Before taking Leaders’ Questions, I call on Members please to stand as a mark of respect to those who have lost their lives or been seriously injured as a result of the horrendous activities in Gaza.

I appreciate the opportunity to express sympathy and to talk about the issue later.

Last Thursday, at a meeting of the Committee of Public Accounts, three memorandums, dating from March and July 2016, revealed that the CervicalCheck management team, the leadership of the HSE, the acute hospitals division of the Department of Health and the Chief Medical Officer had all shared and discussed memorandums related to the CervicalCheck cancer screening audit, as well as decisions on communicating with treating clinicians and not directly with the women concerned.

What was noticeable in these memorandums was the absence of prioritisation of the needs of the women in question and their families and communicating with them, particularly the families of women who had died from cervical cancer. They reveal a mindset focused on managing the risk to the programme and potential negative repercussions, rather than the needs of the women and their families who are simply not prioritised. They also reveal a policy of containment and concealment.

The Minister for Health, Deputy Simon Harris, has stated he became aware of the Vicky Phelan case on 16 April last via a memorandum. I regret saying this but there has been an absence of political leadership in the Department since then. I cannot understand why the Minister did not summon people to his Department there and then and tell them he wanted all documentation pertaining to this issue produced within 48 hours, after which he would make it public. That did not happen and, as a result, the Minister and Government have been apparently caught unawares by the revelations of the Committee of Public Accounts. This reflects a lack of strong leadership and management of the issue in the Department.

Emma Mhic Mhathúna's public interviews, particularly her interview on "The Late Late Show" last Friday, and interviews with members of other families caught up in this terrible scandal have captured the hearts of Irish people. People are saddened, angry and, in some instances, confused about the entire scandal. They require political leadership on this issue.

The statement by the Department on Health on Thursday night leaves many questions unanswered. We need clarity and I understand further documentation will be published and released today.

I have some basic questions to put to the Taoiseach in order that we can get some answers on the record. Did the chief medical officer or personnel in the acute hospitals division ever discuss these issues with the Secretary General of the Department, the Taoiseach when he was Minister for Health or the current Minister for Health? Did the chief medical officer or personnel in the acute hospitals division ever bring the issue of the audit and communicating the audit to the attention of the management committee of the Department of Health by way of discussion or by alerting people to the issue during management meetings in the presence of the Minister or Secretary General? Was the Taoiseach, in his time as Minister for Health, or the current Minister for Health ever briefed by the CervicalCheck management team on the progress of the screening programme? If such meetings or briefings occurred, were any issues ever raised with the Taoiseach concerning the laboratories or the testing regime or were any other concerns raised?

The Deputy has asked questions of a number of people, among others, the Minister for Health, the chief medical officer and the Secretary General of the Department of Health. I cannot speak for all those people and it would be wrong for me to answer questions on behalf of others.

It is the Taoiseach's responsibility.

In my case, the answer to all of the Deputy's questions is "No" and, to the best of my knowledge, the answer is also "No" with respect to all of the other individuals concerned.

The Department of Health will publish documents today. These follow on from a search of records and documents in the Department which has been ongoing for some time. To give the Deputy a rough idea, 40 million emails and other documents have passed through the Department of Health since 2008. As he can imagine, a document search of that scale, even if targeted, is time consuming.

In the dossier to be produced this afternoon, on which Opposition spokespersons will be briefed in advance and a press conference will be held, roughly a dozen documents will be released. These include memorandums between the Department of Health and Health Service Executive at official level, minutes of meetings of officials of the HSE and Department of Health and emails between various officials. The memos and documents confirm that no concerns were raised about patient safety, the efficacy and accuracy of the programme or the accuracy of any particular laboratories. The only issues dealt with in the documents relate to open disclosure or, rather, the non-open disclosure of information to patients and doctors. The documents confirm that these issues were not escalated to Ministers, advisers or the Secretary General. This follows on a full study of all memorandums, submissions, management board meeting minutes, ministerial management advisory committee, MinMAC meeting minutes and all significant issue papers.

It is the practice in the Department of Health that for every ministerial management board meeting a document called a significant issues paper is prepared so that the Secretary General, the management board, the Ministers and advisers can be made aware of those significant issues. The documents released today will show that none of this was escalated beyond the office of the CMO and the office of acute hospital services and that the concerns the Department was dealing with were concerns about open disclosure and about CervicalCheck passing on information about the audit to clinicians. There is nothing about concerns around laboratories, the efficacy, the accuracy of the programme or patient safety, but that will all become apparent today.

When the Taoiseach said no and no, do I take it then that CervicalCheck, as an organisation, never met either him or the Minister for Health, Deputy Harris, in four years? The Taoiseach might just clarify. That is the question I am asking. It would be normal for a significant screening programme to brief the Minister annually on the progress of the programme. The Taoiseach seems to be saying that did not happen and there was never a meeting between CervicalCheck and the Minister.

The reason I ask these questions is I find it difficult to comprehend why the acute hospitals division, a big division within the Department to assistant secretary level, or the CMO did not discuss this issue, as opposed to sharing documents on it, with the Secretary General or with anyone else in the Department. Given the reference in the three memos to adverse publicity of the kind that the "screening [programme] did not diagnose my cancer", one would expect such matters would be alerted to a Secretary General in a Department and to the Minister in the understandable expectation that the Minister might some day have to respond to a public debate around that very issue. It is extraordinary, in my view. I am not casting aspersions anywhere here. I am simply stating the obvious. It is quite extraordinary that the acute hospital division-----

The time is up.

-----did not alert the Secretary General or the Minister or it was never discussed at a management meeting of the Department given the clear implications, as we now know, about the revelations of this kind of thing and the absence of non-disclosure.

My understanding, having spoken to the officials concerned since, is that they did not escalate it because they believed that CervicalCheck and the HSE had the matter in hand. Letters were paused for a reason in the spring but the letters flowed freely through the summer of 2016 and all clinicians-----

Not to the women.

Not to the women, yes. However, all clinicians - all doctors, rather - received those letters through the course of 2016. Therefore, there was a delay. The delay was at the request of one or two of the laboratories which expressed concerns. The HSE sought legal advice and was advised that it was free to continue with open disclosure. It sent the letters out about all 209 women to all the consultants over the summer. The HSE and departmental officials wrongly assumed that the information had been passed on to the women. We now know it was only passed on to a quarter of the women. That is the explanation that I am being given but those officials will be before the Joint Committee on Health tomorrow and before the Committee of Public Accounts and will give explanations for themselves.

As far as the Government is concerned, one point on which I agree with Deputy Micheál Martin is that when I look at those documents, I see the absence of concern for patients. I can understand why CervicalCheck, officials of a previous Department of mine or anyone would be concerned about damage to the programme because that is what has happened. We have a big concern that women may not go for smears now because of the damage that has been done to confidence in screenings. I can understand why they had a concern for reputational damage to CervicalCheck because CervicalCheck saves lives, but what I do not understand is the absence of any concern or care for the women and their families who were going to find out about this in the way they have.

Did the Taoiseach meet them?

Did the Taoiseach meet CervicalCheck?

Did the Taoiseach ever meet them?

This is why the decision we took as a Government and which has been our first priority was care for women and the families concerned. Our second is getting truth and getting to all the facts. Our third is accountability and our fourth is confidence.

Did the Taoiseach meet them?

That is why, on Friday, we announced our package of measures.

Answer the question. Did the Taoiseach meet them?

Did the Taoiseach meet them?

The time is up. I call Deputy Pearse Doherty.

Not about the audit. I would have to check.

No. Did the Taoiseach meet them?

Answer the question.

Wait now.

I can answer that if the Deputy wants.

Did the Taoiseach ask?

Please.

It is a sub-organisation of the National Screening Service which is a sub-organisation of health and well-being, which is a sub-organisation of the HSE.

Taoiseach, please do not encourage them to be unruly.