Statement on Cervical Screening Inquiry

22 Jun 2018

Health Care Oireachtas Submission

The Executive Council of the Irish Congress of Trade Unions has noted the content and recommendations of the first report of the scoping enquiry into the cervical check screening inquiry, being conducted by Dr. Gabriel Scally. While Dr. Scally’s report makes some interim recommendations Congress believes that the recent failures in the national cervical screening service requires a comprehensive response that gives confidence to women and girls that their care and wellbeing is central to public health policy.

As an immediate first step, Congress calls on Government to support the women and families directly affected by the recent failures. All those directly affected should be afforded immediate access to all necessary health care free of charge. Government should also ensure that the women and families directly affected - and any other woman who has concerns arising from the recent failures - are given full access to their medical records and clinical notes.

The policy of outsourcing the reading of cervical smears has come in for significant criticism. The decision in 2006 to outsource the service was opposed by unions representing workers in the health sector.

At that time, the unions were concerned that outsourcing the service to ‘for profit providers’ undermined patient safety because it potentially compromised the reliability of outcomes. The current public service pay agreement provides that outsourcing, can only be considered within specific agreed parameters and Congress is strongly of the view that urgent action is required to insource to the Irish public health service cervical screening and other important diagnostic services.

In line with the recommendations of the Sláintecare care report, this will require significant capital funding for the provision of these vital services in a single tiered, public health service.  

Relocating the cervical screening service will allow Government to provide additional investment so that the move to HPV primary screening can be accelerated.

Congress further notes that there is a national HPV vaccination programme for secondary school girls and believes that resources should be provided so that the programme is extended to secondary school boys. Clinical evidence indicates that the vaccine significantly reduces the incidence of certain cervical cancers in women. The roll out of the vaccine should be accompanied by a national public health education programme highlighting the benefits of the vaccine and the requirements for safe sexual behaviour, particularly in the prevention of sexually transmitted diseases.

The recent controversy has also highlighted the need to clarify the responsibilities of health professionals, health administrators and policy makers. In the view of Congress there is a requirement to ensure the development of a strong culture of open disclosure within organisations, and professional groups. While Congress supports proposals to strengthen legislation to provide for mandatory disclosure, it should be balanced to support health care professionals making disclosures in the appropriate format with associated protections. The focus should be on learning and improving patient safety and health care professionals should be covered by the current protections, as encompassed in the Civil Liability Act 2017.

It is the view of Congress that the implementation of these measures will restore confidence in the cervical screening service. Women should never be again be failed bad policy choices.