Smear test screening still outsourced to US, six years on

Cervical smears are still being sent for screening to a firm in the US six years after the HSE said the outsourcing would be short term.

Quest Diagnostics Inc in Texas was contracted temporarily to carry out screening to clear a backlog of 40,000 smears. After clearing the backlog within six months, Quest got a two-year deal in 2008, followed by a second two-year contract in 2010 and a four-year deal this year.

In the past four years, 1.3m smear tests have been processed. About 70 women die of cervical cancer in Ireland each year.

At the time Quest was brought in, Tom Finn, assistant national director at the HSE national hospitals’ office, said it was seen as “a short-term solution to an unacceptable problem”.

In response to a Dáil question in Mar 2007, he said: “From this point forward, the outsourcing of cervical smears will only arise in the event that the national laboratories providing screening reach a backlog of more than three weeks.”

John Kane, assistant secretary general of the Medical Labora-tory Scientists Association, said he understood Quest had given a commitment in the original tender to open a laboratory here, but had not. He said a valuable skill-set was being lost to the country by the outsourcing of a vital aspect of women’s health.

The tests were later divided between Quest and a second multinational, MedLab Pathology Ltd, in 2010. MedLab has a laboratory in Dublin.

At the time of the original outsourcing, James Reilly, then opposition health spokesperson, said a company like Quest could “take over laboratory services in this country and we [could] end up with hundreds of medical laboratory scientists’ jobs gone”.

He asked then health minister Mary Harney if she believed outsourcing screening was “a sensible use of taxpayers’ money in terms of retaining Irish jobs and a particular skill”.

A spokeswoman for the National Cancer Screening Service (NCSS) said six parties had tendered for the contract earlier this year, but she would not say if any Irish firms were involved.

She said she understood MedLab was continuing to increase the number of samples screened at its Dublin-based laboratory. She said the Coombe Hospital would also process a proportion of the annual smear test volume for CervicalCheck.

The NCSS said prior to the national programme, screening was carried out on an ad hoc basis and women had delays for two decades. Now test results are available in four weeks.