Last year, we witnessed the scandal of misdiagnoses of cancer in women in Portlaoise. Following the unearthing of that scandal we had the usual reports from the Minister for chaos in health that this matter would be rectified and that lessons had been learned. We were told management and governance would be improved and that communications failures would be ended. We were promised that new protocols and rapid responses would be put in place and that there would be no more miscommunications of information. Let us consider what happened recently in the north east.

The HSE became aware of misdiagnoses in the north east last November, at the height of the scandal in Portlaoise. In March 2008, when this matter was brought to the notice of the public by Deputy O'Dowd and others, the HSE played it down and said that CT scans were not part of the review. Last week, six months after the misdiagnoses were first uncovered, a bombshell was dropped on the people of the north east. We were told that 6,000 X-rays and 70 CT scans were being reviewed. Not only that, but the communications were completely and utterly botched. Despite the fact that there are more than 100,000 people working in the HSE, this matter was outsourced to a company. Some patients received part of their correspondence, while some received their own correspondence and correspondence for other people. Letters were sent to persons who were deceased, which is absolutely scandalous and upsetting for their families.

For example, there is the case of Anne Kealy. In March 2007 she went for a CT scan and was told she had pneumonia. She went to hospital and contracted MRSA. When she was still unwell five weeks later, her family demanded a new scan. That scan showed that Anne Kealy had cancer in her kidney, lungs and brain. Anne Kealy got two letters last week. The letter she received on 14 May stated:

The x-rays and scans [. . .] will be carefully re-examined by an expert team of radiologists who are carrying out this look back review. . . . [B]ased upon expert medical advice it is our expectation that in the vast majority of cases there will be no cause for concern.

It went on to say:

[I]f you are reading this letter and are not the addressee, we very much regret any distress this letter may cause you and your family.

Anne Kealy died in August 2007. She received two letters this week.

Does this not amount to a cluster bomb of offences? It is a cluster bomb of incidents of mismanagement and further mismanagement over which the Minister for Health and Children, who was re-appointed last week by the Taoiseach, presides. Is the Taoiseach, as a long-standing Deputy and Minister, not ashamed of this situation? We were told last year that lessons had been learned, that new protocols would be put in place and that such a situation would never recur. Why has it taken six months to act in this matter? Why was the family of Ms Anne Kealy subjected to this type of treatment? How many more Anne Kealys have passed away in the meantime due to misdiagnoses and misinformation presided over by the Government and the re-appointed Minister for Health and Children?

Hear, hear.

First, I apologise to the family for any distress caused in this matter. Obviously, there would have been some distress.

Serious distress.

Regarding the question of 4,500 cases, it can unfortunately be the case that, through human error, an issue such as this can arise. It is to be regretted and responsibility for it must be taken by the company concerned. The review of 4,500 cases and more than 6,000 X-rays is a precautionary measure in line with best practice based on the advice received by the HSE from people in this area. The total review of the locum's work was necessary.

It is important to ensure that people's anxieties are dealt with as quickly and professionally as possible. It will take approximately eight weeks before the last of the X-rays and CAT scans are reviewed and confirmed as being in order based on the previous understanding of the situation. It is important that, where errors occurred under the locum, matters such as the one that arose in 2006 and 2007 be dealt with and that the precautionary principle be applied. That 6,000 X-rays are being examined is not to suggest that the same level of danger applies in each case. Rather, a precautionary principle is being applied in 4,500 cases. It is important we recognise this and allow the HSE to conduct its work as quickly and professionally as possible in a way that seeks to minimise people's anxieties.

It is unfortunate the new Taoiseach must be required to continue where his predecessor finished in apologising continually for a litany of mismanagement affecting people's lives and the sensitivities of their families. The Government accepted the Harding Clark findings to the effect that a new system should be put in place to deal with this issue. While the Taoiseach states it is a question of human error, the company selected by the hospital sent second letters claiming the problem was due to an internal process.

The late Anne Kealy's case highlights what has gone wrong. We were told one thing by the absent Minister for chaos and health — that new systems would be put in place and that such miscommunications would never recur — but Ms Kealy, who went to hospital, had a scan and was told she had pneumonia, was told after another scan five weeks later that she had lung, kidney and brain cancer. She received two letters before dying. In 2008, €15 billion is being spent on a system that carries on in this way and experiences a litany of incidents every day of the week.

The review to which the Taoiseach referred states that eight weeks will pass before the final scans will be determined. The process will be completed eight months after the first patient was known to have been misdiagnosed. The House is aware that, after the bombshell in Portlaoise, the Minister for Health and Children appeared in the Chamber because her head was on the line and arranged for clinics that weekend. We saw them on television. What happens to the people in the north east? They are expected to wait eight weeks for the assessment of scans and X-rays.

Shameful.

Consultant after consultant tells us that patients die on waiting lists because they are not seen or assessed. Early intervention and action saves lives. While the people in the north east must wait eight weeks, the people in the midlands had clinics that weekend because the Minister's political head was on the line. Those in the north east are not waiting eight weeks. Rather, they are attending their general practitioners and presenting at accident and emergency units to have scans and X-rays done. I agree with this.

The Deputy is over time.

The Government is over time.

Neither the Taoiseach nor any other Deputy would await a scan's analysis for eight weeks. Will the Taoiseach call in the absent Minister for chaos and health and tell her to make the same arrangement for the people of the north east as applied in the midlands——

Hear, hear.

——to have those scans assessed in the next week and to have the matter finalised, which he is authorised to do and as occurred in respect of Portlaoise? If he does it now, he will take some credit from another shambles in health. People are becoming desensitised to the Government's litany of failures. Despite presiding over an expenditure of €15 billion in 2008, the situation has regressed instead of progressed. Will the Taoiseach instruct the Minister for Health and Children to complete the process in the next week?

Hear, hear.

It is unfortunate the Leader of the Opposition insists on characterising the Minister in that way.

There is nothing else.

Obviously, it is done for political headlines. The serious issue, apart from——

The Government's mismanagement.

——the tactics in which the Opposition is engaged, concerns best practice in the review of these matters. Best practice has been outlined by the expert clinical advice available.

The Portlaoise situation involved established misdiagnoses and making arrangements to have a number of patients re-examined in the Cuisle Centre. The principle in this case is precautionary. More than 200,000 X-rays are carried out in the hospital in Drogheda each year. A locum's work in four cases came under the scrutiny of a consultant at the hospital.

Navan hospital.

In both Navan and Drogheda. We all have a responsibility in terms of pointing out that some 6,000 X-rays are to be reviewed on the basis of a precautionary principle, not on the suggestion of a misdiagnosis in each case.

That is the concern.

Anne Kealy is deceased.

There is a sufficient level of public anxiety without inflaming the issue or misrepresenting it to gain political effect.

The Taoiseach without interruption. This is Leaders' Questions.

The position is clear.

The Taoiseach should withdraw his remark.

I will not withdraw it.

It is not true.

The Taoiseach without interruption.

I listened in silence.

The Taoiseach is totally out of line and he should withdraw his remark. It is not fair on the family in question.

I am simply explaining——

The Taoiseach should spend a week with the families.

The suggestion——

It was outrageous and I have no respect for him for making that comment.

The Deputy should allow me to explain.

The Taoiseach should bring the families to the Oireachtas to apologise.

Deputy McEntee should not speak during Leaders' Questions.

I ask the Ceann Comhairle to allow me to reply to Deputy McEntee. Deputy Kenny spoke in highly charged language.

He spoke the truth.

It was designed to heighten rather than dampen people's anxieties.

The woman is deceased.

I acknowledge people's legitimate anxieties, but there is a difference in this instance in that we are applying a precautionary principle to a large number of files. It is wrong to suggest that an inherent danger of a possible misdiagnosis attaches to them all.

The ones in which people died should be dealt with.

The Taoiseach without interruption.

It does not assist the situation to portray what I acknowledge is a serious matter in the way it is being portrayed. There is a suggestion that the precautionary principle is not being applied. However, if it was not being done in that way, there is a suggestion that a greater number of files should be looked at. As I said, the purpose is to use the precautionary principle across the board in respect of all files with which that individual may have had contact.

The HSE has said that the CT scans were not part of the review.

The point I have made is fair and accurate. The expert clinical advice is that it is necessary to go through these files over this period. The whole idea is to provide reassurance. The way to do so is to follow the advice provided by clinicians who have greater expertise than me or anybody else in this House as to how we should go about it and do it properly. As I said in my initial reply, before Deputy Kenny put forward his robust supplementary question, we are trying to reassure people in a proportionate way, based on the precautionary principle. That is an important point. Deputy Kenny is suggesting that there is an imminent danger in respect of all these files. That is not the situation.

People are worried. They have to wait eight weeks for the results.

I am aware of that.

Why is action not being taken to shorten that timeframe?

Our responsibility is to explain to those who have any concerns and worries that the expert clinical advice available to us is that this is the best way to go about dealing with that anxiety and concern. If somebody else puts forward the idea that there is another way of doing it which is not in compliance with the expert advice, let them take responsibility for that suggestion.

The key point is that patients have to wait eight weeks before the X-ray results are available.

Would the Taoiseach wait eight weeks?

It is only fair to make the points I have made in response to the way Deputy Kenny is seeking to portray the situation.

I do not have to remind Deputy Kenny, who is an experienced Deputy, that the title of the Minister for Health and Children must be utilised and cannot be distorted.

I have no wish to be derogatory towards the Minister for Health and Children.

I am obliged to make that point.

However, it is the case that she is presiding over failure, chaos and mismanagement.

I have no difficulty with political charges being made. However, Deputies must not distort the name or title of the Minister.

I will take the Ceann Comhairle's advice on this occasion.