Catherine Connolly (Galway West, Independent) | Oireachtas source

I welcome the opportunity to participate in this debate. I echo the comments that the time allocated to it is very short. I have read all 170 pages of the report and it would be helpful if Members had more time to go into its details.

I welcome the comprehensive report and the blunt, clear language of Dr. Scally. He overstepped his brief, however, when he said we do not need a commission of inquiry. That was not for him to say. I checked the terms of reference and do not think he was asked to give an opinion on that. That was one mistake. He was asked to scope the issues and the questions that arise from this scandal.

I am not a Member of this Dáil to reassure women that they should have cervical smear tests or any other test. That is not my job. My job is to ensure that we have an open and accountable system which instills confidence in women and allows them to make up their own minds. That is what was and is sorely lacking in this matter. It is the responsibility of this House to ensure that confidence is engendered by having open and accountable systems rather than on the reassurance of Members. I will leave it to women to decide what they wish to do based on the information available to them in an open and accountable manner.

The report raises serious issues. As has every speaker, I thank Vicky Phelan, without whom we would not be discussing this today. I also thank Dr. Scally and his team for meeting women affected by the scandal throughout the country and abroad. He met 67 women and their supporters in my city, Galway, 130 in Dublin and 60 in Cork. He examined more than 12,500 documents. On occasion, he had to apply pressure to access those documents and needed an extension of time.

He has carried out a scoping exercise. I fully agreed with the scoping exercise when it was proposed by the Taoiseach. I thought it the best and wisest way to go prior to any investigation to establish the issues. Dr. Scally has repeatedly pointed out throughout the report that there are other issues regarding the outsourcing of samples from American labs to Honolulu in Hawaii and many other cities and that, apparently, CervicalCheck and the Health Service Executive knew nothing about that. He wants more time to examine that issue among others. He also highlights an absence of documentation in one of the laboratories and also in Ireland following the procurement because it has been destroyed. As such, he can only reach limited conclusions.

I reiterate the comments by Deputies that outsourcing is a major problem, notwithstanding that the report contains some positive comments in that regard in terms of the standards being good, based on Dr. Scally's observations. The contract stated that the labs should have the IPL accreditation but they did not. No one seemed to think that was a problem. The labs had accreditation under the American system and met those specifications but that is not what was specified in the contract. They did not have what was specified in the contract. The contract also seems to have been loose enough for the tests to be sent to Honolulu and for the labs not to inform CervicalCheck, the national screening service, Mr. Tony O'Brien or whoever was in charge.

This scandal involves a whole systems failure to which I will return because I am not happy that some person, organisation or government allowed it to happen. I will address it now in case I run out of time.

The comment was made by the women that, when we rolled out CervicalCheck in 2008, we also guaranteed the banks in the same month. As we pulled back on resources, staff and money for cervical smear tests, we had no problem rolling out money for the bank guarantee. Notwithstanding that, they struggled on gallantly to provide a screening service as an independent entity, reporting to an independent board with an independent chair that had oversight and outside monitoring. Subsequent Governments of Fine Gael, the Labour Party and Fianna Fáil in their wisdom saw the need to change and allow the Health Service Executive to change its structure, with the resulting consequence that there was less accountability and no independent board to which to report. In fact, before the board was abolished, we had directors of services talking to civil servants in the health sector. There was no accountability whatsoever. We have not had a single accountable person in CervicalCheck for the past number of years. I ask the Minister where the responsibility lies for that. We have also had a number of vacancies.

We then had an open disclosure policy that was really a close policy. It was a case of do not tell, or only tell if it we have to, and only after all of this correspondence between CervicalCheck and the consultants and general practitioners, and we will not tell the women. It was a case that we had a policy of open disclosure but that it really meant that we do not tell at all because there might be screaming headlines and difficult issues we have to cope with and, in true Irish fashion, on a certain level we will not cope with anything like that. It was a case that we will pretend it is not happening and if the person is dead, just put it on their medical notes. That is what is reported throughout this report.

Those of us in the Dáil asked for mandatory disclosure. The Minister saw fit not to support us and now we will have to bring it in by way of legislation and force the situation.

There were serious governance gaps at every level. There were serious problems with a risk register and what was put on a risk register. A systemic failure was not identified as something that should go on a risk register. Can the Minister imagine that?

There was an absence or a limited amount of public health medicine and a limited amount of input from public health physicians. Parallel with the bank guarantee, the withdrawal of the money for the service and the outsourcing at the lowest cost, which I will come back to, we were getting less and less accountability.

I sat on a health forum for ten years. I became a member when it was set up and spent ten years of my life on it. In my first year on the forum we were under pressure from the people working in the laboratory in Galway and elsewhere not to outsource this service. They said not to outsource, that they were in the process of building up their expertise, and that this should remain in Ireland or else they would envisage serious problems. Notwithstanding that, it was outsourced. Now, Dr. Scally, who is very cautious and gives positive results to the laboratories on what his limited time allowed him to do, confirms that one of the firms, the Australian one, Sonic Healthcare, has been in the process of repatriating the system to Dublin with one of its companies because it sees it is far easier to have it based in the country rather than going to New York, for example, with Quest Diagnostics, where there are delays of two or three days and so on. If we read Dr. Scally's report we see that even the private companies are coming back to Dublin. I cannot recall the actual name of it. The CPL one is gone. It is the sister company that is now back in Dublin.

See this speech in context