Expert warned against cancer test outsourcing

The outgoing director general of the HSE was warned more than a decade ago that outsourcing the analysis of cervical cancer screening results could lead to the type of crisis which has now engulfed the system.

Dr David Gibbons, who was then chair of the cytology/histology group within the quality assurance committee of the National Cervical Screening Programme, said he brought his concerns directly to Tony O’Brien, who was then CEO of the National Cancer Screening Service.

Dr Gibbons told RTÉ’s Morning Ireland programme he had been involved with the programme between 2002 and 2006 and that at one stage a backlog of screenings was outsourced to America.

A comparison of the results from the US, versus a similar analysis conducted in this country, showed that the rate of high-grade CINs (Cervical Intra-epithelial Neoplasia or abnormal cells) was 1.8/100 here but 1.2/100 among those analysed in the US.

“One third of high-grade cases we were finding, they were finding one-third less,” said Dr Gibbons. “That was worrying for us. They were finding too few.”

He said he outlined these concerns and forecast it could be 10 years before issues began to emerge. The decision to outsource the test results to America was finalised in 2008. Dr Gibbons claimed his concerns were dismissed and he later resigned.

Mr O’Brien yesterday defended his decision in 2008 to outsource smear test laboratory checks to a US firm, saying tests would otherwise have been left idle for a year or been examined by doctors “on their kitchen table”.

At a press conference on the escalating cervical cancer test scandal, Mr O’Brien rejected growing criticism of the outsourcing plan.

Mr O’Brien said in 2008 the service “was poor, and I mean really poor” with cervical cancer tests being left in filing rooms for up to a year due to a lack of an organised service in Ireland.

He said, as a result, he took the decision to seek help from the US firm now embroiled in the tests scandal, which could offer a service which was not available in Ireland.

“The choice we had in 2008 was not having a proper service, with tests lying around for a year and possibly doctors examining them on their kitchen table. So, do I think the decision [to outsource] was right? Yes, I do,” he said.

Siptu said “the privatisation of critical health services” needed to stop and called on Government to adhere to the outsourcing clause of the Public Service Stability Agreement (PSSA).

Siptu health division organiser Paul Bell said: “The unfolding tragedy of the CervicalCheck scandal shines a bright light on the real human cost of outsourcing.

“There seems to be no control or accountability, until it’s too late. It’s unacceptable.

“Many members of the public would be unaware and quite possibly horrified that their medical records are being analysed thousands of miles away on an industrial scale for profit,” he said. “These services must be provided by the State and not offshored.”

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