David Cullinane (Waterford, Sinn Fein) | Oireachtas source

We are discussing this motion because of the recent CervicalCheck scandal, which will not be solved behind closed doors. It can only be resolved in public and there needs to be public accountability. The Committee of Public Accounts has a duty to examine these issues, as does the Joint Committee on Health. They should be able to do their work and be supported in that regard.

Last week, the former director general of the HSE, Mr. Tony O'Brien, admitted that there had been system failures in the CervicalCheck scandal. That was an understatement. What we are looking at is a cover-up. Let me explain what I mean by "cover-up". It is becoming clear that CervicalCheck and the HSE, with the knowledge of the Department of Health, developed a damage limitation strategy. We know this because, on 29 June 2016, Mr. Simon Murtagh of CervicalCheck wrote to Mr. Michael Conroy of the Department's policy section, told him that there was a letter being issued and updated him on the progress so far. That email had two attachments, one of which I will quote. It is entitled, "Notes for consultant doctors regarding outcomes of the cancer audit process". It reads:

While CervicalCheck supports the principles of open disclosure, it is recognized that there are limitations to its universal implementation, particularly for screening services where there is an inherent recognized error rate. The assessment of avoidable harm that doctors are asked to make, which should be done in consultation with the relevant consultant doctors, should take this into consideration.

At no point in any of the memos and letters that the members of the Committee of Public Accounts, the Minister or I have seen was there an attempt by the HSE to inform the women directly. In fact, what we saw in one of the letters was that two women had asked about their smear tests and contacted CervicalCheck directly only to be told to go to their consultants. At every step of the way, barriers were put in place to women getting information that they should have been given.

CervicalCheck is openly admitting that it does not believe in open disclosure regarding its screening programme. In order to do this, CervicalCheck put in place a three-tier filtering process to limit the number of cases that went public. The first part was to leave it to doctors to tell the patients. As we know, only one in four patients were informed. Of the women who were told and threatened legal action, CervicalCheck and the laboratory in question got them to sign non-disclosure agreements as part of their settlements. Of the women who refused to sign such agreements, their court cases were dragged out so that they would die before they could get an opportunity to have justice. Indeed, three women did die.

The one element that the CervicalCheck strategy did not bet on was Vicky Phelan. We all accept that we owe her a debt of gratitude, as do the other women.

This is a national scandal. When the Taoiseach was Minister for Health, he had an opportunity to support mandatory open disclosure. The chief medical officer was one of the people who advised him not to pursue it. Last week, I and other members of the Committee of Public Accounts asked whether the Department had received any of the three memos laid before the committee which had been given to the director general of the HSE. The chief medical officer sat beside the director general during a lengthy discussion of the memos. The director general was very clear that he had no idea whether the Department had ever seen them. Both the director general and the chief medical officer tried to help members of the committee understand what the memos meant. However, the chief medical never said that he had seen the memos and had been given the information. He knew of the strategy to pause all letters, lawyer up and contact solicitors. The paragraph in the memo which states that the women should not be told because they would become hysterical and go to the media and that CervicalCheck needed to develop a media strategy goes to the heart of this scandal. We now know from emails published today that a media strategy was put in place in October 2016. That was the outcome of a very deliberate strategy. There was a cover-up and people have very serious questions to answer. We will ask more of those questions at the Committee of Public Accounts and elsewhere. The Minister's job is to hold those who are responsible and withheld information in a cold, calculated and deliberate way to account.

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