Catherine Connolly (Galway West, Independent) | Oireachtas source

I welcome the opportunity to speak on this Bill. I have the most serious concerns about this Bill notwithstanding the purpose behind it and the fact the vast majority of affected women seem to support it, which I will certainly take on board. The background is the roll out of CervicalCheck in 2008 after a pilot project. This is the same year during which we decided to privatise it and run down our laboratories. We gave the first contract to Quest and so we continued. It is difficult to put a figure on this because the figure keeps changing. Whatever Minister is left here at the end of the debate might tell us the up-to-date figure regarding the women affected by this scandal. I have seen it listed at 221 and 221 plus. It is an insult to women to have plus or minus in here. Tell us the exact figures at this point.

The Taoiseach came into the Dáil and told us that there would be a HIQA investigation. That was the understanding at that point. We then agreed to a scoping exercise, which completed its report in 2018. The findings were stark. It was followed by a supplemental report recently. It found that there was an over-emphasis on obtaining the lowest cost from suppliers at the expense of an equivalent emphasis on quality. There were no contract governance controls. It appeared to the inquiry that it was difficult for new services to enter the procurement process. Listen to that one. We go to the private market so that we have competition and then when we look at it, we find that it was difficult for new players to enter the market. The inquiry found that there was a noted over-reliance on contract extensions and so on. I do not have the time to go into it except to note for the record that the findings are damning. We have had those two reports arising out of that.

On top of that, we have the ongoing Royal College of Obstetricians and Gynaecologists inquiry and there are many others along with this Bill, which is being rushed through. I will list the measures. They are the Royal College of Obstetricians and Gynaecologists inquiry, Mr. Justice Charles Meenan's report, an audit mentioned by Deputy Kelly that has been suspended since last year without explanation and the Patient Safety Bill that provides for open disclosure but which is lying around somewhere and has not been enacted. We brought in an ex gratiascheme in December 2018 that has still not been rolled out. We are being told it is being rolled out today.

Into this, we bring a Bill. I understand the Bill but I do not understand the women's emotions being used. The shame and fear should be on the system, not on the women. The women have been through the process and have suffered and the shame is on us. It is on Dáil Éireann for not reacting properly and quickly and for continuing, through the Taoiseach, to make mistakes. An example would be the case of Ruth Morrissey, that is, not saying it was appealing it and not communicating it properly. We have had mistake after mistake regarding how information was disclosed. Shame on the HSE and the system. Shame on the laboratories. Dr. Gabriel Scally's supplemental report tells us that he persisted so he got more answers. Just recently, I asked whether he would have got more answers if he had persisted further. Would he have found out that there were more laboratories, not just 16? It took two reports to find there were 16 and Dr. Scally is now reassured by the same laboratories that they did not feel they could tell the truth in the first place - let me rephrase that, that they could not disclose in the first place that there were a lot of laboratories.

We then introduce this Bill because we want to avoid women having to talk in public. I respect that, which is the women's choice, but it should never be our choice. I have a serious worry about why we are introducing this in this manner. I have looked at it. We have never done it before. I have looked to see whether there were any precedents but there are none. Through what I see in the press and various statements, the women want a less adversarial system, as does Mr. Justice Meenan, who came up in an adversarial system. He makes suggestions for a non-adversarial system but, actually, it is an adversarial system. Women deserve the truth. It is an adversarial system except it will be behind closed doors. If that is the choice of each woman as she goes forward, I have no problem with that. I would have preferred it to be in public and at the discretion of the women who might want it in private. That would restore the balance somewhat rather than the other way around.

Regarding the Bill and its adversarial nature, it is on all fours with cases in the High Court. The Bill sets that out and, of course, it has to because access to the courts is fundamental. It is not a tribunal of redress because, as was clearly pointed out by Mr. Justice Meenan, there are serious problems with liability - liability relating to the laboratories and whether they were negligent in reading the slides and then what liability is on the State for not telling the women on time through its agency.

Regarding disclosure, I will deal with the last part of the Bill - restoring trust. I think that should not be part of the Bill. If we want to restore trust, we should do the right thing. Let us tell the truth and use language to mean something. Any institution should be able to hold meetings as a fundamental part of its governance. It should be able to talk to the patient, explain what happened and give maximum information. The part of the Bill about restoring trust is disingenuous.

The Bill is being brought before us ostensibly on the basis of Mr. Justice Meenan telling us that we need a non-adversarial system on the basis that it is quicker, more efficient and less costly, although this is adversarial. There is no evidence before us that this will happen. We are told it is based on Mr. Justice Meenan's reports almost verbatim. Well the Statute of Limitations is not being followed. It clearly has been changed. I have difficulty understanding it but it has been changed to nine months. The Minister of State might try to explain that to me. Why must claims be brought within nine or six months depending on which is the furthest out?

Regarding the matter mentioned by Deputy Kelly, I reiterate the point about determinations having to go before the High Court.

We then put it back to the High Court for it to tell us if the determination is correct or not. We have absolutely no information as to how the High Court judge will decide that. How will the judge decide if that determination is right or wrong? We have no timespan for that determination and then it will go back again to the tribunal.

Consent can be withdrawn at any point. It needs to be spelled out that this tribunal is similar to the Personal Injuries Assessment Board where the consent of all parties is necessary. If the consent is not forthcoming, then the tribunal cannot be used. If the consent is forthcoming and it is in writing, it can be withdrawn at any point. I have serious concerns about a laboratory which has failed to disclose it has labs in Honolulu - God knows where else because I cannot remember their names as they are so exotic – 5,000 miles from this country with four or five different time zones. A lab could enter into this process and withdraw at any time. Where does that leave the woman or the proceedings?

On protocols and speed, I do not know when the tribunal will be introduced. When will the Minister set it up? Issues have been raised regarding the ongoing court appeal and what consequences that might have for the tribunal. Is there a completion date? Have premises been picked? Has the Minister any idea as to how many women will be covered or take part in it? What about the women who are excluded by the narrow terms of reference? We have those who were included because of the review, as well as those who will be included as a result of the ongoing Royal College of Obstetricians and Gynaecologists investigation. What about the other women? I have gone through all the reports in detail but am more confused than ever as to how many women have been affected and what we are providing for with this legislation.

I am worried about some of the provisions relating to costs, particularly if the chairwoman of the tribunal wants to get expert advice or appoint counsel. She needs the consent of not just one but two Ministers. I have a difficulty with that. On every occasion I have taken the opportunity to stand up for those affected and fight for justice for them, as have all my colleagues. However, I am not sure that it has been clearly explained to them what is involved. I am reluctant to say it but I believe there is a sleight of hand or a certain disingenuousness regarding this matter.

Mr. Justice Charles Meenan outlined that, to date, the system has been efficient and that the cases have gone through quickly, notwithstanding what Ruth Morrissey went through for a long time. In her case, that was because liability was being fought. All the protocols are already in place. Mr. Justice Cross made specific provision with barristers and solicitors that cases would be pushed through. Questions arise as to what is causing the delay. The courts are an easy target. I am no defender of courts or high costs for barristers or solicitors. When I see them being misused, however, to justify something which has never been tried before in the context of giving more speed and efficiency without any evidence before me, then I have a duty to raise those concerns.

When will the tribunal be set up? What premises will it sit in? Have premises been identified? What number of staff will the tribunal have? Have the consequence been totally explained to the women involved? What consultation has taken place to explain to them that this process is absolutely adversarial? Mr. Justice Meenan went out of his way to say that we should try to make it less adversarial by taking written statements from the women involved. That is nowhere to be seen in the legislation. Several other suggestions have not been taken on board. They cannot because there would be great difficulties in terms of justice and applying the law.

In the guise of a non-adversarial system, we have an adversarial system behind closed doors. I will finish with a report on a matter which is still prevalent in Irish society. The Irish Timeson 25 June contained a report on a hospital in Kilkenny where tests were carried out on women without their permission. I will not go into the physical aspects of the case such as the flushing out of the vaginas of the women in question and so on. The newspaper report stated, “The equipment involved, including tubes and pressure gauges, was brought in from outside the hospital.” The professor involved said the issue “had more to do with preliminary, exploratory work – as to whether you need consent for that”. It was an open question. He personally did not think consent was necessary for carrying out the procedure involved on a woman’s body. He got worse when he “stressed that no patients were harmed, adding they did not even know it is being done.”

Something of similar mentality pervaded the whole scandal of the cervical smear tests. It was a case of the professionals knowing best and that they would decide when it suited them to tell women what they should have known from the beginning. If we do not learn from that and we do not look at this legislation, then this is a complete sham in this Dáil.

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