Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I will start by thanking Dr. Scally and his team for the work they undertook. The reports are comprehensive pieces of work and we know they were delivered under very difficult circumstances. There was much shock expressed on the benches here and in the media at the fact that information had to be wrestled from the Department in certain instances, which is not good enough. We know, notwithstanding in trying circumstances, that he still managed to produce a report that is comprehensive.

The report seeks to genuinely reinforce and restore confidence in the CervicalCheck programme. The programme has limitations, which we have discussed. It is invaluable, it does and will continue to save lives. I say this as somebody who, like many other women, uses the service and who wants and deserves to have the fullest confidence in that service.

There are many sections of the report that jumped out at me when I first read them. However, nothing jumped out at me more than the chapter on procurement of laboratory services. This section raises a number of questions, most notably as to why the HSE and the CervicalCheck programme reduced the weighting for quality assurance and capacity in the tender process for laboratories to conduct this testing. When I spoke with Dr. Scally, he stated that it was unable to give an answer as to why this was the case. When he had attempted to investigate the contracts and the procurement process, documents and vital information were either missing, destroyed or could not be found. When one looks at the reduction in the weighting for quality and the increase in the weighting for fees, the reduction in the weighting for capacity and the consequent increase in the weighting for fees, we can see that there was an attempt made to get screening services on the cheap. That is certainly what it looks like. They were willing to sacrifice quality and capacity for the right fee. That is wrong and it should not be the guiding principle for any service at all. Clinicians should have been involved. We need to know why the was reduction in emphasis on quality assurance and capacity while there was an increase in the weighting for fees and we need and deserve to have this explained in full.

The report also raises many questions in respect of contracted laboratories using other laboratories without the knowledge of the CervicalCheck programme. I say this as someone whose own test was possibly on its holidays somewhere and I would not have known that.

I would have believed it when I asked my doctor and was told that the outsourcing was to a laboratory in the US. I did not realise then that it could have bounced on to a second and a third laboratory, and possibly then on to another one again. That is not right. Doctors should have confidence when talking to patients. At the outset of the scoping inquiry in May 2018, it was believed that six laboratories had been used. The figure increased to 11 in the middle of the process and we now know it was actually 16. Dr. Scally has not received any evidence from Quest CPL or Medlab that they had notified CervicalCheck in advance in writing in respect of the use of additional laboratories outside those contracted. Nor was he able to provide any evidence that anyone in CervicalCheck, the HSE or the Department actually asked those questions. All we see is a reduction in the emphasis on quality, an increase in the emphasis on price and everybody running around with their fingers in their ears and their eyes closed trying not to ask any important questions about this really vital and important service. While Dr. Scally outlined in the report that the additional laboratories did not result in a reduction in the quality of the screening provided in his opinion, there is no evidence to suggest that deficiencies in screening quality in any laboratory were there because he could not find any. What happened is still not right. Dr. Scally said he could not find any evidence but he did not say that no evidence exists. This was something of an opaque process. The relationships between the contractors and the person conducting the service should have been built on trust yet it appears there was a certain amount of deception. I would say again that those questions were not asked.

Sinn Féin opposed the outsourcing in 2008 when the Fianna Fáil-Progressive Democrats Government introduced it. We did so for good reason and our view has been vindicated. What we see in the Scally report is the loss of control and a loss of oversight. It was a political decision as the clinicians will tell us. We hope that in due course the testing will be repatriated. It will be good for our universities, for jobs and, ultimately, for the health service. It is something clinicians have looked at. We have not had an examination of the results from each of the laboratories and that is extremely regrettable. I do not know how many times I have asked for this and others have as well. We now hear the clinicians saying there is a possibility of what they call cluster errors. That needs to be examined because we are still using an outsourced service. We need to get some answers.

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