Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I want to start by thanking Dr. Scally. He has completed what was a very arduous but necessary follow-up report and I want to acknowledge his work over the past year in shining a light on such an important issue. This is a supplementary report, following his inquiry last September, and we have had an additional report into the implementation of his recommendations. I want to recognise that there has been much progress regarding those recommendations.

When Dr. Scally first began the scoping inquiry last year, we all understood that there were six laboratories involved. It subsequently emerged that work had been contracted out to other laboratories around the world. By last September, some 11 laboratories were involved. Another four were then discovered and just last week another laboratory was found. That gives a grand total of 16 laboratories, with two located in Ireland, two in the UK and 12 in the US. The increase in the number of laboratories from six to 16 is deeply worrying. Rightly or wrongly, it paints a picture of secrecy and confusion which Dr. Scally appropriately described as entirely unacceptable. It is not too much for women availing of the cervical screening service to be able to discover where their tests are going. It is certainly not too much to ask - indeed it is essential - that the HSE and CervicalCheck, which is part of the executive, know where those tests are going and have been. It was almost impossible for Dr. Scally to discover all of this information. He claims that information about the other laboratories was as much of a shock to CervicalCheck and the HSE as it was to him. We know that the HSE and CervicalCheck were not told. The contracts specified that they should have been told but they were not.

What do we know? The report suggests that there is no concern about the standards of the laboratories involved, which is a relief, but is obviously not how business should be conducted. We need to know ahead of time that the laboratories are safe and not have to satisfy ourselves afterwards that it turns out that they were. The phraseology that Dr. Scally uses is very important. He stated that he did not find evidence of deficiency. I imagine he chose those words carefully. It is not the same as saying that there were no deficiencies and that everything was up to scratch at all times. We, and Dr. Scally, do not know that. All he could say is that he could not find evidence of deficiencies, which is welcome, but is not a categoric assurance and he is not able to provide that. We know that some of these laboratories are no longer in operation. Unless there are extraordinary records of these closed laboratories - failing time travel - we may never know the detail on a lot of these issues. Had there been problems with those laboratories, neither CervicalCheck nor the HSE would have been in a position to do anything because they did not know about it. We need to ensure that CervicalCheck has the resources needed for contract enforcement and for developing the standards to which Dr. Scally refers.

Perhaps the Minister is aware of this but my understanding is that CervicalCheck was run on a shoestring budget by a very small number of people doing their very best. The clinical lead, Dr. Flannelly, was trying to run this entire programme - one of the best programmes of its kind in the world - on two or two and a half days each week. I will be very pleasantly surprised if there were highly proficient legal and contract enforcement people in the background who could have enforced these contracts. It is something that we must ensure is there in the future.

The big question is where does this leave the women? The HSE says this supplementary report provides further reassurance to Irish women about the cervical screening programme, notwithstanding the issues raised and we must focus on that. The CervicalCheck screening programme, in spite of the failures of disclosure, has been one of the most successful screening programmes of its kind run anywhere in the world from a medical perspective. Some 50,000 women have been identified with high-grade abnormalities. Cervical cancer rates have fallen 7% per year. The programme is an incredible success. It is incumbent upon us all to support the clinicians, the administrators, the GPs, and everyone involved in ensuring that they have everything they need to continue with the medical success of the programme, while obviously getting much tighter on governance and contract enforcement and the ability to ensure there is a global quality standard for all tests.

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