Simon Harris (Wicklow, Fine Gael) | Oireachtas source

I am very glad to address Seanad Éireann this afternoon on this very important issue which has arisen and which I know has caused a great deal of concern, particularly to women, right across the country. I thank Senators on all sides for providing me with an opportunity to address them today. I reiterate my gratitude to Vicky Phelan for her courage in bringing this issue to light and acknowledge the important role she has played in highlighting a number of weaknesses in respect of how people have experienced our national cervical screening programme, CervicalCheck. I wish to provide the Seanad with an update on the actions the Government has taken since the full impact of this issue became apparent. As Senators know, I took immediate actions, including: sending a serious incident management team into CervicalCheck to get to the bottom of the information that was emerging about the extent of non-disclosure; ordering an immediate change to the process, which was not ensuring that women were automatically informed of reviews of their screens; and announcing that we would have an international review. The Government has since taken a series of further actions, including the establishment of two clinical reviews by international experts: one in respect of the individual cases of women whose screening results were reviewed and who were not told; and a second to conduct an audit of all previous screening results of every woman diagnosed with cervical cancer in the past ten years. All of the work under way as a result of these actions will, of course, feed into a wider inquiry on this matter.

Last evening, I met members of other political parties and groupings in the Oireachtas to discuss the best way forward on the issue. It was agreed that there is a need for early answers here and, as a result, I am now working on a scoping inquiry which will led by an international expert and which, I hope, could conclude by June. I consider that to be an important approach to establish some basic facts which can be quickly put in the public domain, while also identifying issues which may merit a full statutory investigation and developing terms of reference for such an investigation. Let me say clearly that I think we are going to need a commission of investigation with full statutory powers so that people might find out who knew what, where and when and in order that we might learn from this. What we do not want to do - I am conscious of what Vicky Phelan said we do not want to do - is jump straight into a process that could go on for a period. What we need to do instead is gather as many facts, data and information as we possibly can through a scoping process, let that process also benefit from the knowledge of the international medical review panel and allow the scoping process talk to women who have been impacted, engage with them and come up with draft terms of reference as well.

I want to say on the record of this House that it is my clear intention that the process will include engagement with Vicky Phelan and other women who may wish to have an input. Last night, I also invited party spokespersons to continue to input into the consideration of this matter and I intend to bring a proposal to Government next week. It is important that the Government moves forward in respect of this matter next week. We have had a lot of very important discussion this week but now we need an independent expert to get to the bottom of who knew what, when and where, gather the basic facts and look at the terms of reference - and also the process - so that we could perhaps have a modular process to get the answers for women and also the answers that our health service needs.

For the information of the Seanad, I would like to again go through some of the numbers and facts which have been established. When the controversy surrounding Ms Phelan's case came to light, the HSE initially advised that between 2008 and early 2018, 1,482 cervical cancer cases were notified to CervicalCheck. The majority were women who had already been referred for further investigation or treatment by CervicalCheck. As part of the clinical audit process, these notified cases were re-examined and 277 were flagged for further cytology review. In 208 of the 277 cases, the cytology review recommendations differed from the original test. On Friday, 27 April, the HSE established a serious incident management team at my request to go into CervicalCheck and oversee and direct the management of this incident. The serious incident management team has reported that, as of yesterday, 172 of the 208 women involved have now been informed of the outcome of the audit process and arrangements have been made for them to have appointments with their treating clinicians. Efforts to reach the remaining 36 women are ongoing and I expect that this work will be largely completed today. I sincerely regret to say that 17 of the patients involved are deceased and I express my sympathies to their families. In these cases, contact is being made with the next of kin. Let me be clear about this: where a woman is deceased the next of kin, the family, has every right to know and be contacted and that will happen.

Arising from the work of the serious incident management team, it transpired that the number of cases of cervical cancer notified to CervicalCheck does not represent all cases of cervical cancer occurring in Ireland since the establishment of the CervicalCheck programme in September 2008. That was a most astonishing revelation which was brought to my attention approximately 20 minutes before I was due to address Dáil Éireann and take questions and hear statements for the best part of four hours. At that late stage, I was landed with the fact by an official that there may be many other cases. It is the most frightening position to be in, namely, when one hears that what one has been told and what one has truthfully been putting out there now may not be factually correct. It is not frightening in the sense of looking for sympathy for me but it is frightening knowing that I had a choice to go into Dáil Éireann and tell the truth of what I knew but also that it would add to the uncertainty and concern of women throughout the country. I find the situation appalling and it is one I want to get to the bottom of, because regardless of whomever is the Minister for Health of the day - across party lines - citizens in this country should expect that the facts that are given to a Minister are the facts.