Olwyn Enright (Laois-Offaly, Fine Gael)

Probably the most used political phase throughout the duration of the scandal that has surrounded the cancer treatment of women from my constituency has been "going forward". I fear that in the Government's political rush to avoid accountability, it still has not learned from the mistakes of the past. The Minister was correct when she stated she was unable to undo what had been done. No one knows this better than the women directly involved.

There are two aspects to this debacle, namely, the cause of the original misdiagnosis and how the issue was handled on discovery of the problem. On the first issue, I am not satisfied that anything has been learned from the misdiagnoses of the aforementioned nine women. While the Minister talks continually about centres of excellence, I have noticed that she has started describing them as specialist centres. Perhaps she finally has realised that excellence is not designated but must be earned. She continues to side-step the fact that Portlaoise hospital was a designated centre. Although she may not have liked how that came about, she was in government when the designation was made.

Although the Minister has attempted to wash her hands of any decisions in this area, at a Progressive Democrats conference in Emo, County Laois in October 2005 she trumpeted the news that the long-awaited cancer unit at Portlaoise General Hospital would be up and running within 12 months and that interviews would take place to find staff. In reality, staff queries, complaints, reports and comments were not acted upon. Each time a complaint was made regarding equipment, staff were told to file an incident report. Although they did so several times, nothing happened.

Members still have not received a sufficient explanation in respect of what happened to Dr. Naughton's letter of April 2002. The former Minister, Deputy Micheál Martin, accepted last week that it had been received, adding that he had acted on the issues contained therein. His version of action, however, differs significantly from what was needed. Nothing changed at Portlaoise following his action. The letter, however, went missing. What specific changes will be made in every hospital across the HSE to ensure genuine staff concerns about patient safety will be responded to and acted on?

This designated centre had a viewing area for imaging that was completely inadequate. The radiology department put in writing its concerns about the compression plate and the filming and screen system. What confidence can the Minister give that such issues will be addressed in all designated centres? Probably the most important line in Dr. Ann O'Doherty's report was that "a mechanism for measuring standards in each centre and comparing practice between centres should be devised rapidly" as women wish to be reassured that the standard of care they receive is optimal. When will such standards be in place for cancer and all other services?

The second issue pertains to the handling of this affair from August last. The malaise does not lie within the HSE alone. The Minister showed a remarkable lack of urgency from August to November, until she was embarrassed into taking action at the Oireachtas Joint Committee on Health and Children. At that point, as political pressure built, she sought reports left, right and centre, which in fairness are hard-hitting within their terms of reference. No inquiry was made into her Pontius Pilate approach to her brief. The HSE should use her to front their "have you washed your hands" campaign.

In the past 11 years a culture and belief have emerged on the benches opposite that because they have enough bums on seats and can scrape through votes, they can sit matters out and they will blow over. It will not blow over for the women affected.

The Minister set up the HSE, which almost every Government Deputy has criticised at some stage. However, they cannot, or refuse to, see this chain of accountability. We hold our soccer and rugby managers to a higher level of accountability than the Government. While I want the HSE to work and seek the best possible health service for the people I represent, I do not believe it can improve, unless the issue of accountability is dealt with. John Fitzgerald described "systemic problems of governance, management and communication". The Taoiseach reassured Members last November that what had happened in the midlands was not a systems failure. However, the HSE is a failure of the Minister's creation. She herself noted at the joint committee meeting last week that some of the systems were transferred from the health boards. Whose fault was that? Who set up the system with practically everyone still in the same job, albeit perhaps with a slightly different title? No patient-centred system looks for cohorts or would leave concerned women to gather in a relatively public place for tests because it was waiting for a cohort.

The Minister has learned very little. As for change, while I will reserve judgment, I remain sceptical. The Government motion supports the actions being taken but Members do not know how they will work. Last week's big idea appears to have been to appoint one person to oversee crises management. What about averting crises in the first place? Is that not what should demand the most attention?

The Minister has noted that this issue would never have come to light were it not for the courage of the director of nursing whom I also commend. However, this constitutes a huge admission of the shortcomings of the system. Were it not for one person, staff still would be filling incident reports, writing letters, begging for proper equipment and women would be getting sicker, possibly without being aware of the cancer growing inside them. As it is clear the Minister will not leave office, she should, at least, honestly re-examine the HSE, talk to staff on the ground and accept there is no one in charge and that people do not know their role or to whom they are accountable. Until this changes, patients will never be put first.

I have to hand a letter from one of the women who was recalled for a test and received another e-mail today. The women in question still have not been written to by the HSE to be given the all-clear. While they were given the all-clear on ringing the helpline, four months later some women still have received nothing in writing, which is unacceptable.

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