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Cancer Screening Programmes

Dáil Éireann Debate, Wednesday - 14 November 2018

Wednesday, 14 November 2018

Questions (181)

Bríd Smith

Question:

181. Deputy Bríd Smith asked the Minister for Health the reason a reply has not issued from the HSE regarding the number of reviews per laboratory (details supplied) in view of evidence provided to the Committee of Public Accounts on 10 November 2018. [47254/18]

View answer

Written answers

As previously advised to the Deputy, analysis is required in order to make the requested data available. Noting that the Deputy has requested, in effect, that the unanalysed data be provided, the interpretation of such data would not be clear. The requirement for analysis reflects the complexities involved. For example, some women may have had multiple smears, not necessarily read in the same lab; slides may have changed by one grade or multiple grades which is a complexity that would not be shown by a simple breakdown across labs; labs dealt with different regional populations; in the early years of the programme, it was dealing with an unscreened population which is a further complexity.

Once again we wish to emphasise there is in no way any intention to withhold this information. Following significant efforts, appropriate expertise has been sought to ensure that the necessary analysis can be done such that it is anticipated the information sought by the Deputy will be available by the end of the year.

In the broader context in which this data is sought, it is important to reiterate that Dr Scally is clear in his report that the Inquiry is satisfied with the quality management processes in the laboratories contracted by CervicalCheck. As previously outlined to the Deputy, it would be expected that false negatives would have occurred in all laboratories contracted by CervicalCheck since its inception. It is important to emphasise that false negatives are not automatically negligence, and indeed that they are unavoidable in any cervical screening programme. As stated by Judge Meenan in his recently published report, smear tests are a screening test, not a diagnostic process. A significant number of smears will be reported as showing no abnormalities despite there being possible abnormalities present. This does not, of itself, amount to negligence on the part of the person(s) reading the smear. However, “missed” does not mean “negligence”. However, “missed” does not mean “negligence”.

In relation to the 18 month query, the HSE have advised that there was never a criteria in place whereby smears taken less than 18 months from diagnosis were excluded from review. The slides identified for further review were reviewed from a minimum of 1 month prior to diagnosis to up to 78 months prior to diagnosis. The HSE further advise that the Director General has written to Dr Gabriel Scally to provide clarity on this matter and that Dr Scally has welcomed the clarification and published correspondence in this regard on the website of the Scoping Inquiry.

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