I propose to take Questions Nos. 175 to 177, inclusive, together.
In April 2018, following issues which had emerged in relation to the CervicalCheck screening programme, I made the decision to offer free out of cycle smears to any woman who was concerned about her health, where her GP felt she should have a further test as part of her reassurance. Approximately 112,000 consultations were provided by GPs, and 57,810 early repeat smear tests were provided between 01 May and 31 December – in other words, about half of the consultations resulted in a smear test.
Laboratory turnaround times have increased since that time, as a consequence both of the out of cycle smears and the increased uptake generally. While a backlog of around 80,000 smears had built up, this has now begun to fall, and is reported by the HSE to be down to around 54,474 as of 9 June. The programme should typically have approximately 23,000 samples in process at any one time. The HSE reports that more than half of tests are being returned within 8 weeks. However, they can take as long as 30 weeks, and this remains a significant challenge.
Since 1 May, Medlab Pathologies Ltd, which has the largest backlog, has ceased accepting new slides and is focused on clearing its backlog. Agreement has also been reached with Medlab to process tests based on a HPV initial testing model; i.e. HPV testing will be carried out on samples prior to cytology. The HSE advises that this approach was chosen as the most effective way to process all outstanding tests based on prioritising women most at risk. Additionally, CervicalCheck has agreed with laboratories to prioritise those slides which originate from women who attended colposcopy, as this cohort of women are considered to have the most serious need.
However, the HSE has advised that the natural history of cervical cancer would indicate that the disease would normally develop over a period of 10 to 15 years. It has said that in this context, a delay in the return of cervical screening results, whilst undesirable, poses a very low risk to women.
Following a global search for capacity, Quest Diagnostics was identified by the HSE as offering the necessary additional capacity to replace that previously provided by Medlab, given it has ceased to accept new slides. Agreement has now been reached and a contract has been signed for this additional capacity. This agreement comes after an extensive quality assurance review of existing and new capacity to ensure that it meets the requisite standards. The HSE advises that Quest, working alongside the Coombe Women and Infants University Hospital (CWIUH) provides the necessary capacity to allow the CervicalCheck programme continue until the introduction of HPV primary screening.
In relation to the specific data requested on waiting times and number of smear tests by laboratory, I have asked the HSE to respond to the Deputy directly.