David Cullinane (Waterford, Sinn Fein) | Oireachtas source

A number of women and two groups were in earlier. They raised a number of issues with regard to medical card access, accountability, supports in terms of attending clinics in Cork and Dublin, aftercare and support issues, the use of translabial scanners and the extent to which they are available, issues around access to treatment abroad, and many other issues. It strikes me there is a poor lack of engagement between those women and advocate groups and the HSE. I do not know if there a point of contact or somebody in the HSE who engages with these women, but it strikes me that it is quite poor.

If women, who are survivors, are coming before this committee to tell us their experience was not a good one, that is a problem for the HSE. I suggest that the first thing the HSE needs to do, notwithstanding Mr. Kidd's opening statement about the implementation of the CMO's report and the supports and services he says are available, is that the HSE needs to examine that in the first instance, because women obviously have a different view which needs to be listened to.

I want to ask questions about the different treatment options and the clinical, so perhaps I can come to Dr. Murphy. I understand a clinician has to make a clinical judgement as to what treatment he or she feels is best, whether that is a partial or a full removal. A surgeon or specialist will have to decide, from his or her perspective, what is best and safe. However, the women obviously have their own choice and view. It seems to me that either there is a bias within the system towards partial removal, on the one hand, which might be based on the fact that clinicians see it as the best option, or there is a lack of skills and expertise in performing full removals in this State. Which is it? Is there are lack of expertise in being able to perform full removals? Is that one of the reasons there seems to be - I will not say "push" but a view - from clinicians that a partial removal is best?