Alan Kelly (Tipperary, Labour) | Oireachtas source

My party and I will be supporting this motion. We will also be facilitating the new patient safety Bill. It should be prioritised in whatever time this Dáil has left. I believe the current Dáil's time is probably very short and I am not sure if we will get to the Bill because of what has been revealed in the past week or so.

Open disclosure and good governance go hand in hand. The reason we do not have open disclosure in the area of health is, frankly, from what we have seen over the last couple of weeks, that there is not good governance in either the HSE or the Department. At the highest levels, the Department is actually dysfunctional. I am not sure if the Minister can trust his own people or the HSE. I looked back at the Civil Liability (Amendment) Bill. There was lobbying going on to change it from being mandatory for open disclosure and they changed from "shall" to "may". The reason given was to promote a climate for cultural buy-in. That is civil servant speak for saying they do not want it and it is not something that would be conducive to the manner in which they work, the culture of the organisation or the culture of the HSE. That should not have been allowed to happen and now it is going to have to be cleaned up by the Minister. The former Minister for Health, our current Taoiseach, did not do it and the problem continued on into the present day. We have to have mandatory open disclosure. It has to cut through all organisations and has to be across all sectors and throughout every occupation in healthcare. Patients and those dealing with them must be given all the information as quickly as possible.

The memo the Minister received a few weeks ago in respect of Vicky Phelan's case says that, in 2014, the outcomes of clinical cancer audits were used by CervicalCheck for educational purposes only. That does not fill one with confidence that there was going to be open disclosure in the first instance. Today the Joint Committee on Health received a letter. Luckily, I am a member of that committee and of the Committee of Public Accounts, so I have got a great deal of documentation in the past couple of weeks. The letter the joint committee received is from the former head of CervicalCheck to the programme manager of acute hospitals in respect of communication issues. It is astounding. The letter is dated 7 September 2017 and is addressed to Mr. Colm Henry. It states:

The key areas identified for improvement relate to communication - both of the process itself and regarding the outcome and interpretation of any findings. We in the programme have been working on a prospective process of notification and consent.

It also states that a new leaflet - this was September 2017 and women had not been told - entitled Reviewing Your Screening History, would be given to women shortly after diagnosis. A leaflet. It was not a case of sitting down and deciding how the women would be told. There is a series of documents in which, for over a year, those involved discussed this matter. During that time, they did not decide how they were going to communicate and be open with these women. The idea was to produce a leaflet and that was to be used where women wanted to be informed. The letter goes on to describe other actions which, knowing what we know now, are laughable.

In June 2016, a letter was sent by CervicalCheck to clinicians telling them to inform patients. We know that one in five did so. The issue here is why that letter was not sent to managers in the hospital network as well. The Minister must trust me when I say that they are asking the same thing. This issue would have been dealt with a lot quicker. At the Committee of Public Accounts last week, the State Claims Agency indicated that it was told that all women were informed. We now know, and the Minister accepts, that this was not true. They were not told. Open disclosure, my foot.

Open disclosure must be mandatory. From 1 May, the Minister asked for a full, open trawl of all documentation and, in fairness, we got the documents from the Department of Health. We still do not have them from the HSE. I asked two questions on 3 May in respect of when all hospital managers across the 11 hospitals and the seven networks were told about the audit. Guess what? I have not been given an answer. That would be very useful information and I am still demanding that I get it before the Joint Committee on Health meets tomorrow. How long does it take to send an email out to all of these managers to ask when they first heard of the 2014 audit? This is critical information that I and my fellow health committee members would like to have. The Minister also said it was a full trawl. When the Committee of Public Accounts met on Thursday last, the chief medical officer was sitting beside Tony O'Brien and the latter was able to reveal these memos to me in my capacity as Vice Chairman of the committee. The memos were actually known but the Minister had not been told about them. Last Thursday, after two and a half weeks of this crisis, the Minister had not been told about these memos that actually ended up with the chief executive of the HSE resigning. How does that make the Minister feel? I served as a Minister previously and I know how it would make me feel. That is not the way a functional Department of any kind should operate in respect of what is the biggest health crisis in many years.

In recent days, I spoke to the family of a lady who passed away as a result of this in 2016. She took legal action before she passed away. Members of her family have been trying to get the Minister to speak to them but they have not heard from him.

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I will pass on the details to the Minister and I would appreciate if he could ring the family in question immediately. They have made the effort. They did not have open disclosure. They took legal action before she actually died. They do not feel the State Claims Agency is dealing with the case compassionately. That is still going on now. I spoke to the people concerned before I came into the Chamber tonight and I know the details of this case. If there had been open disclosure from day one, the legal issues which are being dealt with now surely could have been concluded. It would have meant her children, her husband, her brother and sister and her extended family could have some form of satisfaction that at least the State acknowledged it had done wrong and that the case was not been dealt with appropriately. Will the Minister please speak to the people in question in the next 24 hours?

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