As set out in the response to Parliamentary Question No. 363 of 26 February 2019, on 28 April 2018, I made the decision to provide for a free out of cycle smear test for any woman who was concerned, where her GP felt she should have a further test as part of her reassurance.
Neither I nor my officials received advice that recommended against these tests in advance of the decision. Subsequent to the decision, on foot of telephone contact by the Department, the National Screening Service raised a number of concerns verbally. Following the announcement, the Screening Service set out concerns in an email to my Department, which related to uncertainty about costs, volume, impact on turnaround times, impact on perceptions of the programme's accuracy, challenges with processing GP payments, and the potential difficulty in ceasing the arrangements in due course.
However, as I have previously stated, the concerns failed to recognise the circumstances of the unfolding crisis in the programme against which such considerations required to be balanced. Were it not for these circumstances, it would never have been necessary to contemplate such a step in the ordinary course of the operation of the screening programme.
The decision cannot be separated from the reality that general practitioners, in difficult circumstances, were dealing with large numbers of worried patients as a result of the issues which came into the public domain over the course of Thursday and Friday, 26th and 27th of April. It was important that GPs be supported while they awaited supporting information to be developed and disseminated by CervicalCheck. A fee to provide for the free repeat smear, and for a GP consultation, was subsequently agreed with the Irish Medical Organisation, and welcomed by TDs across the Dáil and by GP representative bodies. The alternative, i.e. that the State failed to recognise the reality of patients presenting in this way to GPs or the State refused to pay for such smears, would have been untenable in the circumstances.