Simon Harris (Wicklow, Fine Gael) | Oireachtas source

This has been a constructive engagement. In response to Deputy O'Connell, we need to be sure not to second-guess why women chose not to engage with the RCOG process. For a lot of people, their cancer journey may have ended a number of years ago and they may now be in very good health and not wish to have an independent review. The figure I have shows that 63% of women on the cancer registry consented to the RCOG review. That means 37% did not. The Deputy is correct that this was for a variety of reasons. Nobody chose to enter the RCOG process as a passport to the tribunal because nobody knew about the existence of the tribunal. They chose to do it to exercise the option of an independent external review of their screening history and a determination, if there was discordance. Some women decided they would like that while others decided they would not. I do not have the reasons for women making different decisions but we can, at a human level, guess them. Different people are at different stages in terms of health and well-being and their family life. The Deputy makes a fair point, however, and nobody wants to be unfair. I would guess that the number is relatively small because nobody in this room would be able to tell me how many of the 37% have changed their minds and would now like an independent review. Of those, only a proportion will have a discordance and be able to enter the tribunal. Access to the tribunal is based on a finding of discordance from either RCOG or the retrospective CervicalCheck audit. I have not done the maths but I would imagine that the number of women involved is quite small. This heightens the argument to deal with it. I cannot deal with it on the floor of a committee meeting and members are not asking me to do that.

The RCOG review is independent and it is now closed. It is important that it moves on to reporting in the autumn because a lot of women are waiting for it and no one wants to delay it. I will reflect on the issue and engage further with the committee between now and Report Stage, which is a short window, to see if there is a way of dealing with it, either in this legislation or by way of a commitment to return with a proposal shortly. We need to be careful in terms of scope and not to create other inequities by trying to be fair. Today, a woman will go for a smear but there is no audit under way because one of the Scally recommendations was for a new audit. The tribunal cannot be an ongoing process that lasts forever. Patients said that they want it to be timely, time-limited and scope-limited. We should not broaden it too much and we have a broader Bill relating to clinical negligence, which is more extensive legislative work for us to do.

I am happy to work with members and colleagues to put forward amendments to deal with this. It cannot be done easily but I am willing to try and to ask my officials to work on it. I will report back to the committee and, at the very least, I will seek to update the Dáil on Report Stage as to where we are at.