Colm Burke (Fine Gael) | Oireachtas source

I welcome and thank the Minister for making his presentation on this report. It is important to acknowledge that what occurred was wrong in a sense of the non-disclosure to women when the results of this audit were published. It was a retrospective audit on people who were in a programme of treatment. This information was important to them and should have been disclosed to them when it became available. I would like to pay tribute to the women, and in particular to Ms Vicky Phelan, for coming forward and taking on the system and making sure that the information was out there in the public domain. We would not have this report only for her coming forward and bringing her information into the public domain.

I have read the report substantially and I have marked and flagged various areas in it which I have concern about. The report is a very good study of all of the issues in this area: what was not working properly; what could have been done a lot better; how people felt about the way they were treated; and how this was managed.

Dr. Scally's team had to examine a great amount of documentation. There were over 12,000 documents; 6,958 from the Department; the HSE provided 4,994; and there was documentation provided by the State Claims Agency and the National Cancer Registry of Ireland. We need to look at the whole governance structure that was there regarding CervicalCheck and the disconnect in getting the information out, and a disconnect about the management of the structure. For instance, the programme established a system of governance on 1 January 2007. The national screening service had a board which was abolished on 1 April 2010.It was absorbed into the HSE. There seems to have been a problem regarding everyone working together and communicating. Important decisions were not taken when they should have been. For example, there was no one person in charge. Instead, there was a clinical director and a programme manager. Technically, there were two people in charge but there is the question about responsibility.

The report also refers to people within the cervical screening programme not having job descriptions, not knowing what their job responsibilities were and certain individuals having responsibilities that were not contemplated by their job descriptions. This problem of governance leads on to bad management and a systems failure. There was a systems failure here, which added to the problem.

It is important that when we provide healthcare, we recognise that when, for example, a person is first diagnosed with cancer, it is a really traumatic experience. It affects him or her directly but it also affects his or her immediate family. There is the worry of long-term treatment, there are financial management worries for the family and there is concern about the young children in the family. In this instance, we find that the programme and the system of governance relating to it are not really functioning properly. The latter leads, as in this case, to a fairly problematic system. The lack of accountability between the HSE and the cervical screening programme seems to be accepted within the executive to a large extent. People are moving within jobs and nobody is actually accountable. We need to tackle this. In fairness, Dr. Scally refers in his report to a clear pathway in how we should reform and deliver the service and how to manage it into the future. I welcome the Minister of State's comments that Dr. Scally staying on for another 12 months. We should learn from this to make sure there is never a repeat of what occurred in this case. I welcome the comprehensive report but it is important that we now implement the recommendations contained in it.