I refer to the Parliamentary Question No. 244 for written answer on 2nd April 2019. A holding reply had issued to the PQ at the time and I had undertaken to obtain the outstanding information for the Deputy from the State Claims Agency (SCA), which manages claims in relation to clinical negligence. Due to an administrative oversight, my Department had not issued the information which had been received from the State Claims Agency. I apologise to the Deputy for this oversight. The response to the Deputy's question is now set out below.
In relation to the Deputy's reference in his question concerning missed diagnosis, it is important to note that a screening test is not a diagnostic test. Cervical screening aims to prevent cervical cancer through the early detection and treatment of pre-cancerous changes on the cervix. Earlier detection can often increase treatment options, as well as reduce the invasiveness of that treatment. It is estimated that regular cervical screening can prevent 75% (or 3 out of 4) of cervical cancer cases. Since 2008, 1,200 invasive cancers have been detected by CervicalCheck. More than 50,000 women with high grade abnormalities (CIN 2 & 3) have been diagnosed and treated, considerably reducing their risk of developing cervical cancer. CervicalCheck has been successful in reducing cervical cancer rates in Ireland - these dropped from around 14 per 100,000 in the period 2009-2011 to 10 per 100,000 in the period 2013-2015. Cervical screening will not prevent all cases of cervical cancer, and some women will still develop cervical cancer despite regular screening.
Also, I would like to clarify matters regarding the Deputy's reference to alleged failings in the cervical cancer screening programme. It should be noted that the Report of the Scoping Inquiry into the CervicalCheck Screening Programme, conducted by Dr Gabriel Scally, is unequivocal in stating that the widespread non-disclosure of the results of historical screening audits was a substantial breach of trust for the women and families concerned. It caused significant distress and additional suffering to those affected.
However, Dr Scally was clear in his Final Report, published in September 2018, that the Inquiry was satisfied with the quality management processes in the laboratories contracted by CervicalCheck. His report presented no evidence that either the rates of discordant smear reporting or the performance of the programme fell below what is expected in a cervical screening programme. Dr Scally also confirmed that he found no reason why the existing contracts for laboratory services should not continue until the new HPV regime is introduced.
In response to the Deputy's question relating to the number of claims on hand in this regard, I have been informed by the State Claims Agency that the information set out below has been extracted from the National Incident Management System (NIMS) and is correct as at 30th March 2019:
1. Number of Claims on hand: There are currently 98 claims relating to allegations of misinterpretation of slides by the National Screening Service under active management by the State Claims Agency.
2. Number of Claims Settled: To date the SCA has settled 4 of these claims.
3. Amount paid out in claims to date: Due to the low volume of claims paid out to date, the SCA is unable to provide this figure as it could lead to the identification of an individual.
4. Legal costs of the cases: In respect of all associated National Screening Services cases, legal costs amounting to €590,583 have been paid. These legal costs include fees paid to mediation services, which is consistent with the SCA’s policy of using mediation wherever possible to resolve these claims in a non-adversarial manner that does not add to the considerable pain and trauma of the people affected and their families. These legal fees also include matters not relating to the areas in which the State has already accepted liability. It is anticipated that much of the work carried out in respect of these initial cases, and by extension the fees incurred, will be applied in resolving future cases that have been notified to the SCA and that this work will not need to be repeated in managing these future cases.
For clarity, I would ask the Deputy to note that the settlements outlined above were agreed with the laboratories, and the amounts were paid by the laboratories.