Charles Flanagan (Laois-Offaly, Fine Gael)

The hospital in Portlaoise is my local hospital and I know many of the women whose misdiagnoses were the catalyst for the four reports under discussion. Their lives and the lives of their families are in turmoil. The hospital, which is close to me, is used by my family, is the one in which one of my daughters was born and is the only hospital available to most of my friends, neighbours and constituents.

Peopled in the midlands are in shock and are still coming to terms with the events in question. The four recent reports offer cold comfort to those who use the services in Portlaoise hospital. The timing of last week's reports was classic spin, all published together on a big news day with a big bang. After the Kearney murder and the Paisley resignation, someone in the Department or the HSE told people to let it rip and to bury it.

I wish to refer to three matters in the short time available, namely, equipment, the outstanding issue of the letters and where we go now. The issue of equipment in Portlaoise hospital was not thoroughly examined. Why was the machinery in the X-ray department not subjected to scrutiny in the Dr. O'Doherty report? It was not her choice not to examine the machine used for the mammography examinations. The machine was decommissioned when cancer services in Portlaoise were suspended last August. Contrast the speed with which the machine was decommissioned when cancer services became the subject of media scrutiny with the obvious reluctance or, perhaps, refusal to provide a more modern, safer machine prior to that date. The irony of the shameless neglect on the part of the State in this scandal is that the machine was purchased by the community through voluntary fund-raising some years ago. Government negligence in the provision of mammography services in Portlaoise is beyond doubt. Removing the machine before Dr. O'Doherty could examine it was highly irregular given the two major questions to be answered in respect of what had occurred, namely, the equipment used and the staff who used it. Moreover, Dr. O'Doherty was not told how old the machine was. She guessed that it was at least 15 years old, making it something of a relic in the current age of rapidly evolving technologies. Such machines should be decommissioned nationally after ten years. Knowing that Portlaoise hospital's mammography equipment was still in use five years after it should have been decommissioned, I cannot help but wonder about the rest of the equipment in the hospital. The Minister for Health and Children, Deputy Harney, should assure the people of the midlands that all equipment in use at the hospital is both modern and safe.

My colleague, Deputy Reilly, has spoken at length on the issues in respect of the letters from Dr. Peter Naughton, past and present, beginning in 2002. I am concerned that of the seven letters sent by him, which were referred to by the former Minister for Health and Children, Deputy Micheál Martin, only two are in the public domain. This continuing reluctance to embrace transparency and accountability does not bode well for the future. I ask the Minister to publish the remaining five letters to allow the full story to be known. She should assure the House and the people that measures have been put in place to ensure such letters will be acted on promptly in the future. Members are aware that they were ignored shamelessly in the past. Much suffering could have been avoided had the warnings contained in Dr. Naughton's first letter been dealt with promptly by the then Minister, Deputy Martin, and subsequently by the present Minister, Deputy Harney.

The Fitzgerald report documents mismanagement and poor governance within the HSE in respect of how the aftermath of the cancer misdiagnosis scandal was handled. The Doherty report identified serious gaps in the system and, far from exonerating the Department of Health and Children, is most critical of its handling of the issues. Sadly, the Minister in her opening statement this morning ignored this finding. Will she assure Members that she has made the necessary changes to ensure such issues will be addressed in her Department and that the HSE and her Department will henceforth be patient-focused rather than focused on passing the buck?

The Minister has decreed that cancer services are at an end at Portlaoise and will be transferred to Dublin. I support this move with certain provisos to ensure people from the midlands will be able to obtain a service. There appears to have been no consultation with local people when this decision was being made. Why was St. Vincent's Hospital chosen over St. James's Hospital? I have concerns about the capacity of St. Vincent's Hospital to deal with the additional patients from the midlands. Sadly, one of the nine women affected was refused a bed in the hospital for a crucial procedure before Christmas and nothing was done about the matter. Will the people of the midlands face endless waiting lists, more trolleys on corridors or vital months passing by before they are seen, diagnosed and operated on? If the Minister intends to remove local services, she must be able to guarantee an adequate service to those who will be obliged to travel up to 80 miles to be seen in Dublin by an appropriate specialist. Changing the location of cancer services from County Laois to Dublin without consultation shows that patients' needs have been overlooked once again. St. Vincent's Hospital is the most inconvenient hospital for midlands residents, not being close to mainline rail stations or motorway access.

The wording of the motion and the attitude of the Minister show that little has changed in respect of accountability. Such an attitude must change fundamentally if the Minister hopes to restore confidence in the health system that, sadly, has let down the people of the midlands in general and the nine women and their families who were given false information on their cancer diagnoses, in particular. The least the Minister can do is to learn lessons from this tragic chain of events and take the steps necessary to ensure there will never be a recurrence.

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