100 GPs fail to renew screening contract

MORE THAN 100 doctors did not renew contracts to participate in the National Cervical Screening Programme – known as CervicalCheck – when they came up for renewal last year, it has emerged.

In a submission to the recent Department of Health review of fee cuts imposed for those providing smeartaking services under the programme, the National Cancer Screening Service said the first contract with GPs ran from 2008 until the end of July last year.

It said notices were then sent to more than 2,000 doctors and clinics which had been involved, inviting them to renew their contracts with effect from August of last year.

The National Cancer Screening Service said 103 doctors did not renew their contracts. It said in 42 cases clear reasons were given such as the doctor concerned had died, retired or moved away. However, it said that 61 doctors did not respond.

Over the same period 33 doctors sought and entered contracts for the first time.

The screening service said no doctor had cited a reduction in fees for smeartaking as a reason for not renewing their contracts.

However, it said that while there was no hard evidence of an impact, adverse or otherwise, that could be attributed solely or in part to the fee cuts for the provision of smeartaking services, it was vital for the programme to maintain widespread geographical coverage of doctors and clinics.

“Therefore it would not be in the interests of CervicalCheck to see the relationship with this key group of stakeholders put under pressure.”

Under financial emergency legislation the Government has twice reduced the fees for smear tests and related services. The original fee rate of €56.18 was reduced by eight per cent in May 2009 to €51.69.

It was reduced by a further 5 per cent in November 2010 to €49.10.

The Irish Medical Organisation warned the department as part of the review that individual GPs had made it clear that if fees were reduced again, “cessation in participation in the programme is a very real possibility”.

In their recommendation to Minister for Health Dr James Reilly, Department of Health officials urged there should be no further cuts at this time. “Since smeartaking is predominantly carried out by GPs, there is a risk that if fees are reduced a number of doctors may exit the programme or not have the resources to follow-up non attenders. Curtailment of the geographic spread of doctors would undermine programme effectiveness and it could lead to insufficient numbers of women being screened.”

“Alternative models for smeartaking are not available at present. When there is a network of primary care clinics, with good geographical spread, consideration could be given to using these clinics as smeartaking centres. However, this network is not yet sufficiently well developed to be considered as an alternative model.”