Smear test follow-up risk for private patients, says HSE

The HSE has conceded that women who opt for a private smear test because of CervicalCheck backlogs may struggle to access follow-up investigations in the public system because of severe pressure on colposcopy clinics.

Women have been opting for private tests in recent months because of the significant backlog in the national-screening programme.

However it has emerged that these women may now find themselves excluded from public colposcopy clinics if their private test results indicate suspicious cell changes, requiring follow-up.

The HSE has confirmed to the Irish Examiner that its 15 public clinics that provide colposcopy services for the CervicalCheck programme are under “significant pressure” “due to demand for cervical screening in 2018 and a subsequent increase in referrals to colposcopy”.

The HSE said while in the past “some” of these clinics would have accepted women who had a private cervical screening test, it is becoming “increasingly difficult” to accommodate them “in the context of the current pressures facing their services and the need to prioritise referrals from the public screening programme”.

One woman living in Munster who contacted this paper was advised by the nurse in her local GP practice to go for a private smear as there was a wait of more than six months for results through the CervicalCheck programme. Despite the fact that her results flagged concerns, she says her GP advised her that CervicalCheck had refused to give her a colposcopy because she had the test done privately.

While the HSE said that it “remains open to any clinician to refer any patient to a public colposcopy clinic should (s)he feel that is the appropriate treatment pathway”, the referring doctors should bear in mind “the pressures those clinics are under and the resulting increased waiting times”.

The HSE said waiting times for CervicalCheck smear test results is running at up to 14 weeks (down from a high in February of 33 weeks) although “in a small number of cases” the delay is more than 14 weeks.

We are acutely aware of the impact of these delays on women and we have been working hard to reduce them.

The HSE also said waiting times for results, “along with the number of outstanding CervicalCheck smear tests, have been reducing steadily in recent months”.

“We expect all outstanding tests will be processed by the end of this month,” the HSE said. In February, the backlog had climbed to 80.000.

This latest issue emerged in the wake of Tuesday’s revelation that more than 4,000 women had been affected by an ‘IT glitch’ which left them in the dark for months about their test results.

The rapid review by Professor Brian MacCraith of an IT problem in a US diagnostics lab, which was contracted by the HSE, found a “huge communications failure” at the heart of the fiasco that left women frustrated by poor service and a lack of information.

It has now been confirmed that Taoiseach Leo Varadkar will issue an apology to all women impacted by the CervicalCheck programme failures in the next Dáil term following yesterday’s meeting with members of the 221+ CervicalCheck patient support group.

The group was set up last year after it emerged that 221 women with cervical cancer received incorrect smear results.