Pauline Tully (Cavan-Monaghan, Sinn Fein) | Oireachtas source

As many of my colleagues have stated, this is not about the Bill - there is no issue with the Bill - or the amendments. It is about transparency and ensuring mistakes of the past are not repeated. A doctor or clinician should be obliged to inform a patient of the right to a Part 5 review at the time of diagnosis, but that is not the case under the Bill. The Bill does not provide for a statutory duty of candour. It does not place an obligation on the doctor to inform the patient where an error was made or an inaccuracy discovered. It does not matter how big or small the error is; every woman has the right to know that information about a test result. We want to encourage as many women as possible to undergo smear tests and avail of screening but those doing so need to have confidence in the system. They have rights, and those rights must be protected. If mistakes are made by a doctor or service or the system, there must be a forthright acknowledgement of those mistakes.

It is not fair to put the responsibility on the patient but place no obligation on the clinician or service to make an open disclosure where a mistake has been made. That applies to all screening services or tests of any sort, whether cancer screening or otherwise. The onus should not be on the patient to request a review, reply or explanation. It should be her right to receive that. The Minister argues that the anonymised audit means it will not be possible to identify a patient where a slide reading is discordant, but the system could be redesigned to allow for that, especially in the case of severe misreadings that are outside the accepted margin of error.

So many people have been failed by the health service. The biggest hurt of all is the failure of the health service - the HSE or individual hospitals - to acknowledge mistakes, give people answers or issue an apology. Instead, people are being forced to go to court to get the truth. They are put through a lengthy legal process, often at a great financial cost but a bigger emotional toll, to get truth about an issue that affects them or their family. I have heard from families who lost children in childbirth or whose child is severely disabled due to mistakes made at the hospital. As well as dealing with the loss of a child in some cases, they are dealing with a wall of silence in respect of what happened. That forces them to go to court. The same is true for families whose members had organs retained without their knowledge or agreement. Again, they receive no answers. It is just not fair.

There is a need to pass the Bill but we, as legislators, must ensure it is thorough before doing so. That will ensure the mistakes of the past cannot be repeated. We need a better system going forward and we need to give people confidence that the health system will be better in the future than it was in the past. Mistakes will be made, but they must be acknowledged, owned up to and explained to the people.

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