Simon Harris (Wicklow, Fine Gael)
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On the topic of Portiuncula, from my reading of the report I would firstly sympathise with the families who have been tragically impacted by this, many of whom I have heard comment in the media, and all of whom I know were offered briefings in relation to this piece of work, to look into what went wrong in Portiuncula. I think it is important to say, however, for women who may be using our maternity services today, that objectively a lot has changed since then. I welcome the fact that the Chair might do a separate engagement on this, because there is a lot that we could discuss. If one looks at the number of consultants, non-consultant hospital doctors, NCHDs, nurses, or midwives in Portiuncula, one sees they have all significantly increased. There was no director of midwifery, assistant director of midwifery or national maternity strategy. There now is. That is not to suggest in any manner or means that the job is done. Deputy O'Connell knows the area of our national maternity strategy very well. However, I would point out that a lot of the recommendations made in the Portiuncula report are already very much under way.

I took some assurance that from a great tragedy, and a failure, very positive, concrete actions were taken.

I am not going to speak for the director general or offer an interpretation of what he said today. I believe the way the HSE was established was not appropriate. It seems that is acknowledged by everybody in these Houses now, and by most people in the HSE. What are we going to do to fix it? If we bring forward the HSE board legislation next week, it will be a start. We then need to move as quickly as possible to the roadmap for these regional integrated structures, or whatever they will be called. We need to see the community health organisations and the hospital groups working together. There has to be a couple of them around the country, with the country divided up into several areas which have local accountability and devolved structures. That is where we need to get to, and I expect to be in a position to bring that roadmap to Government this year so that we can actually map it out.

On the issue of accountability, I have heard it from many people - Ms Róisín Molloy has said it to me previously - that if something goes wrong in the health service, the doctor is accountable to the Medical Council. Nurses are accountable at the Nursing and Midwifery Board of Ireland, NMBI, but to whom is the manager accountable? Accountability does not mean that heads must roll, but it means professional development and regulatory structures. I believe that many people working in the HSE would welcome that, but how that is legislated for is something with which we will have to grapple. I started a piece of work on this issue a couple of weeks ago, before the latest CervicalCheck situation arose. I know that this committee is very busy, but I would welcome any input it might have as to what accountability legislation looks like. I am aware that the Sláintecare report calls for it to be implemented, as do I, but what does it actually look like? How would it actually work?

Term F is extensive, but it can be summed up by saying that it is about the laboratories. It addresses the entirety of the laboratory issue, from the decision to outsource to how they work now and how they will work in the future, and their accreditation. It is important that it is there.

On HPV testing, it has been said to me and in public that the women of Ireland need to see not just that we have responded to a terrible situation and are trying to deal with it, but that we have gone above and beyond that by saying that women in this country were let down and making clear the steps we are taking to ensure not just that they will not be let down again, but also to make sure that the health services are improved. HPV testing is a real way of doing this as it would provide more accurate tests and a reduced requirement for smear tests. Ireland would be one of the first countries to move in this direction. I do not want to make any commitments that I cannot stand by, but at the moment I am told that HPV testing will be introduced in October. I will scrutinise that further and revert to the committee.