High level concerns about CervicalCheck not having the capacity to simultaneously manage the screening crisis, maintain normal operations and plan ahead, are outlined in documents released under Freedom of Information legislation to RTÉ News.
The documents also warn about the need for extra resources for the Health Service Executive to support the UK review of slides, the speedy release of files to patients and the impact of media coverage on screening uptake in all programmes.
A letter from Secretary General of the Department of Health Jim Breslin dated 7 June to interim HSE Director General John Connaghan stated that it was clear "that CervicalCheck does not currently have the capacity to simultaneously manage the current crisis, maintain normal operations and progress future developments including HPV."
Mr Breslin said it was inevitable, given the range of pressing and complex issues involved, the loss of key personnel and the fact that the service had not been resourced to manage the three strands simultaneously.
The letter said that there was a significant risk that the CervicalCheck issues which had arisen and the related media coverage had engendered a loss of trust and confidence "which could negatively affect screening uptake across all programmes."
It also said there were challenges in relation to laboratory turnaround times and further legal cases, which could impact negatively on perceptions, if communications were not well managed.
Mr Breslin said that Minister for Health Simon Harris wanted the HSE to make available significant additional resources to ensure that CervicalCheck had the necessary clinical and other expertise to engage with the independent Clinical Expert Panel Review of slides by a team in the UK.
He said that the extra resources should be identified from within the HSE, or the wider service and involve the temporary redeployment of people with expertise.
"I want to emphasise that the minister expects that all patient information, including documents, files and audits related to patients, will be made available to patients or their representatives without delay, and that the provision of information will be streamlined to the fullest extent possible to avoid unnecessary bureaucracy", the letter added.
In his response to the letter on 5 July, Mr Connaghan said significant new resources would be needed in the HSE to support the work of the UK review of slides.
He said it was critical that this was planned jointly between the Department, the HSE and the Royal College of Obstetricians and Gynaecology in the UK, doing the review.
That review is expected to take at least six months.
Mr Connaghan also said the executive had advertised the Clinical Director post for CervicalCheck but "I am not optimistic about filling this at present."
He noted that Dr Peter McKenna had taken on the role in an interim capacity.
Mr Connaghan said that the offer of free smear tests to women - which was made by the Government - had resulted in a significant increase in laboratory testing requirements.
As a result, reporting times of results to patients had moved from an average of four to six weeks to eight to ten weeks and that doctors had been notified of this delay.
Recently it was announced that free GP consultations and repeat smear tests for women concerned about their previous test results will end on 31 December.
The correspondence released under FoI, which covers June and July, also said that the financial supports, including retrospective supports to be provided to the original group of 221 women or families, would in time be offered to other women identified by the UK review, if that review found a different result to the original test.
It said that the making of a retrospective payment under the Government support package did not signify an acceptance of liability by the State.
