Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I thank the witnesses for their time and their detailed submission. I know they are all working very hard on trying to clear up some of the damage being done to what appears to have been one of the most successful screening programmes of its kind anywhere in the world. I will start with accountability and move into some of the waiting times and what is being done. I would also like to look at the waiting times for colposcopy. While there has been a lot of focus on the number of women waiting for test results and the amount of time they are waiting, there has not been as much focus on women waiting for access to colposcopy because these referrals have also increased. Approximately 80,000 women are waiting for test results. Some have been waiting for more than eight months. Waiting times for referral for colposcopy have also increased. The HPV test, which was due to launch last September, appears to have been delayed indefinitely. We do not have dates. "As soon as possible" is the language being used. We know this is largely due to the offer of the free out of cycle test because there were 90,000 additional tests that overloaded the system.

We know that on Wednesday, 24 April 2018, the story broke from the steps of the High Court. We know that two days later, in spite of having never met the senior management of CervicalCheck, the Minister said publicly he had no confidence in them. We know this was interpreted by many as there being a problem with the programme itself. We know that at approximately 4 p.m. the following day the Minister tweeted the offer of a free out of cycle smear test. To this day, the Minister maintains that before the offer of the test was made there was no clinical advice not to do so. He has stated this categorically. In response to a parliamentary question three weeks ago, he told me neither he nor his officials received advice that recommended against the tests in advance of the decision. He went further in the Dáil and said that those who persisted in stating he acted against official advice were incorrect and had misled the Dáil. That is a pretty strong position from the Minister.

Yesterday, we received a submission from Dr. Gráinne Flannelly, who was the clinical lead at the time. Dr. Henry is referenced in her submission. What she states directly contradicts the Minister's position. What she states suggests the Minister has misled the Dáil for the second time. He misled the Dáil on the children's hospital and has apologised for doing so.

We now know that at lunchtime on that Saturday, the Department of Health called the national screening service after a meeting attended by Dr. Henry. He is in no way implicated in the advice, he is just referenced as having been there. Dr. Flannelly stated Mr. Charles O'Hanlon, who was running the national screening service, received a call from the Department of Health regarding the offer of the out of cycle test. She goes on to detail she met Mr. O'Hanlon and, in the strongest possible terms, advised against the tests. Not only this, but she predicted what would come to pass. She predicted what we are all dealing with here today. She stated the laboratories would not have sufficient capacity for cytology if the offer was made and that this would lead to longer waiting times. She predicted that the colposcopy service would not have the capacity to deal with the additional referrals and this has come to pass. She also stated that most importantly it would fundamentally undermine the screening programme, which is exactly what this ill-advised offer did. Critically, she states Mr. O'Hanlon called the Department of Health back within the hour, which was before the Minister tweeted his offer, which happened at 4.13 p.m. We have very detailed evidence from Dr. Flannelly stating the Minister and-or his officials at the Department were advised by experts at the national screening service not to proceed and this offer was made before any announcement. We have a timeline to back this up. We also have evidence that the advice predicted the fundamental undermining of the programme, which is exactly what has happened.

At an official level, and I am not asking the witnesses a political question or asking them to peer inside the mind of the Minister, do the witnesses accept that expert clinical advice was given to the Department of Health before the decision was made to offer the free out of cycle smear test?