Bríd Smith (Dublin South Central, People Before Profit Alliance) | Oireachtas source

On behalf of People before Profit, I salute Vicky Phelan, a national hero, and wish her the very best of solidarity in the struggle she faces so bravely. We know some details of what happened, but we do not know enough. The Minister is conducting an investigation, etc. but the Academy of Clinical Science and Laboratory Medicine has asked him to publish the results of the 2014 audit. When will that happen? It is very important to know.

We know that what happened in 2014 was the result of a policy decision and its consequences were debated and well known in 2008. I am sure all Members have read the Official Report of the debate at the time. There were very articulate cases made to the then Minister, Mary Harney, and the Fianna Fáil-Green Party Government against putting the service out to tender. It did not have to be tendered for. She said it had been put out to tender "for reasons of transparency, fairness and equity to make sure it got the best quality assured service" and that "80% of points were allotted for quality and turnaround time and 20% for price". We had a political choice in 2008 to invest in several laboratories based in Irish hospitals, using Irish experts and training new scientists in the Irish public service. As in many other cases, however, where we justify privatisation and outsourcing, we use the excuse that the system is in crisis, that there is a backlog, that it takes months to get a result and that we have to go to the wonderful private market. We treated cervical cancer screening, a vital service on which tens of thousands of women rely and for which they understand the need, like every other service or good and organised a tendering competition for it, inviting firms from around the world to bid for it and awarded it to the lowest bidder. That is the logic of the market in privatisation. That was the action of the Fianna Fáil-Green Party Government, with Mary Harney, in 2008. The justification was that market competition and private companies were better than publicly funded and run health services.

In 2008 very definite and reasoned arguments were made in this Chamber against foreign multinational control of this vital service. Many of the arguments were made by the then Fine Gael health spokesperson, Senator James Reilly, and Deputy Jan O'Sullivan of the Labour Party. Their arguments were sound and clear. The firm that won the initial contract, Quest Diagnostic, had been found guilty of repeated episodes of fraud in overbilling; several studies found that the detection rate for higher grade pre-cancers was low, while we know from several sources in Ireland that there were severe and real problems in allowing a US firm such as this to provide screening for cancer. Dr. Gibbons warned that cases would be missed if we outsourced to the United States. The union which represents workers and scientists in laboratories warned that the outsourcing of smear test screening would mean that we would lose the ability and expertise to conduct such screening in this country. Many experts, doctors, scientists and consultants in the field were shouting at Fianna Fáil, the Green Party and Mary Harney that this was bad, that it would cause problems, that women would suffer and that cancer cases would be missed. They were ignored and the political decision was made to pursue tendering and outsourcing. A couple of years later the very people who had railed and shouted against it got into power. When Fine Gael and the Labour Party were in power, Senator James Reilly did nothing as Minister for Health and the subsequent Minsters for Health, Deputy Leo Varadkar, now the Taoiseach, and Deputy Simon Harris, did nothing about the issue about which they were so worried.

The policy of outsourcing has continued and today we are hearing defences from the Taoiseach, the Minister and the HSE on the basis that the problem was not outsourcing but something else and that these things happen. One thing is clear: the privatisation of the health system is ideologically driven by the main parties in the Dáil and in every area where it has been implemented people have suffered, continue to suffer and, worse in this case, women have died and will die as a result. We have no faith or belief the Government can address this crisis. It might succeed in pinning the blame on something else, but the scandal is political and involves the political choices made by various Ministers and those in power. If the Minister was a bus driver and crashed and killed 17 people, or even one person, he would be sanctioned by his employer and before the courts. Heads have to roll in this Dáil for what has happened. It is not good enough to pass the buck. "Something is rotten in the state of Denmark" and, ultimately, somebody will have to take responsibility and take the consequences.

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