Yesterday, the funeral cortège of Emma Mhic Mhathúna passed Leinster House. It was a very emotional afternoon. A very pointed message was being sent by Emma. It was not directed at any particular person but at the people inside who they wanted to do something. What can the people in here do? We can investigate the actual cause of the death of Emma and 20 other women and ensure that unavoidable mistakes never happen again. Following Emma's death, her solicitor, Mr. Cian O'Carroll, said on an RTÉ radio programme that he is dumbstruck as to the reason the HSE and the Government are hell bent on avoiding the laboratory issue. He said that when the issue is raised with the Minister, Deputy Harris, and the Government, they focus on non-disclosure. Non-disclosure did not kill Emma. Emma died owing to failures in a laboratory in 2010 and 2013, as he said.

It is inexcusable that today, following her death, there is still not a clear and determined statement from the State saying that it will investigate why those slides along with so many hundreds of others were critically misread in the laboratories in the USA and Ireland. He also made the point that the 221 errors have not been properly investigated. They are not being looked at, and neither are the actual laboratories. The laboratory that misdiagnosed Emma and many others is still being used. I want to read a section from a report from Quest Diagnostics to the Tánaiste. It reads:

- We generated double-digit revenue growth in our near-patient - or "point-of-care" - - testing business.

- We continued to reduce our cost structure and improve our efficiency.

- We opened our lab in India.

As my colleague, the former Deputy Joe Higgins, said ten years ago, they could be producing cement for all that could be judged from statements like that. Is it not the reality that the Government's lack of interest in focusing on the labs is because political parties in this Dáil took a decision that cost would be the overriding criterion in deciding on the testing service?

Dr. Scally made the point yesterday that he did not give the labs the clean bill of health that the Minister has been so determined to suggest. He also made the point that a whole host of women could also be affected because the HSE and CervicalCheck took a decision to limit it to within an 18 month range. Dr. Scally and his investigators made the point there was not a clear and unambiguous international accreditation awarded to the labs. Why is it that a decision was taken that cost would be the fundamental criterion for the testing service and is it not the case that the Government decided to do medicine on the cheap and that many women are now paying the price?

I thank the Deputy for the question. First, on behalf of this House, I recognise the significance of Emma Mhic Mhathúna's funeral passing this House and other significant institutions of the State yesterday. I hope that this House will be able to honour the legacy of an extraordinarily brave woman and ensure the truth is fully understood in regard to what happened to her and others so that we avoid making the mistakes made in the past again in the future. The Minister, Deputy Harris, and this Government are absolutely committed to doing that and I thank other parties in this House for supporting us in this work.

I refer to what Dr. Scally said yesterday but first I thank him for his continuing work and his continuing support to the Government and the Department of Health on this. I thank him for his appearance at the committee yesterday and for speaking on his excellent report, which I encourage everybody to read. The reality is that we have known for a long time that the numbers may increase after we get the report of the Royal College of Obstetricians and Gynaecologists, which is currently under way. We know that the overall number being reviewed is higher than the CervicalCheck audit because there were a number of cases notified to the National Cancer Registry but not included in that audit. Members will recall that as soon as the Minister, Deputy Harris, learned this he informed the House straight away. Dr. Scally has done great work in setting out answers to questions. His recommendations have set the Government a goal, and we have adopted entirely those recommendations. The aim of eradicating cervical cancer through a programme of screening and vaccination is now what we want to implement. Dr. Scally is continuing his work and will continue to support the Government. He will independently oversee the implementation of many of his recommendations. The Royal College of Obstetricians and Gynaecologists work is under way, which is an independent, outside, expert review of smear tests and which will provide answers to some of the questions the Deputy is asking today. It is not appropriate to draw conclusions, however, without having the benefit of that report.

The Government is certainly not focusing on using labs for this purpose on the basis of cost. My understanding is that the cost of labs outside of Ireland is no less than the cost of labs used in Ireland in regard to assessing screening results.

I urge caution here because we have made mistakes in the past and jumped to conclusions. Let us wait until we get the detail of the Royal College of Obstetricians and Gynaecologists report which will hopefully be available in early 2019. Let us continue to work with Dr. Scally to ensure that we provide the supports necessary and that we learn from the mistakes that Dr. Scally, to his credit, has uncovered.

Dr. Scally told the Joint Committee on Health that there are still serious issues with slides sent by Clinical Pathology Laboratories Inc., CPL, to other labs in the USA. This is the outsourcing that the HSE did not even know about. Mr. O'Carroll made the point that when a mistake is made in other countries, the person in the lab who made the mistake is debriefed as to why he or she might have made the mistake. That has never been done in any of the labs that CervicalCheck has used. The reason is that CervicalCheck did not even know what labs were doing the testing. That is what we have now discovered in many cases. The outsourcing was being re-outsourced.

I ask about the tender documents. Why is it that we cannot get our hands on the tender document for the labs? It was revealed by Dr. Scally that original tender documents were shredded by the HSE. Was an email ever sent? It is 2018 and there is only one original document, so was it delivered by plane? It reminded me of the quotation that Mr. Tony O'Brien apparently had on his wall about speaking truth to power. When I heard about the shredding of the contract it reminded me of Noam Chomsky's words, "power knows the truth already; it is just busy trying to conceal it." It seems that is the case with the HSE and the original tender documents for the labs.

It is still going on. Sonic Healthcare, which is a parent company of MedLab Pathology and CPL, is now outsourcing to Australia. The kernel of the issue in regard to the death of Emma and other women is still not being investigated and has still not been changed.

I do not accept the Deputy's last statement. The kernel of this issue has been, and continues to be, investigated and if mistakes have been made we will learn from them, fix them and make sure they are not made in the future. We need a screening system in Ireland that women can trust and believe in. That is why Dr. Scally is, and has been, so committed to this effort and why he continues to want to engage with the Government and healthcare system to ensure we follow through on the recommendations he has made. I suggest that we work with him and I support the Minister in those efforts.

I do not have any information on original tender documents but I am sure there is an explanation for it. There are processes under way, some of which have not been completed, and we should not be drawing conclusions in the absence of that information. We also need to ensure that we have the continuing use of laboratories so that we can keep a screening system in place and functioning into next week and next month so that Irish women get the benefit of an effective CervicalCheck screening process. That is an ongoing discussion and negotiation between the Department of Health and the relevant laboratories. We need to maintain a screening process, we need to make sure that it is credible and we need to make sure that any mistakes that have been made in the past are fully uncovered and people are held to account for their actions so that we can learn lessons and fix it for the future.