Mary Lou McDonald (Dublin Central, Sinn Fein) | Oireachtas source

-----and may, in and of itself, beg for further investigation and a commission.

The default position of the State apparatus when it became clear that problems had arisen in a screening system that was, of course, not 100% effective - there are very few 100% figures in life - was to deny, obfuscate and leave women in the dark. I commend Vicky Phelan, Emma Mhic Mhathúna, Ruth Morrissey, Lorraine Walsh and Stephen Teap. They are victims. More to the point, they are an inspiration for us all.

Dr. Scally has made an open and shut case for the necessity to provide for mandatory open disclosure. That debate is over. For anyone who doubted it, the report puts the matter to bed.

Dr. Scally has made positive soundings which we must welcome about quality assurance.

He points to the 80% positive predictive value in the laboratories. He makes the point that it is not stellar but it is more than within acceptable boundaries. He also raises very worrying insights into quality assurance, with the theme in the report of cost efficiency outstripping other considerations. He criticised the efficacy of quality assurance visits, which were very thin on the ground. I am struck by the fact that even though the contract between the screening service and the laboratories allowed for a number of mechanisms where difficulties arose, including a Health Information and Quality Authority, HIQA, type investigation on quality matters, that never happened. I am not raising the issue of quality to cause distress and certainly not to cause panic or to dissuade anyone from availing of the service and having a smear. I want to place on record that while we have a general reassurance in the report about issues of quality, these beg further investigation in order that we will learn from them. Ultimately, open disclosure and treating women as autonomous adult individuals entitled to our medical information is an absolute must. So too is robust quality assurance.

Many questions arise in this report. I know the Joint Committee on Health and other committees will address this. I hope the Minister has a keen eye for that and may even consider a HIQA intervention for the inspection of those laboratories. That would be worthy of his consideration.

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