Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I would like to take the opportunity to correct Deputy Donnelly, because I have been listening to these false political charges for quite some time. I have also listened to the patient representatives, including Ms Vicky Phelan, Mr. Stephen Teap and Ms Lorraine Walsh, asking this committee to focus on the more important issues of the present for now and stop focusing on the past and playing politics with the issue. I have also been listening to people who are regularly quoted in this committee as experts on general practice, like the president of the National Association of General Practitioners. As recently as 8 April, he said that while he would be the first to criticise me - which is true - he believed I made this decision in the belief that it was the right thing to do given the situation at the time. I was in CervicalCheck headquarters as the phones were hopping with patients looking for repeat smears. At that stage women had only two options; they could pay for a private smear, which at about €120 is something a Deputy could afford, or they could do nothing. Many women were paying for a private service and a two-tier system was developing. GPs were put in an impossible position as women requested repeat smears. No woman was refused a smear. If a woman was refused a smear, confidence in CervicalCheck would have dwindled further.

I would like a little bit of time on this, if the Chair does not mind. The committee obviously held an entire meeting on it last week at which political charges were levelled. I was not present or invited to attend on that occasion. I made the decision and I stand over it. I made the decision consistent with the advice of my chief medical officer and no evidence has been produced to suggest that I did not. In fact, a letter to was sent to the Ceann Comhairle in February in response to the assertions of Deputy Donnelly's party leader, not from me but from my Department. It said that my decision and announcement on 28 April was consistent with the advice I received from my officials. Moreover, the letter said that the advice I received from the chief medical officer was reflected in the press statement on the issue on 28 April.

I wish to deal with that issue and the issue of the CervicalCheck screening service advice. I worked hand in glove with the chief medical officer, who showed extraordinary leadership at a time when many clinicians walked off the pitch. Dr. Tony Holohan worked night and day on this. Members have even seen my text messages in the newspaper, released under the Freedom of Information Act, which show how much contact we had. Dr. Tony Holohan's advice to me has been confirmed by my Department in a letter to the Ceann Comhairle and by me in answers to parliamentary questions asked by Deputy Donnelly and his leader in February and March. The advice was that this was an appropriate thing to do. It was absolutely an appropriate thing to do where a GP believed it ought to be done. There was no difference on that. We can reduce this to tweets and quote my tweets and those of others if we want. My tweet said that details would follow. My Department also tweeted that - these days Departments tweet too. About 20 minutes later a press statement from my Department followed. There was no difference in opinion between my chief medical officer, my senior officials or myself. We all believed at the time of a major public health crisis that this was the appropriate thing to do. We were hearing directly from GPs and from women. I am sure Deputy Donnelly was too. My inbox was full of constituents who wanted to know if they could have a repeat smear. Doctors wanted to know as well.

It is fair to say that at that stage I could not have known how long that period of uncertainty would last. Nor could Deputy Donnelly or anyone else. In fairness, I acknowledge that we all worked together on the terms of reference for the Scally report. We expected that report to be published in June. This decision was made at the end of April. When the Scally report was released it provided significant reassurance, but because of its comprehensive nature it did not actually issue until September. There is no doubt that the window of worry and concern was longer than any of us would have liked.

As for CervicalCheck management and what advice its members offered, in reply to a parliamentary question as long ago as 12 March 2019, I told Deputy Donnelly "Neither I nor my officials received advice that recommended against these tests in advance of the decision". However, in that reply to a parliamentary question I also stated:

Subsequent to the decision, on foot of telephone contact by the Department, the National Screening Service raised a number of concerns verbally. Following the announcement, the Screening Service set out concerns in an email to my Department, which related to uncertainty about costs, volume, impact on turnaround times, impact on perceptions of the programme's accuracy, challenges with processing GP payments, and the potential difficulty in ceasing the arrangements in due course.

The Taoiseach said the same on the record of the Dáil.

I was delighted to give the committee the email this morning. I have no issue whatsoever with doing so. The email came in at 5.59 p.m., after the decision had been made.

The email notes that the national screening service takes direction from the Department. I make policy decisions. I own this decision. I believe it was the right thing to do and I have 110,000 reasons to believe as much because 110,000 women saw their GP in seeking reassurance. Only 57,000 of them actually opted for the repeat smear, which shows that GPs did their job. I do not believe that any woman needed direction from me on the appropriate thing to do for her healthcare. However, what women needed from me was not to be insulted by being forced to put their hands in their pockets because of this situation.

The advice was not received by my Department in advance of the decision. The chronology is very straightforward. We make the decision as a Department. I made this decision and I own it. I will stand over the decision. While one would not do this in normal times, these were exceptional times. That decision was then conveyed to the screening service and what we would do was outlined. The screening service outlined some of the risks after the decision was made. Of course there were some risks but they were all readily identifiable. One risk concerned how GPs would be paid. We sorted that out. I thought the risk that it could potentially undermine further confidence in the programme was somewhat ironic. The way in which CervicalCheck had been managed, the audit had been handled and Vicky Phelan had been treated had already undermined the confidence in the programme.

The national screening service did refer to the additional impact this would have on lab turnaround times. This was inevitable. I have spoken to so many women, as I am sure Deputy Donnelly has. They were going for repeat smears anyway. People, including women we all know in our own lives and communities, sought that assurance. Until the State could say that its screening service was safe they would seek that assurance. I did not mislead the Dáil. I took this decision for good reasons after hearing from GPs and women. It was consistent with the advice of my chief medical officer and my senior departmental officials, as the Department confirmed in writing to the Ceann Comhairle of this House as long ago as February. I have never hidden from the fact that concerns were expressed after the decision was made. I have outlined the content of those concerns in answers to parliamentary questions. I am happy to give the members physical copies of the email. I have them here and can circulate them.

I have said I made mistakes around CervicalCheck. There is no doubt about it. Fortunately, others have not. Dr. Scally talked about the frenzied political and media environment. I am possibly the only person involved who has suggested that I made some mistakes and would like to do some things differently. However, this was not one of those things. This was far from ideal. It has absolutely resulted in a very significant increase in smears. It has resulted in a backlog. As the Deputy acknowledged, that is not exclusively made up of new women entering the programme, but I accept they do constitute about two thirds. That is a statement of fact. I want to focus on reducing that backlog.

Women were going to seek the repeat smear regardless of whether the test was free. For me the issue was to support GPs who wanted to know what to do if such women turned up. No matter how many times I am asked this question, my view on this will never change. I lived the CervicalCheck debacle 24-7, working intensively with my officials, who worked so hard and showed real leadership. This was seen as an appropriate thing to do. It absolutely would not be appropriate in normal circumstances but we were not in normal circumstances. We are now looking back from higher terrain, with the benefit of hindsight and different views. Some Opposition spokespeople have said that if they were Minister, they would have done exactly the same thing. Others welcomed it at the time and now say I should not have done it. Others criticised CervicalCheck management at the time and are now quoting it as the font of all wisdom. People can do what they want in that regard. I stand by the decision. I own the decision and I am responsible for the decision.