On 23 November 2004, almost three years ago to the day, the Minister for Health and Children introduced the Health Bill in this House. She stated that, "the two ways Government health policy should be judged; better outcomes for patients and better value for taxpayers' money. To achieve them, we badly need clarity of roles and accountability, political responsibility for the Minister and management responsibility for the management." She specifically stated, "as it is, the Minister and the Government is responsible for setting overall health policy and it is essential that the Minister has the power to inform the executive of policy decisions made and to direct it to carry out its duties in compliance with Government policy. The executive is also required to provide the Minister with any information or statistics relating to the functions of the executive which may be requested."

Whatever we got in recent weeks, or whatever the Minister got from the Health Service Executive, she appears to have got very little information or statistics. Later this evening, we will come to the question of the political and management accountability that she herself so accurately described and set the parameters for when she introduced the Health Bill three years ago.

When the scandal in Portlaoise came to public attention, both Deputy Kenny and I raised questions with the Taoiseach in the House about what happened in Portlaoise. He told us that Dr. Ann O'Doherty had been appointed to carry out some kind of an inquiry or review into what happened in Portlaoise and that he could not give us or the public any explanation for the events in Portlaoise and the misdiagnoses until that report was completed and available.

On 6 November 2007, the Taoiseach informed us specifically that the review would be completed that week and would be published by the end of the month. Is it true that the report has been completed and, if so, where is it? When will it be published? Why has it not been published before we debate this issue in the House this evening? Is it true that Dr. O'Doherty did not interview the consultant radiologist who has been put on administrative leave? Three months after it came to the attention of the Minister for Health and Children, do we now have an explanation for the misdiagnosis which took place in Portlaoise and which has been added to by the truly horrific addition of 97 other cases in the course of the past week?

A number of questions were asked about Portlaoise. The Minister learned on Wednesday of last week about the existence of a separate review of ultrasounds that was under way in Portlaoise, in addition to what had been previously announced, namely, a review into radiology services in the hospital being undertaken by Dr. Ann O'Doherty at St. Vincent's Hospital. That review is being undertaken by a team led by Peter Naughton, a consultant surgeon in Portlaoise. Deputy Gilmore is aware of the circumstances of how that came to light last week.

I previously stated in the House that Dr. Ann O'Doherty is examining the earlier cases, and that is the position. That report is not completed but is in draft form. I cannot give Deputy Gilmore information on who Ann O'Doherty spoke to. I will inform him when we see the completed report. I understand the report will be published but, obviously, as with all medical reports, it will have to be examined for the purpose of legality and redacting of issues. That will not happen until the final report is available.

The Health Service Executive has appointed an advanced nursing practitioner who will co-ordinate the initial nine cases. Dr. Ann O'Doherty's job was to go through the 3,707 mammograms. As Professor Arnie Hill said yesterday, extraordinary work was done by Dr. Ann O'Doherty. It would be considered a very good work rate for a top class professional to do that many in a year but she did that in a short period of time. I do not think Deputy Gilmore meant it, but I do not wish it to be implied in any way that there was a delay of three months. Dr. Ann O'Doherty did the work of any other top class professional in a very short time and I praise her for that. She went through 3,707 mammograms and nine cases require to be followed up. An advanced nurse practitioner has been appointed to co-ordinate further treatment for these initial nine cases as a result of the review of the mammograms in the hospital.

As I said on Friday, I thank Professor Arnie Hill and his team for working all day on Saturday. They saw more than 80 patients in that time. Those whom they thought would require further clinical treatment were sent to Beaumont Hospital where a breast clinic was set up on Sunday morning. Staff were also on stand-by in St. Vincent's Hospital. The other people whom they were not able to contact were seen yesterday. A final special clinic will be provided by surgeons this evening for the remaining people who have been contacted and are available. A small number of people still require surgical review and this will be provided on a priority basis.

Given that this is something which came to light on Wednesday night or Thursday, it is an indication of the extraordinary dedication by the team involved to have contacted, seen and undertaken a review of the clinical records and diagnostic assessments of these people, with the remaining few being seen tonight. I thank the team involved. I thank also the person who brought all this to light in the first place. Otherwise, we would have known nothing about it in late August.

I am not reflecting on Dr. O'Doherty, as the Taoiseach well knows. The Minister stated in the House in a reply in early November that Dr. O'Doherty's investigation would examine the mammographies and the ultrasounds. By whom or where was it decided that there should be a separate investigation by Peter Naughton into the ultrasounds? The issue I raise does not relate to Dr. O'Doherty's work, but when we raised the matter with the Taoiseach earlier this month, he told us Dr. O'Doherty's report would be ready in a week and that it would be published by the end of the month. It is now three months since the Health Service Executive and the Department of Health and Children first became aware of the problem in Portlaoise and neither the Taoiseach nor the Minister for Health and Children appear to be in a position to give the House or the public any coherent explanation as to what exactly happened in Portlaoise. All we seem to find out is that the problem is getting worse with each passing week.

Later this evening we will address the Minister for Health and Children's accountability for all this. If the Taoiseach were to give his Deputies a free vote on this issue this evening in the House, I do not think there would be any doubt about the outcome.

Hear, hear.

This House does not have confidence in the Minister for Health and Children, nor does the public and the staff of the health service. When will an explanation be given to the public and to the women concerned about what happened in Portlaoise, or is the Taoiseach's concern now related to protecting the Government and the State from any possible claims for compensation that might arise?

My only concern from the outset, as it is with any medical, surgical or health issue, is for the individual, that we provide the best service at any time and the best medical standards we can, and, if something goes wrong for whatever reason, that we try to correct that to the very best of our ability in the interest of patient health and safety. That is my only concern.

I do not know why Mr. Peter Naughton, the consultant surgeon in Portlaoise, decided to carry out a review of ultrasounds separate to the work being done by Dr. Ann O'Doherty on the mammograms. I am not a consultant but, from what other consultants have said, I assume Dr. Peter Naughton was trying to be sure. He was checking and going back over issues where he thought perhaps something was missed. That is what it seems he was doing. That does not appear unwise, given that other people were involved and in the circumstances of somebody's work being called into question. Dr. Ann O'Doherty is an expert in this area and she has been praised by all her colleagues for the work she has done. I accept Deputy Gilmore would add his praise to that. I am sure she has been trying to go through the 3,707 mammograms. Writing the report is important but it is secondary to that job. When we have her report, we will deal with it. I will not put pressure on her, other than to do that. We will have the report when it is available and then we will deal with the issue.

I do not wish to take great issue with Deputy Gilmore, but if he checks the record of what I said on the first day when this came up, I said I would not stand up in the House as a non-medical expert and start making comments about what one did not have to be much of an expert to see. The consultants who examined this did not believe that the service given by somebody who had misread a number of these mammograms was satisfactory. That was their view and that is what I said. However, I said that was not a judgment I was in a position to make, nor was I going to blame somebody I did not know. I was not competent to do so. What I said was that I believed there were issues surrounding the medical competence of somebody reading these mammograms and it appeared that others, who were experts, believed that this rate of error was not acceptable. Rather than a judgment being made by me or any other lay person, Dr. Ann O'Doherty was brought in to make it. We will see what that judgment is in due course. That is the position.

I do not agree that this was left sitting for months. Decisions have been made about moving services, reviewing cases and bringing in experts to assist the unfortunate people who had to go through the shock and hurt of what happened, for which everybody has expressed regret. I do not believe that the Deputy's comments are fair.

If Deputy Gilmore had a free vote on his side of the House, a large number of his Deputies would vote for the Minister, Deputy Harney, tomorrow night. That is my view.

Why does the Taoiseach not try it?

That is a good challenge. Throw down the gauntlet.

There would be the meeting of the year after that.

In my view, Deputy Gilmore would be holding them back at the door.

I accept that challenge.

The time has expired.

Let us have a free vote on the issue.

Deputy Gilmore has already made his intervention. The Taoiseach is some way over his time limit.

Tonight and tomorrow night we will return to the amazing amount of good reform being carried out by the Minister for Health and Children.

She speaks of it, but does not implement it.