Clare Daly (Dublin Fingal, Independent) | Oireachtas source

I am sharing with Deputy Joan Collins. I find this entire discussion utterly depressing from start to finish. It should not be necessary, but we have to start by reaffirming that our screening service is a public health initiative that saves lives. It does not guarantee that someone will not get cancer, it does not guarantee that if someone does get cancer that it will be picked up and there is no guarantee that someone's life will be saved by it but it massively improves the odds. It is not good enough for us to pay lipservice to that and then come in and eviscerate the service with non-evidence-based comments, as though the two can be tallied and we are all on the one side. Everybody in here, on all sides of the House, supported and egged on by the media, has created a situation where the trust of women across the country in our public screening system has been seriously eroded and damaged. That is an extremely serious situation when we want people to take up that programme. We must be very upfront about this from the outset.

The very fact we are here tonight is indicative of that. We are here tonight because around ten days ago, this was the big scandal and everyone was looking for Dáil time. Now, CervicalCheck has moved off stage and its the children's hospital and no one is here because no one gives a toss. They do not give a toss because the print masters in the media do not give a toss either. They are not prepared to undertake any serious scrutiny on these matters, they are just interested in a cheap headline.

The latest scandal is around writing to these 4,600 women as a result of the delay in checking for HPV in one lab outside the debate. The media is asking how these women are supposed to feel. I am in the middle of the screening process and I do not feel especially great about this, nobody does when their health is in question, but what they should feel is that it is great that a retest is being done and a quality check has picked up a weakness in the system that in normal terms - and I have heard nothing to contradict this - would not have batted an eyelid because the risk is negligible. Is that not good? While I am sure that people will be sick if they get a letter telling them there has been a retest and there has been something different, is it not great that they will know and there is a chance of an intervention?

To be honest, I am a bit sick at how all this has been dealt with because that issue has been conflated with the backlog and the delays in the Minister's decision to have a retest. If anyone is even half honest, they will know that if the Minister had not offered the retest, there would have been an avalanche of demands for retesting from the media and the world in general. Everyone must take responsibility for this because it is a fact that medical advice said do not do the re-test, it will cause problems for our system. That point was made earlier. That is a fact and we must take the consequences of that. The biggest consequence, I think, is that it has potentially delayed the introduction of HPV screening. The responses from departmental officials on this issue are written in real Civil Service speak. They speak of needing to stabilise the programme and the operational challenges during the year but they mean that they were dealing with this bloody crisis and could not get on with making the system better. That should be our key job and I want to hear more on that.

Some 19 countries do screening, 12 of which conduct audits. Of those 12, only seven use the results and only one has a policy of telling people. We are different. It is not necessarily a bad thing, it is a better thing.

It has been said that privatisation has caused this situation. Has it? Maybe it has but I have not seen any evidence that it has. We are all very fond of coming in here and quoting the Scally report. Dr. Scally did not say that we should not continue to use the labs. He did not say that and I have seen no evidence that says that the rates are any different. It is the case that the US labs operate to a different standard but it is not necessarily a lesser standard. Again, I have not seen evidence that it is a lesser standard. Honolulu is the capital of Hawaii, which is a state in America. I do not think that America is the be all and end all - which enough of my record in the Dáil will confirm - but it is not Ethiopia. I am not being derogatory in saying that but it is not a developing country. It has state-of-the-art colleges, high medical standards and so on. We must be very careful. I do not know. We know that a lot of people are suffering because of uncertainties and because of misinformation around this issue.

I want to make a point about the 221 cases and litigation. These are claims at the moment. I am not saying that their situation is not traumatic - all these people have cancer and we know that - but we do not know how many of them were caused because of normal problems with false negatives or how many were the result of negligence. How many were so glaring that they should have been caught? We do not know that. We should know that. I am very concerned about why the review by the obstetricians and gynaecologists has not been done and I would like the Minister to tell us why not.

We should know whether our rate differs from that in other countries.

The two issues we really need to address are the ones within our control and that Dr. Scally flagged as the main problems, the first of which is open disclosure. It is all very well for the Minister to tell the House that a patient information and safety Bill will be delivered this year. I was told by the Taoiseach last May that the Bill would be delivered last year on foot of this evidence, but it would have been delivered the year before if the amendments to require mandatory open disclosure that we had succeeded in having approved at the justice committee had not subsequently been removed by the relevant Ministers at the behest of officials in the Departments of Health and Justice and Equality. If we are serious about this, that is key.

The second issue is legal costs. In other countries people do not sue over delayed diagnoses caused by false negatives because they have much better systems in place than ours. We need to consider these lessons. The way in which the entire matter has been handled from start to finish is regrettable.

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