Mary Lou McDonald (Dublin Central, Sinn Fein) | Oireachtas source

As has been said by others, it is very important that we get this legislation right. It is important legally that we have clarity and we are clear procedurally that what we are agreeing to will work. This is because, of course, women and their families have had the awful experience of the CervicalCheck scandal but as my colleague, Deputy Tully, referred to, that is not the only scandal, and the only hardship and heartbreak, that has emerged as a result of the resistance of the system or systems to simply provide information.

I recall that this legislation is all about the provision of information. It is not about malpractice, or establishing negligence or any of those things, which require separate legal processes, as the Minister is aware. In that spirit, we need to come at this looking to maximise information flow and access to information for the woman and the patient. I say that because, culturally, within the system the reflex action is not to tell. We have all of the evidence of that. I do not know whether the Minister agrees with that assessment but the evidence shows us that the system is conservative or anxious to protect itself, to protect its staff and not to tell. Furthermore, even when mistakes are established, the system's next reflex is to fight those odds, very often through the courts. The women and their families have had that experience. Indeed, some will go into court tomorrow on this. I understand Stephen Teap, the widower of the late Irene Teap, is in court tomorrow. Such legal action is the second instinct. We have to be very real in formulating this legislation. We have to provide the legal basis and the procedural certainty but we also have to be real about the culture in which this legislation will operate.

The reason we are zoning in on this legislation and taking the Minister through his paces on it is simply that we want to be sure that we get it right. There are several parts of this legislation we do not believe that he has right yet. We want to work with the Minister to correct that. A positive duty of mandatory disclosure and candour places the onus and burden of responsibility on the system, clinician and service provider. That is what it does. If it simply places an onus or burden on the woman, or the patient in the case of other screening services, what is that? Not just legally but operationally, what does that say to the system?

The right to review, which I acknowledge was widely consulted on and this is the advice the Minister has been given, is an excellent opportunity for women and patients. However, it is problematic that the legislation does not state, as a matter of obligation, that the woman or patient must be told and informed of their right to that review. The Minister should correct that in the legislation. His proposal to move to an anonymised - I struggle to say that word - look-back or audit is also problematic. If we think about it, in legislation and a system that is all about recognising the right of individuals - not numbers or statistics but real women and real patients - to their information, is there not something kind of ironic and almost inappropriate in anonymising, in totality, that process? That is a mistake. In fact, if we think about Vicky Phelan's experience, and her name echoes throughout this debate, had the look-back been anonymised at that stage and, of course, it was not, would the information regarding the error in reading her slide ever have found its way onto her medical records?

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