The first response to the cervical screening blunder in the North Western Health Board area must be to acknowledge the very real shock and distress of the women in question. Almost 70 women have faced the harrowing experience of being told that the results of tests conducted eighteen months ago, and initially reported as normal, are in fact abnormal. It is to be hoped that no more women will face this ordeal, although the report by the health correspondent of this newspaper today that the North-Eastern Health Board also used the same private laboratory for testing will give further grounds for concern and anxiety.
The North Western Health Board decided to award the testing work to the private laboratory after a backlog developed at Sligo General Hospital in late 1997. But the fact that such a backlog was allowed to develop in such a critical area of women's health speaks volumes; at the very least, every health board and hospital laboratory should be provided with the resources which would guarantee speedy and efficient testing. It is now over two years since the Department of Health was advised by its own committee that a properly resourced national screening service should be established. At the present rate of progress it could be some considerable time, perhaps up to three years, before such a programme is in place.
The blunder in Sligo does raise wider questions about the commitment of successive governments to a national screening programme. Eleven years after such a programme was introduced in Britain, it is remarkable, to put it at its mildest, that no comprehensive programme is in place in this State. The Minister for Health, Mr Cowen, readily acknowledges the importance of regular screening as the best means of preventing cervical cancer but the State has still to discharge its responsibilities in this matter. On RTE last night, Mr Cowen trumpeted the additional £2 million that his department had allocated to cervical cancer prevention but, given the life and death issues involved, this is a wholly inadequate response.
On average some 80 women die every year from cervical cancer in the Republic. International evidence has conclusively shown that screening significantly reduces the incidence of cervical cancer. An abnormal result does not necessarily mean that a cancer is present: it is also true that there is a margin of error in all test procedures in this area. However, regular testing, such as that taken for granted in other EU states, reduces that margin of error as well as providing comfort and reassurance for the women in question. Remarkably, in this State, it is still up to the women themselves to present for screening. But, when they do, they appear to get a less than satisfactory response.
It is important to point out that the integrity of most smear tests remains high, despite the most recent controversy. But the backlog for tests - there is a waiting period of months in several health board areas - and the blase manner in which the State addresses this key area of women's health are entirely unacceptable.