LAST UPDATE | 13 Feb 2019

THERE ARE NOW 78,000 slides left in the CervicalCheck smear backlog, the Joint Oireachtas Committee on Health has heard this morning.

The number was revealed by Anne O’Connor, Interim Director General of the HSE, in front of the committee this morning, when she said the HSE’s focus was “on supporting women and their families who were impacted by the cervical check crisis”.

This included providing 602 medical cards and the reimbursement of €1.3m in expenses and costs to those affected, she said.

We also continue to support women and their families in the provision of access to their records and ensuring women get their slides from laboratories where required for legal review.

However, O’Connor also said the HSE was concerned at the length of time being taken for reporting of cervical smears, which is on average 93 days – although it can take up to 27 weeks for the report to be provided.

It emerged in January that Health Minister Simon Harris was warned his announcement of free repeat smear tests was “dangerous” and that it put the CervicalCheck screening programme at risk. 

Labour health spokesman Alan Kelly said the delay brought about by the backlog had led to concerns about the health of women who had opted to have the repeat procedure.

Peter McKenna, clinical director of the women and infants programme, said that while most women would not be affected by the delay, some would have abnormal smear results.

“We’d always share the concern that a waiting time in excess of a couple of months is far from ideal,” he said.

“It would be foolhardy to say there is no risk, but in general the risk is low.”

Speaking during Leaders’ Questions today, Fianna Fail leader Micheál Martin said the health minister was warned about the impact of giving an extra free smear, stating that doing so has damaged the programme. 

Taoiseach Leo Varadkar said today that he acknowledges that there is “enormous anxiety” among women who are still waiting on the results, stating that the wait is between four to six months, while it used to be four to six weeks. 

He said the backlog is due says this is due to an increase in the number of women going for their regular smear, and also the additional test uptake.

The backlog is predicted to fall, he added. He added that when the helpline was set up following the CervicalCheck scandal, women were calling asking for another smear test.

When the free test was decided upon, it was welcomed by many, including many TDs, and the IMO, said Varadkar.

At the time, the government were under enormous pressure, said the Taoiseach, adding that the decision to roll out additional smear tests, was made in “good faith”, but he admitted perhaps at times “we acted from the heart”.

Laboratory capacity

In 2018, around 370,000 women presented to the CervicalCheck programme, an increase from 280,000 in 2017. The HSE said that it has been working to try and grow its laboratory capacity.

However, the HSE told the committee that while it continues to pursue active leads “this has proved very challenging due to the global shortage in cytology”.

It has also signed an agreement with one private provider and is working on the details of a contract with a second provider.

While this will “take some time to develop”, the HSE believes it will provide “a better balance between public and private provision” of lab services to the cervical screening programme, the committee will hear. 

However, the committee also heard about a report by Dr Gabriel Scally - due to be published in coming days – was set to reveal more questions over quality control at US labs where cervical screening took place.

Last year, it emerged that some Irish women’s smear samples were outsourced to American labs that were not authorised to carry out screening, due to a backlog that came about as a result of under-resourcing.

Asked by Kelly about the possibility that such outsourcing was “far worse than what’s being reported”, Department of Health Secretary General Jim Breslin confirmed that it was likely that there were more labs involved.

“The very fact of that is a basis for concern,” he said. “The oversight is an issue.”

O’Connor, meanwhile, added that the HSE was committed to implement HPV primary screening as soon as possible. 

In addition, the TDs and senators will hear that all six recommendations from Dr Scally’s interim report into the CervicalCheck scandal have been fully implemented.

They were told the HSE is “absolutely focused on stabilising the cervical screening programme”, which will enable it to progress introducing a new enhanced HPV primary screening testing methodology.

With additional reporting from Stephen McDermott and Christina Finn