THE COST of the provision of the CervicalCheck service in Ireland is high by international comparisons, a new report published by the Health Information and Quality authority (Hiqa) has found.
The report on the Evaluation of the Use of Resources in the National Population-based Cancer Screening Programme and Associated Services, which was published last Friday, said that the current professional fee paid to GPs for performing the smear test and providing the appropriate follow-up and communication with the patient is €51.69, following an 8 per cent reduction introduced last year.
The Hiqa report said that this cost “appeared high”. It said that in the Netherlands, for example, the cost was €10.95 (based on 2005 figures).
“The overall cost to the Irish health service of delivering the CervicalCheck programme, based on the current information, is estimated to be €43 million annually to screen approximately 300,000 women.
“In the UK, the annual cost to the National Health Service of providing such a service to 3.8 million women is estimated to be €175.95 million (£155 million). The average cost per woman screened in the UK is therefore €45.95 (£41) compared to the average cost per woman screened in Ireland of €144,” it stated.
The report found that differences in costs between countries may reflect differences in service configuration and reimbursement.
“However, the degree of variation in costs between countries is unlikely to be explained by these differences alone, suggesting that the costs of CervicalCheck are high”, it stated.
The report said that fees in Ireland in respect of smear tests presented an opportunity for cost efficiencies in the overall screening service. “A significant withdrawal from the programme by any contractor due to a fee reduction could however limit the choice of smeartaking locations”, it stated.
The report said that there were clear benefits associated with the provision of cervical smear tests in the primary care setting. These included:
- The holistic relationship established between the woman and her GP/practice nurse, which is beneficial for other aspects of her healthcare;
- The ready availability of the full medical history and case records for the woman if previously seen within that primary care practice;
- Continuity of care including the follow-up of abnormalities;
- Support of the GP for the practice nurse, and immediate access to the GP for a second opinion if required.
