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

I thank all three witnesses for coming in today. Everybody in Ireland owes thanks to Vicky, Stephen and anyone else who has come out on this issue and explained to us, from where we are, how it has affected them, their families and all those around them.

I want to home in on one particular aspect, which I believe Vicky said. It is the idea that it would not have made any difference. I keep thinking about her saying that. Who decides what a difference is? It may not have made a material difference to the outcome in some cases. It is difficult to quantify in some cases, although I am not saying in the witnesses' cases, but the fact that something has to have a change in staging for it to have made a difference is getting to the crux of the issue because we are ignoring the feelings and the considerations someone goes through when they have a diagnosis of cancer. They wonder what could have been if they had noticed something earlier. Vicky went through her symptoms in great detail, and I thank her for doing that. It is very difficult but it is important that we hear the actual detail of what she has gone through. However, it is important to acknowledge that in terms of families or individuals who have a cancer diagnosis, everyone will meet that news with a different reaction. The difference does not have to be a stage or a level in terms of how long they have got left. It is more to do with how they deal with it, and how they deal with it as a couple, in Stephen's case. It is very difficult for any of us here who have husbands and young children to consider how they would get on without us. In terms of the future, it must be very difficult for Vicky, with her diagnosis, to consider that it might not be her but those she may leave behind who will have to continue her fight.

Vicky mentioned the 12 months of wrangling with the HSE and laboratories. Like Deputy Kelly, I sit on both the Joint Committee on Health and the Committee of Public Accounts. So much has come out in the past week but I am almost sure that we were told that period of wrangling occurred between March of 2016 and the summer of 2016 and that was the reason for the line in the memorandum, "Pause all letters", or whatever it said. The justification I heard this morning at the health committee for that period was that this was dealing with that issue, but Vicky has told us she was wrangling with the HSE for 12 months. I do not want to put her under pressure but it is important because my understanding is that we were led to believe that this was a short period of a few months. Is it possible for Mr. O'Carroll to find out where that is coming from because it is important for tomorrow's meeting?

I am shocked at the way Mr. Teap was treated. I cannot believe the insensitivity shown in that people were brought into a holding area, for the want of a better term. We need to find out who in God's name decided in the past few weeks that this was the appropriate way to treat these people. I suspect it was not anybody with a medical degree, but perhaps I am wrong.

What comes to the fore in all of this is that people have a vocation. They are clinicians first and they see patients before they see data. We have a serious issue in our health service when somebody like Mr. O'Brien opens an email and decides, without his medical degree, that this is not a significant error. A committee, and I believe it should probably be the health committee, needs to get to the bottom of who decided that was the framework in which Stephen should be treated.

On the magnitude of errors, in Vicky's case, when the audit of the slide was done, it was essentially extensive cancer. It is becoming more alarming to me, as we find out more information, that the 15%, 20%, 30% or whatever was the acceptable level of false negatives or false positives was not a consideration. To my mind, we have not seen any evidence that anyone quantified those errors. Was it a systemic error in a particular laboratory? It is shocking to me that anyone could look at Vicky Phelan's case in particular and say, "Okay, we have this false negative." However, it is not really a false negative. It is active cancer on a slide. My understanding from the conversation around it is that they would not really need a microscope; it was that obvious. It seems to me that this would be fundamental to the audit process. If there was a 30% rate, they would need to make sure that it falls within the category of false negative and that it is not something extra to that.

We spoke about the auditing process at the health committee earlier and there seems to be a serious issue with that process. There seems to be many people in the HSE with the word "audit" in their job titles. One of the fundamental aspects of audit is that one should know what one will do with the results when they are received, and there should be a pathway. Critical to this is that there was no pathway decided before anything happened, so what was the point of the audit? It appears the point of the audit was data rather than people.

I hate giving round figures because everyone is a person in this but we have a figure of 1,500 and then 1,641 from the cancer registry. If we combine them we have approximately 3,000. That is the number of women with a diagnosis which have been audited. Of those, there are 209 in the first batch - excuse my terminology - and another number in the second batch. We do not know that number. In the case of the error on Vicky's smear, it seems obvious to me that an immediate random audit has to start of all of the samples, not just the approximately 3,000 women because all of those have cancer-----