Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

As others have stated, this is a technical Bill and I am happy to provide support for it. The Bill provides for amendments to the CervicalCheck Tribunal Act 2019 to extend the period for receipt of claims by the tribunal and provides that the Minister, by order, can extend it on one further occasion, giving a total extension of one year. There is no issue with that as far as I am concerned. I will support the Bill.

It is important though that we pay tribute to the women and families who were so tragically impacted by this failure of the system, and the many women who died as a result of the errors that were made. I also pay tribute to the leadership of the 221+ patient advocacy group, which has done the State and women so much service. The group continues to do the State service in improving the health system. In that regard, I identify Vicky Phelan, Lorraine Walsh and Stephen Teap for the outstanding work that they have done.

I join others in welcoming back Vicky Phelan after her period of treatment in the US. I was delighted to hear her in such good voice and in such good form on Sunday talking to Miriam O'Callaghan. I wish her the very best for her time with her family before she returns for further treatment. I hope everything works out well for her in that regard, as I do for all of the women involved in this issue.

I acknowledge what the Minister said about his meeting with the 221+ group. My concern is that further work could have been done to reach an understanding with them. The decision to go ahead and establish the tribunal probably should have been given further consideration and thought to see if there was a way of addressing the very real and genuine concerns that the 221+ group had in terms of trying to find a non-adversarial route for the tribunal which would not oblige the women to fight the labs. I fully recognise the legal difficulties involved in that, but I think it might have helped if more time had been taken to see if another route was possible.

The Government's position is clearly that the labs may need to be present in proceedings as a third party because they have indemnified the State and will need to take their responsibility and be part of any settlement agreement for compensation. This eliminates the possibility of the State in turn suing the labs and dragging out the number of hearings. While I accept that, I would also say a mistake was made in proceeding to the tribunal without teasing out the full implications of that for women who are to attend the tribunal and be part of what is inevitably an adversarial route, and maybe more time should have been taken in that regard.

Obviously, the 221+ group also wanted applicants to the tribunal who receive an award to be eligible to return to the tribunal if they suffer a recurrence of cancer. I am not sure why that could not have been addressed satisfactorily. I do not believe the Minister responded to that issue in his opening statement and maybe he will in his wrap-up. However, that is a very reasonable request to have made and I feel it should be accommodated.

The 221+ group also has concerns about the statute of limitations, given that a large group may not be in a position to partake because of how long it took to set up the tribunal. It would have been good if there had been a more positive response to that request to extend the statute of limitations. I am not sure why that could not have been done.

All of the concerns that have been expressed by the 221+ group in regard to the tribunal, and all of the issues which gave rise to the need for this tribunal, are issues that have not yet been dealt with. There are two elements that Dr. Gabriel Scally found in his examination of the whole issue. First, there was the fact of the original decision that was taken by the State some years ago to outsource the processing of smears in labs that were outside this jurisdiction, and to effectively move to the private sector to do that. Most of us would accept now that this was a serious mistake. It has given rise to problems, obviously, and it is the reason we are in the situation we are in now, but there are also issues in regard to how the concerns raised by the women can be addressed. There was a recognition of that at the time this issue came to light but we have not yet got to a position where there is full capacity within this country to do the processing of the smears in Ireland and through a State system. We absolutely have to get back to that and we have to be in a position to provide our own service.

The other issue which is at the heart of all of this is the question of mandatory open disclosure. In May 2019, in a review of HSE practices after the CervicalCheck controversy, Dr. Scally found that the deeply flawed policy of open disclosure was still in place at that stage. I know there is legislation on Committee Stage at the moment and it is making its way through very slowly, but that legislation does not go far enough. We know from looking back that when the whole CervicalCheck debacle came to light, many promises had been made and the Government of the day had backed down, finally, before the legislation was due to be introduced to provide for mandatory open disclosure. We also know that the Crowe consultancy team submitted a report on the evidence to support the Independent Patient Safety Council for the development of recommendations on a national policy framework for open disclosure in healthcare in Ireland, and that report was provided in January of this year to the Department.

We need to make amends to the women and families who were so tragically impacted by this incredible failure of our health service to provide basic services and to meet the needs of this group of women. We need to make proper amends to those women and to their families, if that can even be done, but there has to be a significant element of compensation, at a very minimum. The best tribute we can pay to those women is to take the steps that were so clearly recommended by Scally, first, in terms of the processing of smears and doing that within our own public health care system, but also by ensuring there is full mandatory open disclosure, as recommended by the Crowe report. It is regrettable that the Minister did not reference those two fundamental issues which go to the very heart of this debacle, and it would been helpful if he could have provided an update on where we are and what his current thinking is in that regard.

I will leave it at that. Again, I pay tribute to all of the extraordinary women and their families who have been so tragically impacted by this failure of our system and the failure of leadership within the healthcare system which led to this appalling situation. I will be happy to support this legislation going through this evening but so much more needs to be done.

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