Dr. Gabriel Scally:

We need to sort that out, and that is part of changing the culture. I firmly believe that.

Another element is to ensure there is a better understanding of citizenry among the citizens of the Republic of Ireland. I am still not convinced that the people do not have too deferential an idea of doctors. They need to be more robust in dealing with the medical profession and to have higher expectations of doctors. The public should not hold them in awe any longer. Those days have long gone. I hope this report and the exposure of some of the ridiculous attitudes that they hold will encourage the public to be intolerant. Because I come from Belfast I am an advocate of intolerance at times. Being intolerant of doctors who are patronising and sexist is a good thing to be. I would encourage people to address that.

In terms of compensation, the Deputy's point was very well made. Part of the cost-benefit analysis of a screening programme should include issues of compensation for those who are actively damaged by the screening programme just as it needs to take into account the physical damage that can sometimes be caused by over-investigation as a result of a screening test, or the anxiety that results from having a screening test and then having to wait a very long time for the results. That is a stress on people that should be avoided if at all possible.

I firmly believe that patients turn to lawyers and litigation as a last resort in the absence of any other way of getting their issues dealt with. The best way of stopping the lawyers getting involved and the costs associated with that is to return to the points elements I mentioned, namely, telling patients what has gone wrong and why, getting someone who is responsible to say "sorry" and mean it, and assuring them that everything will be done to try to ensure it is not repeated. All the evidence from across the world shows that if that is done properly the public is much less likely to go to court to seek satisfaction. I have seen it happen many times where people go to court, sue and the only way the courts have of responding to that is in terms of a financial settlement. Such a settlement may be fine in one sense, but it does not bring resolution for many people. I look forward to Mr. Justice Meehan's proposals and to reading what he has to suggest in regard to that.

Regarding three, four or five key points, one is open disclosure; the second is a national screening committee; the third is that screening services need to be brought out of the cold, given a higher profile within the HSE and better management; and the fourth, which is a negative rather than a positive point, we should not indulge in the blame game anymore that we have to.