Eamon Ryan (Dublin Bay South, Green Party) | Oireachtas source

We owe it to Vicky Phelan, her family and her courage and honesty to correctly set up a means through which to find out what happened, who was responsible, and how we can avoid it happening again. I have listened to various views expressed in that regard. I have a concern about the view that we should opt for a commission of inquiry because all Members know that in spite of constant promises to the contrary such inquiries take years and always have, which would not be in the interests of families caught up in this scandal. I agree with Deputy Clare Daly that perhaps a way to approach this would be to immediately instigate an inquiry by the Health Information and Quality Authority, HIQA, and set up a wider commission which would investigate how to create a patient-centred healthcare system and would consider the key issue of how to avoid a recurrence of what the Minister referred to as the paternalistic approach to medicine displayed in this case. That commission would be key because the scale of the change we must make is huge.

Any inquiry should begin with the question of what happened in 2008. There was a clear Dáil debate on the issue at the time. Dr. David Gibbons and Dr. Sam Coulter-Smith have made clear that at the time they placed on the record real concerns with the policy approach that was taken. I have asked colleagues and friends who were then in Government to recall the Government internal mechanisms around the issue. To the best of our recollection, it was not a contentious issue. Whether it was motivated by a desire to scale up the number of cervical smear tests in order to save lives or, as some have argued, an attempt to save money by contracting out that service must be investigated. I have no recollection of it being the latter rather than the former.

Neither the Taoiseach nor the Minister in his statement addressed the argument of Dr. David Gibbons which I heard yesterday that the divergence between an annual versus a three year screening system may have been the cause of some of the problems. Although that question may have been answered elsewhere, I hope it will be answered here this evening. The Taoiseach clearly stated that there does not appear to be a difference between the various screening processes being used in terms of the level of accuracy and so on but we must have more detail on that issue.

We must have answers to key questions, such as who was involved in the 162 of 208 cases in which the information was not passed on and the reason for that. Which clinicians were involved? Who was responsible for that lack of disclosure? The most numbing and frightening effect for everyone involved in the Irish health system is the question mark over whether a patient can trust that he or she is being told the right thing. We must have further details on that issue.

I listened with interest today to Members I respect and who have much experience in this area, and from them I heard the common theme that the lack of candour or disclosure may have been due to a fear of litigation. That brings me back to the wider commission of inquiry. I raised earlier with the Taoiseach and the Minister for Justice and Equality, Deputy Flanagan, who answered my question on promised legislation, the issue of whether there are plans to move away from a legally based system to a no-fault medical liability system. As Deputy Shortall and others stated, we must ensure that everyone involved in this process of inquiry will not be shut down by the fear of legal action. How can that be done without a shift away from the current system? As the Taoiseach stated earlier, there always will be a small percentage of false negatives or false positives. Given that is the case, surely it would be better for us to move away from this being a legal process towards admitting fault, helping patients and being patient-centred in what we do.

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