Michael Harty (Clare, Independent) | Oireachtas source

It is extremely important that women, not the process of investigation, remain the focus in this regard. While the process is important women should remain the focus. Population health screening is an important part of our health service, and none more so than cervical screening. Confidence must be restored in the cervical cancer screening programme because this programme has identified 1,482 cases of cancer over the past ten years. The majority of those cases have been identified by the cervical screening programme. Many thousands of pre-cancerous changes have also been identified, preventing people from developing cancer and preventing the progression of cancer in some people. The importance of the scheme is without doubt. Hundreds of thousands of consultations take place in general practice each year where sexual health is the subject of the consultation when people attend for screening. This is also very important. There are many aspects of the screening programme that must be maintained and confidence in the programme must be restored.

The cervical cancer screening programme works for the vast majority of women in Ireland who engage on a regular three-yearly cervical screening smear. The regularity is essential - one smear is a case in point. If a woman has a regular smear it adds to the value of those smears.

Like all screening programmes, cervical screening has its limitations and false negatives will arise no matter what the screening programme is. These must be kept to a minimum by having a double reading, by having high-quality screening laboratories and by upskilling those who perform the screening. This will keep mistakes to a minimum.

This scandal is what transpires when mistakes are identified but the information is not transmitted. This is the core issue. The failure of open disclosure of false negatives to patients is unforgivable, and there may be additional false negatives now because we are hearing that not all cases have been audited. It is true that disclosure would not have affected the treatment of these patients' cancer but that is not the point. Disclosure would have helped the women to deal with their illness. It would have provided them with knowledge and it would have given them the opportunity to take legal action if they felt they had been damaged or injured by the process and if they wished to do so.

The issue now is that the process has trumped the patient. This is so often the case in many health scandals; the process becomes much more important than the patient. Governance and poor judgment are the key to this. Such paternalistic attitudes towards transmitting information have to be eradicated from our health service. In one sense Vicky Phelan was lucky in that she had the capacity, the will and the knowledge to pursue her case. Many of the patients whose false negative results were not transmitted to them have not had that opportunity. This scandal has arisen by not disclosing these issues for fear that the cervical screening programme had something to hide and by not being upfront and honest. Being upfront and honest, admitting that a mistake had been made and transmitting the knowledge would have empowered the programme and the patient. Admitting a mistake is very empowering for the person who admits it but it is also empowering to the patient who receives the information. By not disclosing these issues we now have the current scandal and the lack of confidence in the cervical screening programme. Quite often it is the cover-up of the issue that attracts the attention rather than the original mistake. We have to recognise that it is most likely that the cervical screening programme did not wish to reveal the false negatives for fear of litigation, but now we are in midst of this scandal. Open disclosure is the only way to go and mandatory open disclosure is extremely important.

We have to engage in a root-and-branch review of the cervical cancer screening programme. We have to review outsourcing, the frequency and quality of testing, the governance of the cervical screening programme, the responsibility, and the transparency in it. We have to review open disclosure and have mandatory disclosure. We have to review compensation and try to restore credibility in the service.

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