I propose to take Questions Nos. 123 to 126, inclusive, together.
On 28 April, at around lunchtime, 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. My Department’s advice on this decision was reflected in the subsequent press statement issued on 28 April which said that, “for any woman who has had a CervicalCheck smear test and where her GP feels she should have a further test as part of her reassurance, the Minister has asked CervicalCheck to make the necessary arrangements, including payment provision. These arrangements will be confirmed next week."
After the decision was made, and on foot of telephone contact by my Department regarding implementation, the National Screening Service voiced unhappiness, but this failed to recognise the circumstances of the unfolding crisis in the programme. Following the announcement of my decision, the Screening Service set out concerns at 6pm that evening in an email to my Department. These 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.
These concerns were already readily identifiable, and of course would have been a sufficient reason why such a step would not have been taken in the ordinary course of operation of the screening programme. However, these were unique circumstances, as reflected in the level of queries forthcoming from women and also in the exceptional measures already initiated by the Department and the HSE, including the necessity for the Department to direct the establishment of a Serious Incident Management Team (SIMT) to address the CervicalCheck response. The reality was that general practitioners, in difficult circumstances, were dealing with large numbers of worried patients as a result of the issues which had come into the public domain in the preceding couple of days. GPs needed to be supported while they awaited supporting information to be developed and disseminated by CervicalCheck. The alternative, which would have been that the State failed to recognise the reality of patients presenting to GPs in this way, or that the State refused to pay for such smears, would have been untenable in the circumstances.
The email was received and shared within my Department at Principal Officer level and I provided a copy to the Select Committee on Health on 10 April. A copy of the email has been forwarded to the Deputy. The Deputy has requested specific phone records. It would not be possible to isolate records associated with these contacts from others, given that over the time period from 26 April, including Saturday 28 April, there were extensive ongoing contacts between my Department and the National Screening Service. However, I am advised that the telephone contact was made with the National Screening Service at Principal Officer and Management Board level. It is important to stress this was regarding implementation of the decision and the phone calls took place after my decision was made.