Alan Kelly (Tipperary, Labour) | Oireachtas source

Okay, I do not mind. To be fair, it is a little confusing because there are three sets of amendments to the initial set of amendments. In any event, we will work through them.

On the basis of discussions we have had, I probably will not press my amendment, but the spirit of it was based on ensuring there would be a full understanding of what was required to ensure there would be open disclosure throughout services and screening. My amendment will provide for an obligation for patients to be informed of their right to make a request for a Part 5 review. As part of this, patients will be told they can do so at the point of screening or before that. We wanted to ensure something that was a strong request of the patient advocates, including the 221+ group and everyone else, namely, that this would also be done should somebody be diagnosed with cancer. It would not necessarily have to be done imminently, given it is a difficult period for people, but within a reasonable timeframe, such as three or six months. That is what our amendment seeks to provide for, although subject to how the Minister responds, we will decide whether to press it.

This is a critical issue because of cases such as that of Irene Teap, who found out during the birth of her child about her cancer diagnosis. Women have been told previously that they have the option of undergoing a patient review, but four or six years later, will they remember that? The key ask of the advocates was that if somebody has been diagnosed with cancer, within a given timeframe after that they would be reminded of that option. This was the most important issue we felt was not covered by what had been provided for, and it was deemed essential that this be dealt with.

Under our amendment, therefore, patients will be told post diagnosis that they have this option for a patient review and that will be done within a reasonable timeframe. For me, that would be three to six months. I understand that the Minister will table an amendment to ensure this is covered and that this will be future-proofed by communication he will give directly to the HSE. This is critical. We would not have been able to move forward today if we had not resolved this issue in communications we had before Christmas, last week and even yesterday.

There is one other issue I want to highlight as part of this and I might as well raise it now as it comes under the same bracket. It is an issue that might have got a bit lost in much of this conversation, namely that the audit stopped. Once Vicky Phelan went out to the steps the audit stopped then until now, effectively, and probably will be stopped until this legislation is enacted and operable. What are we going to do to ensure that those women, in particular, have the same access to review as everyone else?

I thank the Minister's officials for the work they have done over the past few weeks, and the past few hours in particular, but I understand that when it comes to legislation that we pass in this House there are often legal issues around retrospection and so on. However, I am sure that as part of this process, the way that the Minister implements this and directs this and directs the HSE to implement it that he can deal with this issue. Anywhere between 1,000 and 1,500 women could have the opportunity to look for that review. Based on the figures that I have calculated with others, that is the number of people who might do that. Although it might only be a fraction who do it, they have to be treated the same way as all the others before that. I have often pointed out, for those women all the issues, around the time lines of what happened to Vicky Phelan, Lorraine Walsh, who is sitting in the Gallery tonight, Irene Teap, Ruth Morrissey and everyone, the variables have not changed in respect of the labs, the process etc. for a considerable period. There have been improvements in the past number of years but for a considerable period after the time that Vicky Phelan's case was settled and dealt with and she came out because the audit stopped those women have not had the same look-back. They have not had the same opportunity. To be frank about it, if they are not a part of it then that is not open disclosure but that is hiding that opportunity from them. As part of this process, I would like the Minister to deal with that.

The amendment tabled by myself and Deputy Duncan Smith was to deal with patients being told post diagnosis that they would have the option of a review. If the Minister's response in the form of his amendments and what he is going to say to this House is acceptable, we will not push the amendment but I want to make it clear here that I expect that to be amendments that will deal with reviews being post diagnosis that will happen after screening that will be a combination of what is in this legislation, a combination of a letter that will be written by the Minister to the HSE directing it on that, that the Minister will stipulate that the patient representatives will be part of the process of putting this in place and, of course, there will subsequently be the two-year review. On that basis I will not press the amendment based on the Minister's reply.

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