Kate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

Very well. I have a question for Mr. O'Brien. How can Irish clinicians conduct multi-disciplinary teamwork with people in different time zones, who use different nomenclature and perhaps different terminology regarding cervical cytology? That is the first question. Second, from the time the cervical screening programme was introduced, and we did not have the capacity in Ireland because there was a backlog, was any attempt made by the HSE to increase the capacity in the Irish system? When the backlog was dealt with abroad, was the HSE working to ramp up capacity in the Irish system, based on the concerns of clinicians in Ireland in 2008? Doing the job in the United States was a third of the price of what it was here. Did that ring any alarm bells when it came to quality analysis? I have come upon the McGoogan report from 2004, which laid out what we should be doing before we had the screening programme. Here is recommendation 1.7 on how it should be conducted:

"A management structure with clear governance arrangements is required to ensure that the legal obligations to eligible women, health care professionals and staff participating in the Programme including Phase One are met."

Another recommendation: "The establishment of effective governance arrangements with immediate effect is necessary in order to provide overall leadership and direction in terms of policy development", and so on.Recommendation 1.12: "A quality assurance (QA) programme should continue to be given priority in the ICSP." The report further recommends that:

"Structures must be put in place to allow review or revision of quality standards by a National ICSP Quality Assurance Committee which should include representation from the Professional bodies, other key stakeholders such as the Cancer Registry, the Cancer Society and other cancer screening programmes".

It seems that much of what was recommended did not actually happen. Then I found the women's charter. This is addressed to the women: "All members of CervicalCheck staff will respect your privacy, dignity, religion, race and cultural beliefs." It makes a commitment that women would always have the opportunity to make their views known and to have them taken into account. Women are assured that their smear tests will be screened in an accredited quality-assured lab. CervicalCheck also committed that a woman's result and any treatment recommendations would be provided to her and her nominated smear taker by the programme within four weeks. In regard to that last point of the women's charter, I do not think Vicky Phelan got what it said on the tin. Would Mr. O'Brien agree?