Alan Kelly (Tipperary, Labour)
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This is a hugely important issue. As we all know, the CervicalCheck scandal that broke last year did huge damage to our confidence in the health system in this country. Specifically, I want answers to the following matters. At the time of the response by the Government to this issue, we found out that the Minister had established a review of all the slides of women who had cervical cancer by the Royal College of Obstetricians and Gynaecologists, RCOG. That review was to be concluded by May but it was not as it was not commenced. The Taoiseach said in the Dáil in July that he was very disappointed it had not been commenced. That was six months ago. It was then meant to be concluded before the Scally report issued. That did not happen either. We know now, as of this week, that the Minister for Health has said that the slides are being transferred and the review should be concluded within six months. That will be well over a year. I do not believe it will be concluded even this year.

There are real issues here. In all these cases the women are waiting to find out if they have issues to deal with and, in particular, if there is negligence. It is not acceptable that these timelines are so far out. It will be the end of this year possibly, and it might not even get done this year. That is not acceptable to Ms Vicky Phelan and to the 221 women and families affected.

Furthermore, the tribunal, which was to be set up after Mr. Justice Meenan's review, will possibly not be set up and be in place this year. We have all the legislation on Brexit and on other matters, and which is complicated legislation. However, that tribunal will not be in place and operating until 2020.

Let us not beat around the bush on this matter. I will 100% guarantee the Minister of State that a number of women will end up in the High Court and will have to give the details of their situation in the same way in which the late Emma Mhic Mhathúna and Vicky Phelan and others had to do and it will happen very soon because the Government has not honoured its commitments to ensure these women would not have to go through that ordeal. I guarantee that this will happen. People will come in here and will ask the Government questions, as will the media, because it is scandalous.

I know of one woman who will be going through this process in the coming weeks and she and her family are terrified of it. This woman should not have to go to the High Court. She does not want to do so and wants to avail of this tribunal. It is not acceptable that she should be put through this, given the situation she finds herself in.

What is the status of the slides for the 221 women affected? This has also been delayed for a long time. We have no idea of the outcomes. Why is there such a delay with this? These are the priorities, and the ones we know about. This is outside of the National Cancer Registry and the review that is being done by RCOG. Why have we not got this information yet? There needs to be a reprioritisation of this issue otherwise there is going to be a huge wake-up call for the Minister of State's Government because the public is still focused on it and it supports the women and the families affected. This issue is not being prioritised by this Government. It has gone off the priority radar. I have given the Minister of State two examples - Mr. Justice Meenan's tribunal and the RCOG review. In both cases, they are essentially a year behind schedule.

Finian McGrath (Dublin Bay North, Independent)
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I thank Deputy Kelly for raising this important issue which is one he is doing a lot of work on. This also provides me with the opportunity to update the House on this very important and urgent matter. The Royal College of Obstetricians and Gynaecologists has been asked by the Government to undertake an independent expert panel review of the screening results of women who have developed cervical cancer and who had participated in the screening programme. This will provide independent clinical assurance to women about the timing of their diagnosis and issues relating to their treatment and outcome. Upon completion, each participant will be provided with an individual report, and an aggregated report will be submitted to the Minister for Health. It is the Minister’s intention to publish this report, following Government approval. Over the past number of months, a significant body of work has been undertaken by the Department of Health and by the HSE in progressing the expert panel review.

This has included seeking the consent of women or their next of kin, where the woman has, sadly, died, for participation in the review. This ensures that only those who wished to be involved would have their screening history examined. The HSE also set up a dedicated information line, staffed by administrative and clinical staff to support those invited to participate in the review.

The HSE has noted that the validation of data held in relation to all the women eligible for the review has been a very complex process involving engagement between the National Screening service, the HSE acute hospital division and the National Cancer Registry Ireland. Over 1,700 women or their next-of-kin have been written to, and approximately 1,100 have given their consent to be included. This is a high participation rate of 62%, which indicates a very good level of engagement with the review. The high participation rate will ensure that the expert panel can provide the necessary robust analysis in their aggregate report for the Minister. The HSE has informed the Department of Health that it is expected the process of transferring the slides from the CervicalCheck laboratories to the expert panel review will commence later this month, which is the answer to the Deputy's question. The RCOG expert panel has indicated that it will take at least six months from the commencement of the analysis of the slides, for the review to be completed.

It is of paramount importance that the review is conducted in a way that ensures the quality, comprehensiveness and integrity of the results. The Department of Health is committed to continuous support to facilitate RCOG and the HSE in progressing this review as expeditiously as possible, and this the priority for the Minister for Health, Deputy Harris.

Alan Kelly (Tipperary, Labour)
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The Minister of State said that his response answered the question. The RCOG review will commence because slides will be transferred but this will take a period of time. I am looking for detail on this from the Minister of State. It will take at least six months but I do not believe it will be concluded by the end of this year. That is a failure of this Government.

The Taoiseach failed these women with his foolish commitment on "Six One" that they would not end up in the High Court. They are going to end up in the High Court in the coming weeks and months. I guarantee the Minister of State that. The Taoiseach made that commitment again in conversation with Ms Vicky Phelan, which she has spoken about.

Some of the women who are not part of this audit and who are part of the second tranche through the National Cancer Registry are in a very bad situation, unfortunately. They cannot avail of the assistance that is being given to the women who are part of the audit and the programme that was put in place to support them. That has to change as it is not acceptable. They are in the same situation as the women who are part of the audit but they are not getting the support of the Government. I ask the Minister of State to address that.

There is a backlog of cases where women who are waiting for reviews are waiting up to 20 weeks for checks. There is no prioritisation in respect of women who need to be prioritised. If one is going for one's three yearly review or if one needs to be prioritised, one is still in the same pot. That is not acceptable. When will the 20-week period be reduced to what is an appropriate time limit?

A matter that is really bugging me is that in October I raised the issue of Pembro being made available to all women at stage four cervical cancer whose clinicians advocated for it. The Taoiseach, the Minister for Health and Professor Michael Barry of the National Centre for Pharmacoeconomics, NCPE, said that women would get this. Over Christmas I have been left in the difficult situation of taking calls and receiving messages from women who want to go on this drug. They want to know if they can say "Yes" and start it given these public commitments. The Government, however, has still not confirmed that it will pay for the drug.

I am left in a situation where I had to advise them that in order to help prolong their lives they should take the drug. Why in the name of God has the Government not come out and said that the women will be allowed to take this drug and that it will be paid for?

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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The Deputy is way over time.

Alan Kelly (Tipperary, Labour)
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They are taking the drug on the basis of oral promises made by those three people on the national airwaves. That is not good enough. That is not the way to treat them.

Finian McGrath (Dublin Bay North, Independent)
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I again thank Deputy Alan Kelly. The women in this particular case deserve all of our support. I will personally raise the issue he mentioned about the drug with the Minister, Deputy Harris.

As Members will be aware, the independent expert panel review is one of two reviews undertaken on CervicalCheck in 2018. The completion of the review is a priority for the Government. It is one key aspect of the work being undertaken to ensure the national cervical screening programme is as effective as it can be. Separately, Dr. Gabriel Scally was asked to undertake a scoping inquiry and his final report was published on 12 September last. An implementation plan has now been published on the website of the Department of Health. Significant work is under way within the Department, the HSE and the National Cancer Registry in progressing the implementation of the 50 recommendations made by Dr. Scally in his report on CervicalCheck. Significant funding has been allocated in budget 2019 to support the implementation of the recommendations. In addition, funding will also support the extension in 2019 of the HPV vaccine to boys, as well as the introduction of HPV testing as the primary cervical screening test. The work of the expert panel review, together with the implementation of the recommended improvements in the cervical screening programme, are vital to ensure that women can feel confident in the cervical screening programme. Through a combination of screening and vaccination for boys and girls, we can make cervical cancer a rare disease in Ireland. That is the Government's goal and we take it very seriously.