I also condemn the genocide perpetuated by the sectarian apartheid Israeli state against innocent Palestinians and I support the boycott, divestment, sanctions, BDS, campaign against that nation.

I want to return to the cervical smear issue. The way in which this issue is being handled is an absolute disservice to the women at the heart of it and it is perpetuating a situation whereby we will not change things if we do not cop on. That there are people who are surprised about a memo which stated to leave a decision on telling people until the legality is sorted out shocks me. Where have those people been? Do they not know there are people who have seen their babies die or be gravely injured in our hospitals who have not been given answers? Do they not know there are men who have held their wives' hands as they were robbed of their lives as a result of clinical negligence in our hospitals and they cannot get answers? Have people in here forgotten Portlaoise and Portiuncula, and it taking ten years or three and a half years for reports to be published, and that today five bereaved families are still before the courts? Do people not know this is what happens in our health service, that maybe five or ten years after people suffer a devastating loss they might settle with the HSE and they might get an apology or a few answers, but they might not? That is our health service.

We might need a commission to find out how the latest scandal happened, but we do not need a commission to tell us why. It is happening because of the actions of everybody in this House and frankly I am sick of it. I could not care less if the Taoiseach was the health Minister or if Deputy Micheál Martin was the health Minister because it goes on. Governments are too busy staying in power to actually govern, the Opposition is too busy scoring cheap political points to actually hold the Government to account, and the media are too bloody lazy to analyse what goes on in here so the Civil Service rules, unelected and unaccountable.

We do not need a new oversight governance body here. There is a suite of measures which has long been flagged that could alter and transform the situation now. It is in the programme for Government. There is mandatory open disclosure, which the Government baulked from and which Fianna Fáil was knobbled on and on which it voted against us last year. Last year, Deputy Frances Fitzgerald promised us that mandatory inquests into maternal deaths would be delivered before the summer. The Taoiseach told me in February the legislation would be published. It has still not been published. We passed pre-action protocols but they have not been enacted.

A huge amount of what has gone on in our health service is because of litigation in the backdrop. It is a requirement to notify the State Claims Agency 48 hours after a serious adverse incident but not to tell the patient.

Clinical claims against the State have an estimated cost of €1.98 billion, an increase of €1 billion in five years. Families are being dragged through the courts. If a family do not have the funds required, they cannot do this because they have to pay for their own expert reports. We know of the case of one family with a child with cerebral palsy in whcih 46 expert reports were commissioned over six years before the family received damages. Of the 244 cases that were settled in 2016, only five went to court. There are measures in the programme for Government which, if they were enacted, would transform the situation. Will the Taoiseach look at them, including having a no fault compensation system to deal with this issue once and for all to take the lawyers out of hospitals?

The Deputy makes some very valid points. There has been too much political point scoring on this issue and a degree of political opportunism. If we genuinely want to put women and patients in general first, we should look for solutions and ask what we can actually do to improve the situation that has gone on for decades. A suite of measures is required. I argue that we are making good progress in implementing it. The Government of Fine Gael, the Independent Alliance and Independents has brought about significant legal reforms in the past two years. For example, we have the Mediation Act 2017 and have seen cases in recent weeks that were settled by mediation to the satisfaction of both sides. We have brought forward the legislation on periodic payment orders to move away from massive settlements of €10 million or €13 million in order that a person's needs can be assessed along the way and that he or she can be given additional compensation if he or she requires it. We also have the Legal Services Regulation Act 2015 which provides in law for pre-action protocols. I am aware that it has not yet been commenced, but we have the legislation which we will commence as soon as possible.

We have the Civil Liability (Amendment) Act 2017 which provides for voluntary open disclosure. That legislation is very important. I know that some people have dismissed it, but it is important because it removes the excuses. It tries to create a culture of truth rather than one of secrecy in which doctors, nurses, midwives and managers will not be afraid that an apology will be used against them in a court and that admitting to a mistake could be used against them as an admission of liability. That is why we brought forward and passed the Civil Liability (Amendment) Act 2017. That is why it will be commenced by June, once we have the guidelines in place. In addition, the Patient Safety Office has been established within the Department of Health. It is a very important measure.

The Deputy is correct - there are two major outstanding issues in the programme for Government which is a five-year programme and we are only entering year three. There are two outstanding issues in the programme for Government that need to be dealt with, the first of which is mandatory reporting of serious reportable incidents. We will do this. The heads of the patient safety Bill have been through the Cabinet and we will get it done in the next couple of months.

I have also initiated the establishment of a working group to look at alternative means of settling medical negligence cases, including a no fault system. Such a system operates in New Zealand and some other countries. There are pluses and minuses and it must be borne in mind that some people do want to ascribe fault and find out who was to blame. Where there is a no fault system in place, it can work quite well and should be considered as an option. We shall establish the working group, as committed to in the programme for Government, under an independent chairperson, which will involve my Department, the Office of the Attorney General, the Department of Justice and Equality, the Department of Health and the Department of Public Expenditure and Reform.

I do not believe the Taoiseach listened to what I said. I genuinely do not blame him for anything that has happened before now. I am, however, going to blame him for what will happen next. On the day he announced that the Attorney General was being instructed to cease litigation in cervical cancer cases, a Kilkenny family who had appeared before the High Court went to the courts for the ninth time to seek discovery in a case involving Pandemrix. We know that in September 2009, before any child or any person was given Pandemrix, the chief medical officer of the HSE received a letter from the chief executive of the Irish Medicines Board, now the Health Products Regulatory Authority, expressing the board's concerns about the impact of the absence of data on information on the product and the dangers with reference to the dosage for children and pregnant women. One month later, in October 2009, the HSE issued a glowing report that stated Pandemrix was safe for use as the seasonal flu vaccine. This was in direct contradiction with the letter the HSE had received from the Irish Medicines Board just days before. There are dozens of families before the courts who have been waiting eight years to get answers.

If the Taoiseach is serious about there being a change in culture, the first step must be a moratorium in respect of these cases, which have put families through years of devastation, litigation and cost. The Government should call a halt first and then embark on having a proper redress scheme in advance of a no-fault compensation scheme.

I do not know anything about the details of that specific case, so it would be improper for me to comment on it. It relates, obviously, to a vaccine rather than the issue of cervical cancer screening, but I appreciate it is part of the bigger issue of how we deal with medical harm and medical negligence.

The last time I studied that topic and got a briefing on it, my understanding was that there was not sufficient epidemiological evidence - or scientific evidence, to make a long word sensible - to show that that vaccine caused the harms that were claimed, but I will take a look at that again because it is not something I have had an engagement on in at least two years.