Pressure now on colposcopy clinics following CervicalCheck crisis

Clinical need will determine access to clinics as smear test backlog to be cleared in weeks

Rotunda hospital, location of one of the State’s 15 colposcopy clinics. Photograph: Cyril Byrne

Rotunda hospital, location of one of the State’s 15 colposcopy clinics. Photograph: Cyril Byrne

 

Women who seek colposcopies after private smear tests will not be discriminated against relative to public patients, the Health Service Executive has said.

Colposcopy clinics, for women requiring examination of the cervix after a smear test shows cell changes, are under increasing pressure in the wake of the CervicalCheck crisis. Access to such clinics will be determined in all cases on the basis of clinical need and not whether a woman had a test carried out publicly or privately, according to a HSE spokesman.

Increasing numbers of women are having smear tests carried out privately due to long delays over the past year in the processing of tests under the State’s CervicalCheck programme.

The HSE said that the current backlog is 28,118 tests waiting to be processed, down from 81,346 in March at the height of the crisis when women were offered a second free smear test in a bid to re-assure them about the quality of the State’s screening process.

Normally 23,000 smear-test samples are in progress at any one time and the 5,118 remaining tests are expected to be cleared by the MedLab facility in Dublin at the end of this month, after an average waiting time for results of 14 weeks.

It is understood however that demand has now moved from processing smear tests to seeking colposcopies.

One woman complained on social media about being refused a colposcopy examination after a smear test revealed evidence of low-grade cervical cell changes. She claimed subsequently that at least 50 other women had also been refused.

Triage

The HSE said it could not comment on individual cases but insisted that cases were being triaged on the basis of clinical need. The target for provision of the diagnostic test is four weeks for high-grade changes and eight weeks in cases of low-grade cell changes.

Earlier this week, the HSE indicated that public patients would be prioritised due to the pressures being experienced by the State’s 15 colposcopy clinics but a senior spokesman insisted this was not the case.

The row over colposcopy provision follows the latest error when approximately 400 women, whose smear test results were delayed for months, received a letter with incorrect information about those results.

In an automated letter they were told their HPV status (the virus linked to cancer) remained negative, when they should have been told their HPV status remained positive.

The 221+ patient representative group described the error as “gobsmacking” and said that it was time for CervicalCheck to “stop making mistakes”. A spokesman said women were going to give up on the service because of the repeated communications and systems failures. The group also expressed its disappointment that yet again its patient representatives had not been informed of the error.

A spokesman added that the HSE must follow through on the 67 recommendations from the Scally and MacCraith reports and on the HSE director general’s commitment to “putting women first”.

Labour health spokesman Alan Kelly described the error as “inexcusable” and asked why, after everything that had happened in the past 18 months, there were “no proper checks and balances before women are contacted by CervicalCheck”.

Separately the Academy of Clinical Science and Laboratory Medicine said there had been a systemic failure of quality management in the handling of the tests of 4,088 women whose results were delayed for months over the IT problem between Quest Diagnostics in the US and the CervicalCheck system.

It said it was “extraordinary”, given the interest in this service and the need to maintain confidence, “that the standard reporting system was suspended and that women should contact their GP. It is still unclear why this critical failure was not appropriately escalated, and remedial action taken.”