Holly Cairns (Cork South West, Social Democrats)
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Every year in Ireland around 290 women get cervical cancer. Almost 90 of those women die from it. In women aged from 25 to 39 years cervical cancer is the second most common cause of death due to cancer. It is the responsibility of individuals, families, communities and the State to do everything possible to drive this number down. This week is European Cervical Cancer Prevention Week and an important week to highlight that cervical screening is one of the best ways to protect from cervical cancer. Recognising the importance of this protective measure, the State provides free, regular cervical screening tests to women aged between 25 and 65. I, like thousands of others in Ireland, am used to receiving letter informing me that my screening is due. I cannot emphasise how important it is to make this appointment. We are all busy and rushing around but this screening is a vital part of health care.

When discussing this, it is important to acknowledge the CervicalCheck scandal. The tragic death of Vicky Phelan is a symbol of this massive and unforgivable State failure. Her dedication and unyielding spirit brought this scandal to light. We now know that 206 women had developed cervical cancer after having a misdiagnosed CervicalCheck smear test. Of these, 106 were not informed of the initial incorrect results. We are still feeling the impacts of this scandal. While I strongly disagree with the Government's handling of much of this matter, including the adversarial tribunal, the important thing for us a public representatives now is to highlight the reforms of the system and the absolute necessity of regular screening.

There has been reform of the cervical screening programme because of Vicky Phelan and many other women who became involved in the CervicalCheck issue. In Dr. Gabriel Scally's final review of the implementation of changes to the CervicalCheck screening programme, he said that women can have confidence in and should take full advantage of the cervical screening programme. It has saved many women's lives and will continue to do so.

Nonetheless, there were issues raised in the scandal that need to be addressed. Open disclosures are crucial to help prevent the likes of the CervicalCheck scandal in the future. The Patient Safety (Notifiable Patient Safety Incidents) Bill 2019 is the main legislative reform to change the culture of the health service through a system of mandatory open disclosure of serious patient safety incidents. However, that Bill is moving disgracefully slowly given its significance. It was introduced in 2019 under the previous Government and there was a nine month delay between Committee Stage and Report Stage. This legislation needs to be progressed. The Bill needs to be prioritised and advanced immediately.

The other major issue which goes to the heart of the CervicalCheck scandal is the commitment for a national screening laboratory. The HSE response to the final Scally review notes that this lab has been commissioned, however there is long delay for it to be completed. Screenings are still being sent to the United States for analysis and while we are assured by experts that this is an effective and reliable system there is still the Government commitment and the public desire for a national cervical screening laboratory, fully staffed with appropriate medics and scientists. This is essential. Will the Minister of State provide an update on this important matter? Although there are outstanding issues, from the CervicalCheck scandal it essential that all public representatives align and advocate for everyone to avail of these really important screening processes.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank Deputy Cairns for raising this important Topical Issue matter which I am taking this on behalf of the Minister for Health, Deputy Stephen Donnelly. This week marks European Cervical Cancer Prevention Week. This is significant initiative in women's health and it is the first time the world has committed to eliminating a cancer as a public health problem. It is a perfect opportunity to reaffirm the Government's commitment to eliminating cervical cancer as a public health problem for women in Ireland.

The HSE launched Ireland's roadmap to reach the global targets set by the WHO. In Ireland we are already well on the way and we are in a strong position to meet the targets. This is due in large part to the introduction of cervical screening and improvements in early diagnosis as well as our HPV vaccination programme. The incidence and mortality rates from cervical cancer are declining. We are all united in our desire to eliminate this cancer, which is within reach of us. We are one of a small number of countries with the best in class testing and offering HPV screening, and this is more effective than previous screenings.

As well as screening we also have a highly effective HPV vaccination programme. Last year the Minister announced an extension to the programme, the Laura Brennan HPV vaccination catch-up programme. It is important to acknowledge the role Senator Martin Conway from Clare played in this. He raised it with me more than three times in the past two years in the Seanad and has been a very strong advocate. This programme now offers an additional opportunity to those who were previously eligible for the HPV vaccine but, for whatever reason, did not get it. The Minister was pleased to show his strong commitment to the elimination of cervical cancer and has invested more than €750,000 through the women's health fund. This is for the strategy, information, and communication campaigns and the new HPV vaccination catch-up portal. Included in this funding is a research element to explore the use of self-sampling of cervical cancer, which may assist in understanding and assessing barriers in marginalised groups when providing cervical screening. Importantly, National Cancer Registry Ireland has reported that, since the introduction of cervical screening in 2008, the incidence and mortality rates for cervical cancer are declining. Women who attended screening were more likely to be diagnosed at an earlier stage.

We know some populations are less likely to take up invitations to screening. CervicalCheck is committed to identifying any barriers to participation and working to overcome these. CervicalCheck regularly runs targeted campaigns to raise awareness among women over 50 that screening is still for them and the importance of taking up screening invitations. Screening at regular intervals is one of the best ways to reduce the risk of developing cervical cancer. It is exciting that we are one of the leading nations in cervical cancer prevention and that we continue to see our programme adapt and evolve. The WHO European regional director, Dr. Hans Kluge, has acknowledged and welcomed Ireland's new roadmap and our commitment, saying they look forward to Ireland as a trailblazer in achieving this ambitious goal.

Most importantly, I urge Members to inform everybody, particularly women, parents, and young adults to get informed about the causes of cervical cancer and to understand how HPV vaccination, cervical screening, early treatment and awareness of symptoms are the key tools to fight against cervical cancer. Cervical cancer is preventable and curable if detected early and managed effectively. The HSE is running an extensive social media and communications campaign to highlight that.

I am conscious the Deputy has raised issues that I have not addressed in the script and which I will bring back to the Minister, Deputy Donnelly, about open disclosure and the laboratory in Ireland. They were not addressed in the script but it needs to be addressed.

Holly Cairns (Cork South West, Social Democrats)
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I thank the Minister of State for her response and for her commitment. I would appreciate an update on the laboratory. The Minister of State is also right to highlight that awareness and accessibility are essential to the success of the programme and ultimately to the prevention of deaths. The Department of Health and the HSE must continue to promote and explain the relevance of the service, and this must include multifaceted campaigns to reach everyone between the ages of 25 and 65. The Minister of State mentioned social media initiatives as being important to reach younger cohorts. We need easy to read information to improve accessibility and translated materials to reflect the diversity of people living in Ireland. On this particular issue I am glad the Minister of State is taking the question instead of the Minister for Health. Accessibility is an issue that is continually raised at the Committee on Disability Matters, especially around women's health. Physical barriers around entering GP surgeries or health centres are still common, and the complexity of transport remains a massive obstacle for people with disabilities in accessing healthcare. It is only right the screening service is free, but the Government needs to ensure there are no financial barriers to anyone who needs to access the service, because it is something disabled women have highlighted to the committee. People with a disability often live on fixed and limited incomes and have to pay for taxis and other transport to avail of services, and that sometimes involves delaying appointments or not making appointments, so we need to do everything possible to avoid those situations. While we appreciate the importance of the service, there are more steps the Government and HSE could take to ensure greater uptake and accessibility. I urge the Minister of State to look at those and engage with all stakeholders to develop a truly universal, free and accessible service. It was Disabled Women Ireland in particular who spoke strongly on that at the committee.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Deputy for giving me the opportunity to come in on that particular piece, and what she has raised is very important. When particular campaigns are being run and women have the opportunity to participate, there should be no barriers, especially when it comes to transport. We know accommodation issues such as access to primary care need to be addressed, particularly where a lady cannot access a particular service for whatever reason. I believe we have learned from Covid-19. We have inreach models and outreach models, so nothing should prevent the opportunity for that person to be supported, especially when it comes to screening. There should be, however, when it comes to all health issues, inreach and outreach options and transport available, which is one matter raised by the Deputy. Transport should not be the sole reason for being able to access it. It is very important that if a person feels there are barriers, he or she should identify those barriers and communicate them, after which we need to address them from a community public health point of view, because that is what it is all about.

Again, I thank the Deputy for raising this in the week that is in it. I pay particular testament to Ms Laura Brennan and her family. I acknowledge again the work the Minister, Deputy Donnelly, has done along with Senator Conway on this issue for the families who have lost loved ones. The Deputy raised many issues that I, as a female, believe strongly need to be addressed in a timely fashion. It should not be adversarial by any manner or means. There should be open disclosure and that legislation should come before us. At the same time, we have the best trained people in the country and we should look at having our own screening in-house and on our own soil.

Catherine Connolly (Galway West, Independent)
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Ligfidh mé don tríú hábhar Shaincheist Thráthúil seasamh ar feadh nóiméid toisc nach bhfuil an Teachta anseo. Bogfaidh mé ar aghaidh go dtí ábhar Shaincheist Thráthúil uimhir a ceathair.