Liam Twomey
Question:4 Dr. Twomey asked the Minister for Health and Children the status on the roll-out of the cervical cancer screening programme; and if she will make a statement on the matter. [12266/07]
View answerThursday, 29 March 2007
Questions (4)
Oral answers (9 contributions)
It is my objective to have an effective national cervical screening programme rolled out, beginning late this year. The programme will provide free cervical screening for women in the 25 to 60 year age group nationally and aims to reduce mortality from cervical cancer by up to 80%. For that purpose, on 1 January 2007, I established a national cancer screening service, which amalgamates BreastCheck and the Irish cervical screening programme. The total allocation to the new service is €33 million which is a 71% increase on the 2006 allocation to the programmes. This includes additional funding of €5 million for 2007 for the service to commence the roll-out of the programme by the end of the year. The national cancer screening service plans to have cervical screening managed as a national call-recall programme. This will be done through effective governance structures that provide overall leadership and direction, in terms of quality assurance, accountability and value for money. All elements of the programme, including call-recall, smear taking, laboratories, colposcopy and treatment services will be quality assured, organised and managed to deliver a single integrated national service.
In 1997 the then Minister for Health decided to set up a cervical screening programme and in 2000 a pilot scheme was introduced in Limerick. Does the Minister accept Irish women are dying at a rate twice the European average from cervical cancer? Our cervical cancer rate is higher than the UK even though when the programme was proposed in 1997 our rate was half that of the UK. Does she accept that in the past ten years little or nothing has been done in this regard? Could she be realistic about what will happen in the future given that a patient registration scheme is not in place and she does not know how much that would cost? The Minister referred to an additional allocation of €5 million but I do not know where that money will go. The HSE is still working on a report on laboratory capacity. When will that be presented, given that it will take another year at least if there is a need to build capacity?
It is ten years since the Minister for Health decided to set up this programme and the cervical cancer rate among Irish women has dramatically increased during that decade but nothing has been done to address it. Smear tests were sent to the US during 2006, which means capacity is a problem in our system, particularly when women must wait six months for test results. Will the Minister be realistic in outlining how long it will take to implement a cervical cancer screening programme? It is amazing that the rate of cervical cancer among Irish women exceeds that in the UK, given it was half that in 1997. That is the reason we must move quickly on this. Nothing the Minister said in her reply gives me confidence that she understands how far behind we are and the serious consequences involved, especially in protecting women who are most at risk.
The former Minister, Deputy Noonan, established a pilot project in the mid-west, which was not the beginning of a national roll-out and much has been learned from that. I do not disagree with much of the Deputy's contribution. Cervical smear testing was introduced in Canada in the late 1960s while it was introduced in the UK in 1988.
It was also introduced in the UK in the 1960s but the programme was reviewed in 1988 to upgrade it.
Since 1988, results in the UK have improved. Approximately 73 women a year die from cervical cancer in Ireland, even though significant numbers of opportunities for smears are conducted. There is a number of issues. The HSE did not go to tender because of the emergency resulting from a five-month backlog for such tests.
On a point of order, I was informed the reason the HSE did not go to tender was there was no capacity in any laboratory in Europe.
It was done to speed up the process on an emergency basis because generally one is required to go to tender. Two issues are involved relating to capacity and quality. We all accept BreastCheck is a quality assured programme. It must be ensured cervical screening is quality assured and, therefore, that the laboratories are accredited and meet the standard required, which has not been the case in many instances to date. The HSE has appointed a group to examine laboratory capacity and I am not sure when it is due to report. However, whether domestic laboratories will be available or we have to continue to outsource, that will be done. Staff must be recruited for the new programme. It takes a long time from agreeing the policy to writing to women to come forward for smear tests but that will happen later this year.
The Minister is almost in agreement with my comments. The Government's commitment to the cervical screening programme is weak. No progress has been made on patient registration and the Minister has no idea how women who need smear tests will be identified. She has acknowledged the HSE has no idea what is the laboratory capacity in this regard. These are two basic issues before one considers where sufficient doctors and nurses are available to conduct the tests and whether additional investment is needed in colposcopy clinics. That highlights a serious lack of commitment, ten years after the programme was proposed.
We know the age group and the programme will operate similarly to BreastCheck. Everybody accepts that is a terrific programme and the same people will be responsible for the cervical screening programme. When a screening programme is rolled out, quality assurance is essential. The roll-out will begin later this year and it will take a while to roll it out to the entire population. The programme will cover approximately 250,000 women annually.