Smear backlog delays HPV testing

The introduction of HPV testing is set to be delayed beyond this year as the HSE struggles to clear the 78,000 smear check backlog.

The HSE cannot even give a date for the rollout of the already delayed HPV test as they work to address waits of up to 27 weeks for Cervical Check results — and the head of the HSE’s Women and Infants Health Programme also said it is “inevitable” that some women who are now waiting up to six months for results will have abnormal smears.

Health Minister Simon Harris had promised to introduce HPV testing, which provides more accurate screening, by last September, but this has now been shelved.

In the Dáil, Taoiseach Leo Varadkar came under fire for the Government’s decision to provide free repeat tests in the wake of the CervicalCheck scandal last year, which Fianna Fáil leader Micheál Martin said has created the “shocking backlog which is now damaging the programme and undermining its overall objectives”.

Accusing Mr Harris of overseeing a “chaotic system” Sinn Féin’s Pearse Doherty called for the health minister to be sacked, insisting he was “out of his depth”.

But Mr Varadkar blamed the “enormous pressure” the Government faced last year, including from the media, as a reason for offering the free tests which has led to the backlog.

Sometimes we acted perhaps from the heart rather than the head but this decision was made in good faith.

Meanwhile, the Cabinet is due to receive a second report from Dr Gabriel Scally as early as next week which is expected to confirm that contracted labs did more outsourcing than previously revealed without the permission of the HSE.

Appearing before the Oireachtas health committee yesterday, HSE interim director Anne O’Connor said the primary focus now is to clear the lengthening backlog of smear tests.

Asked whether the HPV test will be available to women in Ireland this year, Ms O’Connor said: “I can’t put a date on that, our priority at the moment is to address the capacity challenges that we have.”

Secretary general of the Department of Health Jim Breslin said: “I think the world changed last year. We went into 2018 with a certain view of the screening programme and a policy objective to introduce HPV and funding agreement on how we would do it and so on, the world changed during the course of April and May of 2018. 

"The challenges the programme was facing was changing by the week.

“I think the minister’s announcement and the minister’s view on what would be possible was overtaken by events,” Mr Breslin said in relation to the pledge to introduce HPV testing.

Fianna Fáil’s Stephen Donnelly asked about the potential clinical risk to women where abnormalities are detected after a six-month wait for results.

Responding, clinical director of the HSE’s Women and Infants Health Programme, Dr Peter McKenna said: “We would all share the concern that a waiting time in excess of a couple of months is far from ideal.

“Of course, there will be women in that group in the 80,000 that will have abnormal smears.

“Most of those women who have abnormal smears will be a long way from developing cervical cancer but there will inevitably be some women who are nearer the stage of transition from pre-invasive to invasive.

“It’s not really possible to give an estimate on the number but it would be foolhardy to say there would be no risk, but in general the risk would be low.” 

The Irish Cancer Society said urgent efforts are needed to alleviate these delays and to end the poor experiences for the women who are waiting. 

“The delays will not only impact the women who availed of the free smear in 2018, but the women who are now being invited for a smear as part of their scheduled screening cycle,” said head of services, Donal Buggy.

More on this topic

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Simon Harris: Warning about free smear tests had 'nothing new in it' and email was not passed on

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