Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

We have raised the issue of outsourcing. When a cytologist who gave evidence to the HIQA inquiry into the case of Ms Rebecca O'Malley raised queries about the inferiority of the US screening, the chair of the inquiry advised him that the terms of reference of the inquiry did not allow it to consider this aspect of the matter. He said that the question of outsourcing was outside the scope of the inquiry, but he offered to make a note of it. As a woman who uses that service, I am absolutely reassured when I hear that someone made a note of this somewhere. How many audits were carried out regarding these outsourced companies? How regularly were they carried out? How many of the teleconferences on which Mr. O'Brien has advised he relies for the exchange of information actually took place? At what level did they take place? Who was talking to whom?

Have the contracts for outsourced smear testing been renewed since 2011? Does the company, Clinical Pathology Laboratories, still hold a contract with the State for smear tests or for any other diagnostic work? I think this is an extremely important question. It appears from what happened in the HIQA inquiry I have mentioned that it will be precluded from looking at outsourcing. If so, that inquiry will be deficient from the very beginning. I am not alone in expressing the view - it has been expressed by clinicians - that the decision to outsource this service is at the root of this problem. The then Minister for Health and Children in the Fianna Fáil-led Government of the time, Mary Harney, was quite prepared to say she believed the savings were in the magnitude of one third. Mr. O'Brien would not comment on the cost of it at the time. I voiced my opposition to it at the time. At no stage do I recall anyone relying on quality or other evidence. The then Minister was very quick to point out that we would be getting it cheap. As we know, if one buys cheaply, one will pay twice. I would be interested to know about the scale of the audit. Were any concerns raised? When the cytologist who was giving evidence to the Rebecca O'Malley inquiry advised that the tests in the US were inferior, was that flagged?

I would like to go back to the note that was received by the Minister. He has said it would be normal for him to get a formal note as a ministerial briefing. He has pointed out that he gets many emails and I am sure that is the case. Does he not think officials in his Department should have flagged this up to him as important? From the moment they knew about it, they should have been asking questions about how many people were going to be involved in it. They should have been bringing the potential impact of this issue to his attention in order to avoid the Minister coming into the Dáil, as he has done tonight, to give us his best guess at the figures without knowing what the actually are.

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