Darren O'Rourke (Meath East, Sinn Fein) | Oireachtas source

I welcome the opportunity to speak on this group of amendments and on this legislation. One of the central findings of the CervicalCheck scandal was showing up in lights the paternalistic nature of medicine and healthcare in Ireland. Ireland is not unique in that regard but we have a particular history, especially when it comes to women, poor people and people who are disadvantaged. In response to that, there are clear asks to address it. One of the things I took from the Scally report and this whole dreadful experience is there is a need for a culture shift. There is a need to address that information imbalance that exists between doctor and patient. It was at the heart of the CervicalCheck scandal and how these women were failed.

The absence of the statutory duty of candour is a glaring omission that does not address the key issue at the heart of the scandal. The question of whether we can go further and do better must be asked. We all appreciate these are complex issues, that there are considerations, that no two cases are the same but after everything that has gone on, after all the dreadful experience, this is a unique opportunity and we in these Houses are uniquely placed to respond, to address those failings and to introduce legislation and a process that is fit for purpose and at its heart constantly shows people their information is their information. It is about saying that exchange or transaction, for want of a better word, between a person and their clinician is an equal transaction. The person is not a part of a broader system. Their sample, their cells, their biopsy or tissue material is not in a system for the sake of developing and improving a system but is instead a central part of that transaction between patient and doctor.

At the heart of this is the need to ensure confidence in CervicalCheck. Central to the lack of confidence, or the hollowing out of confidence, is the experience of the scandal. Related to that was the decision to outsource cervical screening. I worked in our hospital laboratory system in advance of that decision. Through my role as a union representative, I , along with other medical scientists, could see clearly what was going to happen with cervical screening if it was outsourced. We also saw the motivation. It was a cost-saving exercise. Of course, the HSE had alternatives. It could have resourced cervical screening in Ireland but it did not. It was part of a broader strategy. At the time, we invited those private laboratories that we outsourced cervical screening to into Ireland. It was not just cervical screening that our Fianna Fáil and Progressive Democrats Government wanted to give them. It wanted to give them hospital and GP diagnostics as well. They now have facilities out on the M50. They did not come here to do private testing; they came to do public testing, and a Fianna Fáil-PD Government wanted to give it to them. It outsourced cervical screening, with detrimental impacts. Thankfully, thanks to the efforts of union representatives and workers, it did not outsource the public and GP work.

We need to re-establish confidence in the cervical screening programme by investing in and resourcing our laboratories. We need to repatriate cervical screening and bring it back. We need to do it in accredited labs. I recall the shock when people learned that many of the labs that cervical screening was outsourced to, and subsequently outsourced from the outsourced laboratories, were not accredited, but many of the laboratories in Ireland are accredited only on a voluntary basis. They are not supported or resourced adequately to be accredited. That needs to be addressed. We need to train up cytologists and we need to bring that work back to Ireland to give people confidence in it. We also need to establish this legislation and the process, to ensure that women can have confidence in the process so they know that when their cells and samples are in the system that they will have as much access to the information as their clinicians. To do that, we need a clear statutory duty of candour in the Bill.

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