Catherine Connolly (Galway West, Independent) | Oireachtas source

Fáiltím roimh an deis páirt a ghlacadh sa díospóireacht seo.

I accept the apology, which was the right thing to do, but for it to mean something, we will need action. Earlier, I raised the issue of the public hospital in Galway. Last week, Caranua appeared before the Committee of Public Accounts, of which I am a member. In 1999, the then Government made an apology to those who had attended residential institutions. When Caranua appeared before us, it was a perfect example of an institution having become far more important than the people it was there to serve.

Apologies can be given. They are very important. It is what the women in question deserve, but action is also necessary. I regret that within the Taoiseach's statement, of which I do not have a copy, I did not hear the Government take responsibility for the mistakes made by each Government during the debacle. In the chapter of his report entitled Women's Health, Dr. Scally states:

One key point that surfaced on several occasions was that most of the doctors involved in the disclosure (or non-disclosure) process were male. This, and the general way in which they felt they had been treated, led the women to develop concerns that the attitudes and lack of openness were accounted for by paternalism in the healthcare system.

The culture of paternalism and "we know best" has been mentioned but there are many further serious issues with decisions made by Government after Government. On the same page, Dr. Scally states, "There was a period when women’s health was taken very seriously." Can the Government imagine that? It should be grateful for that. He does not go on to say it is taken seriously now but states:

In 1997 the then Health Minister established The Women’s Health Council (WHC) with a remit to advise the Minister ... It had a comprehensive list of functions ...

That was then. Over the period CervicalCheck was in operation, I sat on a health forum in Galway. We knew then that the wrong decisions were being made by the then Minister for Health and Children, Ms Mary Harney, and her colleagues in respect of the matter. It simply should not have been done. More important, the people involved in the laboratories appealed to us and begged us not to allow it to happen but still it went ahead, in a manner whereby women's lives did not matter but the cost did. That is the underlying theme of the issue, namely, that women's lives were incidental to the cost, which was uppermost at all times.

A few passages of the report are worth highlighting. I have read all three reports, the first of which was minimal. It was followed by an interim report and then the final, detailed report by Dr. Scally. What strikes me as I read his report is that if we let him continue to investigate, he will uncover more issues. When we gave him free rein to return to his inquiry, he discovered there were laboratories in Honolulu and many other places. The more he searched, the more he discovered, which is interesting. Where do we stop Dr. Scally in his uncovering of issues about which the HSE and the Government knew nothing? The system in place was not perfect but, gradually, Government after Government made decisions including, as has been mentioned, abolishing the health boards, the Eastern Regional Health Authority and the independent board of directors.

We are told by Dr. Scally that from 2010, CervicalCheck did not have an accountable senior person responsible for the delivery of the programme. That is a Government decision. Staff recounted how the bank guarantee occurred three days after CervicalCheck was launched nationally in September 2008. As the financial crisis contributed to an economic recession, public sector programmes and organisations saw a reduction in the level of resources afforded to them, with CervicalCheck no different. As its budget was reduced, CervicalCheck struggled to replace departed staff adequately. Such decisions were made at Government level.

I turn to the chapter on CervicalCheck within the HSE governance system. Dr. Scally states that screening was downgraded, having been absorbed into the HSE, and staff felt they had little influence within the HSE as a whole.

In 2017, there was an appreciation at the top level of the HSE that not all was well. There were several findings and then a number of recommendations. The report made a series of eight recommendations. I do not have time to read them out but they are outlined on page 33 of Scally's report. Surprise surprise, nobody knows what happened to those recommendations but they certainly do not seem to have been implemented.

The board was dissolved, which meant the removal of an external, independent input into the running of the Health Service Executive at the highest level. The Scally report concluded what we really all knew, at great cost in deaths, suffering and the mental and physical health of the women. It confirmed the failure of CervicalCheck to tell women. We knew it afterwards. The crisis centred on the failure of CervicalCheck to tell women about their own medical information and disclose to them the results of a retrospective audit of their screening history carried out after they had been diagnosed with cervical cancer. A paternalistic milieu, a "We know best" attitude and economic decisions made by Government after Government led to this.

When giving an apology, it is extremely important to put the apology in context. It is important to listen as well. We have only a short time. We on this side of the Dáil have repeatedly been dismissed for being left and radical. I have been quoting Dr. Scally and the staff that worked for CervicalCheck throughout. I have listened to the women. When the Taoiseach gives an apology, I ask him to please put it in context and tell us what he will change. He should tell us how many of the 50 recommendations have been implemented. Following publication of the MacCraith report, will the Taoiseach tell us when the outsourcing is going to stop? That is the kernel of this debacle, along with the milieu and the culture. When will that stop?

On the role of the State Claims Agency, I note Ms Ruth Morrissey has been mentioned. Some clarity on that would be very helpful. Finally, I wish to raise a serious issue that shows the system is not functioning in an open and accountable way. None of this would have surfaced without the bravery of the women concerned, particularly Ms Vicky Phelan, who refused to sign a non-disclosure document. All of us would understand if she had done so, given the pressure she was under. She did not succumb to that pressure and neither did the other women. These are just some of the key issues in this debacle. With the Taoiseach's apology, let us hear context, practical recommendations and steps towards taking this vital service back. Let us look back to when women's health was theoretically important, in 1997. It is now 2019. Let us make women's health important.

See this speech in context