the data to the extent that the current systems identify only a trend in the progression of the disease and not necessarily the prevalence of the disease in the population.
I, therefore, asked the sub-committee on Surveillance/Epidemiology of the National AIDS Strategy Committee to make recommendations to me on how these improvements could be introduced. The sub-committee have submitted an interim report to me and have recommended that (i) AIDS cases should continue to be reported centrally as at present, which has been the practice since 1982. However, the reporting form should be amended to indicate the county or, in the case of Dublin, the postal code of the case and that this should be done without prejudice to the confidentiality of the case. Confidentiality must remain the most important aspect of case reporting; (ii) HIV positive test requests to the Virus Reference Laboratory should indicate the health board area or, in the case of Dublin, the postal code of the case and that the existing request form be amended appropriately. Existing confidentiality of these tests should be maintained; and (iii) Information on the regional spread of infection, both AIDS notifications and HIV positive tests, should be made available to health, boards on a monthly basis.
The sub-committee are continuing to examine the feasibility of establishing a new surveillance programme which would monitor the spread of HIV infection under the following headings: (a) anonymous unlinked testing of blood specimens of pregnant women, already being tested for rubella; (b) anonymous unlinked testing on new born infants, currently being tested for PKU using the Guthrie card; (c) anonymous unlinked testing of blood from outpatients' departments of general hospitals and (d) anonymous unlinked testing of blood of hospital admissions.
I expect to receive the final report of the sub-committee in the near future. When it is available, I will consider all of their recommendations with a view to their implementation in this country.
I have to object to the Minister taking five minutes of priority time to discuss a net point which in the end he did not answer.
Does the Deputy want me to read—
Given that the Minister recognises a bias in the existing data, does he accept that these new surveillance methods are needed? Does he accept the advice of his chief adviser on the AIDS issue who is recommending the introduction of such tests? If the Minister fails to act on this advice, how can we tackle the AIDS crisis? We do not know whether the true figure is 1,200, as official statistics show, or 4,000 as suggested by other people.
The Deputy is correct on both counts.