Bríd Smith (Dublin South Central, People Before Profit Alliance) | Oireachtas source

I do not agree with the previous speaker that extending the time limit is the only thing that we can do. We could scrap the current tribunal structure and listen to the 221+ patient support group, which pulled out of talks with the Minister because the group was not being listened to. The fact that this Bill exists at all is an admission by the Government and Minister that the original Act has failed. If the Act had succeeded in its aims, it should not be necessary to extend the deadline. The extension is an admission of failure and an extension in time will not address that failure. It has not failed because of Covid, time delays or any other external event. It failed because the Act and the tribunal itself failed the women affected, just as the State has largely, since the start of this scandal, failed those women.

It is astonishing that this House passed the original Act in July 2019 and two years later, just five women have applied to the tribunal. When this Act was introduced, the Opposition, including the current Minister, warned Deputy Simon Harris, the then Minister for Health, that it was seriously flawed, exclusive to some victims, risked being overly adversarial, excluded victims' families and did not offer the supports needed to them, and did not allow for subsequent claims for compensation in the case of recurrence of cancer. The Act has spectacularly failed in its stated aim to provide a fast, cheaper, less adversarial route for women affected, and the Minster's insistence on proceeding with it, despite the concerns of the 221+ group, is an example of how the State has failed yet again to listen to the women affected. If Vicky Phelan's case was just starting today, she would not be eligible to apply to this tribunal. Most of the household names that we are now familiar with would not be eligible to go before this tribunal.

It is clear that the laboratories involved have actively resisted progressing cases in the courts and have tried to delay them. Unfortunately, there is nothing to suggest that this tribunal will be any different or less adversarial and this is just one reason many women have failed to seek to have their cases heard there. It is bitterly ironic that with the current trends, the tribunal is more likely to spend more State funds on itself than on the women affected by the screening failures.

Unless the tribunal is reformed in line with what the 221+ group quite reasonably asked for, it will continue to be a failure. The fears of many of us about this tribunal have been proven correct. It is not about the State making amends to woman affected or following through on its apology; it is about the State circling the wagons and ensuring secrecy about its failures. Two of my amendments have been ruled out of order on grounds of costs. Ironically, the purpose of the amendments was to make the tribunal more open to women affected who are not included in the 221+ or Royal College of Obstetricians and Gynaecologists groups. I ask the Minister how he intends to address the issue, given that when he was in opposition, he seemed to agree with and share these concerns when we discussed the original Act.

I will make some general comments on the CervicalCheck scandal. Women affected by this scandal, and some of us who have raised it here, have had to listen continually to an avalanche of commentators and experts explaining to us that screening programmes are not diagnostic, they are not perfect and it is perfectly natural to miss some discordant slides. Women have been talked down to and told that them raising concerns is threatening the screening programmes that have saved thousands of lives. We are warned that if the legal claims continue, the poor laboratories will have to withdraw from providing the vital service. The hidden and not-so-hidden message has been to shut up and move on.

The women affected know exactly what the natural limitations of screening are and so do I. We do not need that to be repeated. Screening is not a diagnostic check. There will be natural and unavoidable errors in screening. False negatives can mean different things depending on the actual smear. Some false negatives are not negligent. There are different grades of errors in each individual test. I and other women understand that but we also know what negligence is. The CervicalCheck scandal is about negligence. Multinational corporations have paid out millions of euro and the HSE and State have apologised because negligence has cost lives.

The question of how this happened remains unanswered. From the start, I believed that contracting out the screening service to private for-profit laboratories in the USA, competitive tendering for such a vital service, and closing down domestic and publicly controlled laboratories that did the screening were mistakes. Since the scandal broke, we have been repeatedly told that there is nothing to see, to move on, and that the privatisation of the screening programme was not an issue. Ministers and HSE officials have become angry with me at committee hearings for suggesting that there were any connections.

At no stage has the State seemed interested in why catastrophic errors have been made by private laboratories while conducting a service on the behalf of the State. That is astonishing. What we know about the US laboratories as a result of the past three years is that laboratory screeners could examine 100 slides a day, whereas when we had Irish laboratories, an individual screened between 30 and 60. Screening is laborious, difficult work. That is why the NHS and the HSE insist on a high level of qualifications and put limits on how long examiners can screen in one day. Some US laboratories did not have ISO accreditation. Some US laboratories subcontracted cervical check screening to other laboratories. There were only two site checks of the US laboratories in ten years by the HSE.

The rate of false negatives from Ireland that were subsequently judged to contain high grade abnormalities was astonishing. Quest Illinois had an incidence rate five times that of the Coombe, while Quest New Jersey had an incidence rate four times higher and CPL Texas had an incidence rate seven times higher. I did not believe the previous Minister, Deputy Harris, then and I do not believe the current Minister now. The scandal has shown the devastating effects of contracting out vital public services. I thank the 221+ group, which has fought to show this up. Despite their courage, tenacity and dignity, they have failed to get justice. The extension of this tribunal by one day or even by the months that the Minister is proposing will not bring that justice any closer. The State has created an impression that this is a compensation tribunal; it is not. It is just as adversarial as the courts.

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