Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank the witnesses for their contributions/This entire episode has been marked by tragedy and misinformation. There is a widespread misunderstanding among many people as to what has happened. There are three issues, the first of which relates to the laboratories. Some people believe that the US laboratories have been less accurate but the data do not back that up. However, we should wait to see what the future investigation shows. Perhaps there are areas where there are difficulties, and we need to investigate them thoroughly. At the moment there is no data to show that the United States laboratories were inferior.

The second issue is the question of who made the decision. The assertion has been made at this committee has been that this was a political decision. One or more witnesses have just answered Deputy O'Reilly's query concerning whether clinicians were involved in the decision. The answer provided, when we look at the transcript, will say that there were none involved.

I would like to quote a speech from the former Minister for Health, Ms Harney, in 2008, because it is important that we understand who made this decision and why:

The tender was examined not by the Minister or any official from the Department of Health and Children, but by a group established by National Cancer Screening Service, [which at the time was independent of the HSE, with an independent board] which included doctors ... who has been running the service in the mid-west, and a doctor from Northern Ireland, who was charged with the responsibility for quality assurance there and who is also involved in the accreditation process in the UK.

The former Minister went on to say:

The National Cancer Screening Service did not have to go to tender but chose to do so for reasons of transparency, fairness and equity to make sure it got the best quality assured service.

The Minister, in 2008, explicitly stated that there were no politicians, no officials or civil servants involved, and that an independent body, the NCSS, brought a group of doctors together to make the decision and to run the process. The witnesses have just said that there no doctors or clinicians involved and that it was a political process. Was the Minister lying? Was she completely unaware of the process she had just overseen? Why do we have such a massive discrepancy?

There is a widespread belief among the public that there is a clinical link between non-disclosure and clinical outcomes for women. That has been categorically refuted by everyone that I have put that question to at these committee hearings. Most women I have spoken to believe that the HSE sat on data that it could have provided to doctors, which could have helped them. That is what most people believe because of deeply irresponsible statements that have been made by Oireachtas Members.

Mr. Casey said the MLSA is "deeply saddened by the impact of the system failures on individual women." I acknowledge the association is not trying to add to the confusion but that kind of language adds to it. The phrase suggests a causal link between non-disclosure and clinical outcomes for women. The majority of women to whom I have spoken believe that to be the case. I will outline what happened. In 2008, a national cancer screening service or CervicalCheck was set up, which was great. In 2014, an audit process was introduced. We are one of the only countries that carry out such an audit process, and that was a good development. In 2015, CervicalCheck decided to provide full feedback to the doctors for ongoing communication with the patients. Ireland was one of only two countries that conducted such an audit and gave feedback. All of these developments were good. In 2016, CervicalCheck communicated with doctors on the assumption that they communicate onwards. The systems failure in all of this is that the doctors did not tell their patients. The doctors have replied that even if they had told their patients it would have made no difference to their treatment. I know that I have gone on but it is important that we get clarity on this matter. I do not believe it was intentional but I believe the association's opening statement unintentionally supports the causality argument, which we have been told by every expert that we have questioned is false.

I have two questions. The Minister at the time said that no politician or official were involved and a group of doctors with international group of doctors was brought together. We were told earlier that a political decision was made without the involvement of clinicians. Which of those two statement are true? Is it the witnesses' opinion that there was, or was not, a causal link between non-disclosure and clinical outcomes for the women?