Mr. John Connaghan:

I will start again. I thank the committee for the invitation to attend the committee today. I am joined by my colleagues, Mr. Damien McCallion, Dr. Stephanie O'Keeffe, Mr. John Gleeson and Mr. Paul Connors. I will begin by setting out some points regarding the issues of concern about the evidence given by the HSE to the meeting of the Committee of Public Accounts held on 17 May and further concerns raised by the committee at its meeting of 31 May. I reassure members of the committee that as director general I fully understand the obligation placed on me to provide any information requested, to act with integrity and to be accountable, open, honest and transparent in evidence provided to this or another committee of the Oireachtas. My colleagues are also aware of these obligations and have and will fully comply with them.

Before I address the specific issue of the evidence given to the committee regarding the conference call with the State Claims Agency, I will briefly update the committee on the interim report on recommendations issued by Dr. Scally last Tuesday and to bring it up to speed on the actions we have taken since the last meeting of the committee, bearing in mind that members of this committee have previously raised issues on communication, transparency, management and governance.

On Dr. Scally’s interim report, we welcome the report and the recommendations. In the interests of transparency, it would be my intention to not only publish any recommendations on the HSE website but to also publish our progress tracker against each of the recommendations in the final report such that the public can observe and measure progress.

Since the commencement of the scoping exercise, the HSE has prioritised the provision of all relevant documents to Dr Scally in a manner that is both useful and timely. As previously advised to the committee, we have a special team in place to do this work in a manner that is both useful and timely. This remains an ongoing process. The HSE had a productive engagement with Dr Scally and his team yesterday morning, Wednesday, 13 June, with regard to how required documentation has been provided up to this point and how the HSE can guarantee the future management of documents to the satisfaction of Dr Scally. The HSE has provided to Dr Scally as many of the documents as possible that have been requested by him within the timescale required. Documents pertaining to contracting of the laboratory services have been prepared for release but in some instances require legal clearance and in others the consent of other parties prior to their release. This was discussed with Dr. Scally at yesterday’s meeting. We have been working intensively with our legal teams to release the laboratory contracts without compromising the terms of those contracts. We have made a breakthrough in the past number of hours on this matter. Consequently, we hope to be in a position to release the contracts to Dr. Scally shortly.

The HSE has provided the vast majority of documents to Dr. Scally’s team in electronic format. Due to certain technical issues, relating to software limitations in some locations, it has not been possible to provide some documents in a searchable format. However, a methodology is being agreed with Dr. Scally to overcome this problem in the future, which is designed to further enhance and sharpen the focus of the document searches. This involves more specific technological interventions.As director general of the HSE, I reiterate my intention to continue to fully co-operate with Dr. Scally in the most productive manner possible to ensure that he is properly assisted in his work.

Turning now to the actions we have taken thus far, we have strengthened the overall management of the programme with a national director, Mr. McCallion, reporting to me as director general. Mr. McCallion’s role is broad in scope and will not only cover the existing task of informing and supporting the women involved but will extend after the Scally review reports to ensure all recommendations are implemented fully. We have engaged external support as part of a records support team to ensure we fulfil the requirement to meet both legal requests and access requests for clinical records. I ask the committee to note that in the absence of a fully computerised electronic healthcare record, this entails a manual search for records dating back, in some cases, years and potentially over a number of sites. We are committed to meeting the standard of 30 days on access requests.

The committee previously voiced concern on risk management and oversight in screening. We are in the process of establishing a risk committee, which will be chaired independently by someone from outside the screening programme, enhanced with the appointment of a chief risk officer to support the work of that committee. The CervicalCheck programme has a quality assurance committee, which has an independent chair.

Since the establishment of the helpline, we have taken more than 24,000 calls with the vast majority of these now returned. Four support centres have been established, with 50 staff engaged to provide that support at various stages. I ask the committee to be aware that we continue to receive calls on a daily basis, although these are reducing significantly in number. With regard to practical support for the 209 women, each of these has an individual named person who is based in each community healthcare organisation. For those who want to access that support, it has so far covered the provision of medical cards, home support, physiotherapy, counselling, etc. Our job is to provide immediate support to the women affected and to ensure that is delivered with empathy and consideration.

We are supporting the international review panel, which is being commissioned by the Department of Health. We have provided matching data from the national cancer registry. We are transitioning from the CervicalCheck audit process to the audit process being developed by the Royal College of Obstetrics and Gynaecology. This will require a significant team to be put in place within the HSE to support this process. We understand the Department is concluding the contract for this work and the scope of work will include all women who were part of the CervicalCheck audit and those registered with the national cancer registry.

Turning to the substance of today’s meeting, at a meeting of the committee on 10 May 2018, the State Claims Agency, SCA, confirmed that it was told by CervicalCheck that all the women had been communicated with. The SCA, by letter dated 22 May 2018 to the committee, confirmed the basis for this initial evidence to be a teleconference held on 20 April 2018 in which the SCA legal team of four was provided with information by Mr. John Gleeson of CervicalCheck. This information, ascarefully notedby the SCA legal team, was "that all women whose smear was part of the audit had now been informed or assumed that they had been informed by their treating clinicians". The committee will be aware from my letter of 30 May that I had asked the SCA and CervicalCheck to discuss why there were two apparently contradictory statements. My letter of 30 May accepted that the advice on the teleconference of 20 April that, "All women whose smear was part of the audit had now been informed or assumed that they had been informed by their treating clinicians", is correct and accepted by the SCA and CervicalCheck. In particular, Mr. Gleeson has advised me he does not dispute the note as recorded by the SCA on the legal file as it reflects his understanding of the position regarding communication with the women at that point in time - 20 April. With the Chairman's agreement, I will ask John Gleeson to make a short statement.