Dáil debates

Tuesday, 1 May 2018

National Cervical Screening Programme: Statements

 

8:15 pm

Photo of Ruth CoppingerRuth Coppinger (Dublin West, Solidarity) | Oireachtas source

We have a very patronising attitude to women in this society, as evidenced by the outrageous treatment of the women involved in this case, a paternalistic attitude among doctors to women, and a refusal to allow full disclosure to patients. I want to speak about an issue which some of the parties in this Dáil do not seem to be interested in, namely, privatisation, which has led to this situation. The outsourcing of cervical smear tests in 2008 was part of the privatisation of health services. A critically important part of health services for women was starved of funding and resources. A HSE recruitment ban meant test backlogs inevitably built up and outsourcing became the solution. This is the way in which privatisation is usually forced through.

Individuals must account for themselves but the majority of parties in this Dáil also must account for themselves. In 2008, the then Minister for Health and Children, Mary Harney, was warned by senior people that private testing would be less rigorous and unsuitable for a three to five year frequency, that detection rates on tests carried out by Quest Diagnostics would be lower, at 85% versus 95% in the Irish laboratories, and that Quest Diagnostics had been fined $40 million for fraud and false claims. In response, Mary Harney and the then Fianna Fáil Government opted for value for money and we got the worst of both worlds, with less frequent and low-quality testing leading us to where we are today. Dr. David Gibbons should be heroically saluted for warning about this ten years ago. How prophetic was what he said. It is likewise with Sam Coulter-Smith. The Rotunda Hospital had a world-class testing service and the majority of parties in this Dáil opted for testing on the cheap.

Profiting from health had been good value for Quest Diagnostics. Only two weeks ago, it reported revenue of almost €8 billion and profits of more than €1 billion in 2017. It is a company that carries out 80 to 100 smear tests per staff member per day when a maximum of 50 per day is the National Health Service recommended rate. In Ireland, 30 to 35 tests was the norm but nothing happened. The unusually low percentage of negative results was highlighted but nothing happened. The former Minister for Health and Children, James Reilly, and the then parties in power also did nothing. The test results never reached the 1.8 average which is international best practice, the reason being that the system chosen was not as good as that which pertained in the US never mind in Ireland. This outsourced service was retendered in 2010, 2012 and 2016 but no action was taken by those who were Ministers for Health and Children during that time, including Mary Coughlan and James Reilly. Despite the warning issued by James Reilly to Mary Harney in 2008, he chose not to act. The former Minister for Health and now Taoiseach, Deputy Varadkar, and current Minister for Health, Deputy Harris, also have questions to answer in regard to why they did nothing about the low rate of results. There were many debates in this House on the national screening programme down through the years but the nothing was done because the Government does not support public health services. It continues to underfund them and to look for the next privatisation opportunity. Thanks to this State, MedLab, the company which Vicky Phelan had to sue, has the contract for the privatised bowel screening programme. Does the Minister propose to do anything about this?

The brutal treatment of Brigid McCole by Deputy Michael Noonan was eventually exposed. Despite all of the solemn undertakings, we now learn about the appalling treatment of the women in this case. What will be the next catastrophic failure of privatisation in this country? Will it be the privatised bowel screening programme? Will the Minister stop cutting corners on women's health and return to a nationalised public testing laboratory system that is adequately staffed and carries out deep screenings? The Minister said in his speech that a further tendering process will take place for testing carried out outside of the public system. Following on from the platitudes we have heard today, this Dáil must ensure that the testing system is returned to public ownership and adequately funded and staffed. It is unbelievable that we do not have two pairs of eyes on every test result, as is standard in other countries.

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