Bríd Smith (Dublin South Central, People Before Profit Alliance) | Oireachtas source

I wish to start by stating something obvious. I am not being smart, but I hope it is obvious that I am a woman, that I have access to CervicalCheck services and that I support the screening programme. I have received a lot of criticism for scaremongering. I am not scaremongering; rather, I am querying why the outsourcing issue has not been properly addressed. Privatisation and outsourcing are at the core of the crisis women face in this country.

Yesterday I attended a protest outside the gates of Leinster House with a busload of women from Cork whose organisation was called Women's Lives Matter. A number of women in the group had been misdiagnosed and had false negatives returned. They were very upset that they had not been told properly by the clinicians. They were also very upset at the scandal concerning disclosure, but most of all they were extremely upset that their lives and future ability to have children had been jeopardised by outsourcing. They demand the repatriation of the service.

The Scally report shows that there was a deep problem with outsourcing, even though Dr. Scally himself said to me that he did not have a problem with the continued outsourcing of the test to the US laboratories. He said that if he was a woman, he would have faith in Quest Diagnostics. I refer to his report to indicate why I believe it shows that there was always a problem with outsourcing. First, the US laboratories were not ISO accredited. I tabled two parliamentary questions to the Minister for Health in May and he said they were accredited. It may be the case that they were ISO accredited in May 2018, but they were not ISO accredited when the contracts were awarded and renewed from 2008 onwards. That is a fact.

There are different standards in the US laboratories than there are in ISO accredited laboratories. US laboratories perform 100 screens a day, whereas generally the accepted norm and standard in Irish public laboratories is 60 a day. There is a big difference already, one that could jeopardise the scrutiny of the tests. Irish laboratories have screeners who are educated to degree level and often go on to undertake postgraduate studies in cervical screening. They are overseen by clinical pathologists, which is not the case in the US laboratories. According to Dr. Scally, the cost of the service in the tender from the State to the US laboratories was overemphasised. The Irish laboratories scored very highly when they tendered, except for costs. They were not as cheap as the US laboratories. CPL, the company that settled with Vicky Phelan, was found to have problems on the site in 2011 that were not adequately addressed, yet we still awarded it another contract in 2012. We may never know why and how that happened because we discovered from Dr. Scally’s report that the tender documents had been destroyed in 2017. Will the Minister, please, explain why that would happen? I worked in the public sector, in the library service, and we had to keep a record for years and years of every penny that came into or went out of the library, even though libraries do not normally handle money. Why would the tender documents have been destroyed?

Outsourcing is at the heart of the issue. I have asked the Minister twice about it. I asked Mr. Tony O'Brien when he was in situas director of the HSE. I asked the Tánaiste here one day and the Minister for Finance who had replaced the Tánaiste one day during Leaders' Questions if he could, please, tell us the laboratories from which the 221 false negatives had come. I was assured I would receive the information. I asked the clinical professionals if it was difficult to find out. They replied absolutely not because each slide had its own identity and as soon as a problem was triggered, the first thing that would have to happen was an audit at the point where the slide had originally been tested. The audit has to happen in the laboratory from where the slide came. Could we, please, get a simple answer to the question of from where the 221 false negative slides came? I believe that is at the heart of the matter.

The definition of outsourcing and the privatisation of women's health are at the core of this problem. The reason I raise the issue is the Minister is about to sign off on, if he has not already done so, the continued outsourcing of the service to Quest Diagnostics and MedLab Pathology, a subsidiary of CPL.

Is that not the definition of insanity - doing the same thing over and over again but expecting a different result?

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