Louise O'Reilly (Dublin Fingal, Sinn Fein)
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I thank the witnesses for attending and for their evidence. I have a few questions. Most of them are for the HSE. There seems to be some discrepancy in the figures we are hearing. Mr McGrane talked about 29 cases as having been diagnosed. We also heard there were 43 diagnosed and potentially 400. This gets to the heart of my point, which is that there really does not seem to be much by way of verifiable data. The witnesses might explain how the numbers are collated and what they use as a measurement to decide what numbers should or should not be counted.

The witnesses might also outline how Ireland compares with other European countries in dealing with this issue, for example, in terms of the services that might be available for the sufferers and those who have been diagnosed, and also in the paths to diagnosis. There seems to be some resistance or difference there. Are the witnesses satisfied that there are sufficient systems in place now and that women are warned? I was contacted by someone fairly recently to say that she is of childbearing age, that she picked up her medication, which was in a see-through bag, and that there was no patient alert card with it. How is it policed? How does the HSE ensure that when it is issued, the alert card actually gets to the patient? I think the witnesses will accept that it has not done so in all cases. What penalties are there for people who do not comply with a patient alert card? I am sure everybody wants to comply and do their best. Is there any penalty?

Regarding the victims of this, Dr. Gilvarry mentioned the 1960s and 1970s in her statement. She stated that new studies have been published more recently. It strikes me that there is a fair amount of information available that would have set off alarm bells. Dr. Gilvarry might elaborate on exactly what she meant by "more recently". I am interested in when the risks were known about, how serious the level of knowledge would have been, and how it was communicated. I think there are doctors who would have prescribed in good faith without being aware at all that there was an issue. There may have been a time when there was some awareness among the medical community that there may have been a risk, but it might not have been widely known. Then there is a period, which I would be interested in exploring with the witnesses, when the risks were very well known and the prescriptions continued. Those women's children would now be in their 20s and 30s and they are dealing with a range of complex and difficult conditions. As was outlined, the women very often have more than one child in this situation. Perhaps the representatives from the HSE might outline for us what is in place for them. Is there a specific package or are they simply in the mix with everybody else, trying to scrap it out for the services that are there? Or, as was outlined by Ms Keely, do they have to go to the private sector to purchase services that should be available in the public system? What specific packages are in place and how can they be dealt with?

I may come back with other questions at a later stage if that is okay.