Dr. Colm Henry:

Impaired access could never be defended in terms of people getting access to opinions and diagnoses. The fact is that screening and diagnostic pathways are not 100% sensitive either. As the Chairman will know, when a doctor is faced with a clinical scenario, he or she makes a decision and assessment in real time based on the information available. Sometimes looking back there is what we call a bias looking back where, with the benefit of knowledge, everything becomes clearer. We know, for example, in radiology where there are good standards in radiology, if one looks back with the knowledge of a cancer developed, for example, one will see something in 5% or 10% of cases that had not been seen at the time. Unfortunately we cannot provide 100% sensitivity in the care pathways we provide. That is not to defend poor practice or appointments or impaired access but while clinical medicine is improving and is safer now than ever, it is not 100% perfect.