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Dáil
‹ Ceisteanna ó Cheannairí - Leaders' Questions

CervicalCheck report and independent review

Summary

Deputy Kelly questions the latest CervicalCheck report, the handling of missed opportunities, and the independence of reviews for affected women. The Taoiseach acknowledges errors, says he will consider involving Dr. Scally again, and explains that the tribunal can appoint genuinely independent experts.

Yesterday, we finally got the aggregate report from the Royal College of Obstetricians and Gynaecologists, RCOG, on the CervicalCheck programme. We are thinking of the 159 women who had missed opportunities to get interventions. Following the publication of the report, the 221+ group will help and support those women over the coming weeks. We know that cancer screening is not diagnostic and is not perfect. We also know that the promotion of screening is critically important. This House knows that screening saves lives. Collectively, all of us are making progress on HPV screening and HPV vaccinations, on which my party has led. We are changing the quality assurance and management of our screening programmes. All of this good work represents good progress.

We know there have been a large volume of mistakes and errors in the administration of the screening programme when it comes to the HSE and the Department of Health. This has been demonstrated in the two Scally reports and the MacCraith report and has been compounded by incredibly inept communications and failures with regard to mandatory disclosure. Yesterday, the chief patient advocate who was on the RCOG review and the cervical cancer steering group, Lorraine Walsh, told us that she resigned from both roles on 31 October last. I know Lorraine Walsh very well. She is one of the most formidable people I have ever met in my life. She explained on "Prime Time" on RTÉ last night that she resigned because she simply did not have confidence in the RCOG review. For me, this is some revelation. On 22 October when I and the Taoiseach stood here and he apologised to the women of Ireland for what happened to them through the screening programme, I raised with him, in fact I pleaded with him, in relation to an intervention on the RCOG review because I had fears that the same mistakes were going to be repeated. Unfortunately, he did not listen.

Today I am asking questions on behalf of Lorraine Walsh. The minutes of the cervical review meeting on 6 October state that over 50% of all reviews carried out by RCOG and sent to the HSE had to be sent back. How were proper controls for this review not in place by then and that that amount had to be sent back to RCOG to be re-examined? It has been revealed that three women, from a total of 1,051, had their slides relabelled in error as part of this process. Two of the three women in question were Lorraine Walsh, the patient advocate, and Vicky Phelan, who revealed all of this on day one. Statistically, what are the chances of them being two of the three women, from a total of 1,051 women, who had the labels taken off their slides and moved around onto other women's slides? How could Lorraine Walsh get two reports from RCOG on 15 November and 16 November, one saying her report was concurrent and the other saying it was the total opposite? How was that possible over 24 hours? How did RCOG know that it was Lorraine Walsh's report without her confidentiality being broken? Finally, how many women whose slides were lost or unavailable have been told as part of the RCOG review that their reports were concurrent when we do not actually know and they should be categorised as unknown?

Comment on this
Leo Varadkar The Taoiseach Fine Gael

In fairness to the Deputy, he has asked some very specific questions, one relating to the minutes of a meeting held on 6 October last. I was not present at the meeting and I have not seen the minutes so the Deputy will forgive me if I am unable to answer questions at that level of detail. It is the case that some errors were made during the process of the RCOG audit. They were flagged at the time and I am advised that they were dealt with.

I know Lorraine Walsh too. I have met her many times. I read her resignation letter when it arrived on 31 October, five weeks before this report was published. It was extraordinarily complimentary of the Minister, in particular, and of many of the people who now work in CervicalCheck. It did not mention RCOG at all. I appreciate that she is honest and truthful in what she has said since then, although that was not the reason that was given five weeks ago. I want to express my appreciation and thanks to her for the work she did as a patient advocate over many months. She certainly helped me in my work when I was putting together the apology I made in this House. She has made a difference in helping us to improve our screening programme and to restore confidence in CervicalCheck.

RCOG is the professional body for obstetricians and gynaecologists in the United Kingdom. It is well-respected. It is the world expert when it comes to gynaecology, cervical cancer and women's health. It is independent. It was asked to do this report on behalf of the Government and it did it. I think the right thing is for the college to account for it. RCOG is not a public body or a Government body. They are experts brought in from the UK because we wanted to make sure the report was totally independent. They are willing to come to the Joint Committee on Health on 18 December - I understand this date has been set - to account for all of the matters relating to their report. That is as it should be.

Comment on this

I ask the Taoiseach to respond to the specific questions I asked on behalf of Lorraine Walsh. He said there was an independent report. I have to question that. If a report or review that is being conducted has to be constantly validated by the HSE, I am not sure it is fully independent. A number of people were upset by the response of the Minister, Deputy Harris, to the report yesterday. They have suggested that his response was too categoric and clinical and downplayed the findings of the report. They are not my words - they are the words of Stephen Teap and others.

Lorraine Walsh made attempts on 2 September, 2 October and 22 October to talk to the Minister and explain her concerns regarding the RCOG. He never contacted her until, literally, an hour after he discovered that she had resigned. He also tried to contact her before the report was launched yesterday but nobody will be surprised to hear that she did not answer him.

I have two questions for the Taoiseach. There is a request that in the context of the women who were part of this review, particularly those who have questions as regards what is in the report, the State would pay for an independent review of their cases, at a cost of approximately €3,000 each. I do not foresee there being a huge number of women involved and, thus, there should not be a huge cost to the State. Will the Taoiseach consider the request? Will he also ensure that Dr. Gabriel Scally fully reviews the RCOG review outcomes and the process by which it was done and report back to the Dáil in the near future?

Comment on this
Leo Varadkar The Taoiseach Fine Gael

I will certainly give consideration to the Deputy's suggestion with regard to involving Dr. Scally again. He is very much trusted by the Government and, I think, by the House and the patient advocates. I would prefer to have that discussion with him rather than make an announcement on the matter now. We can certainly give consideration to funding independent reports for women who wish to have them. The Deputy should bear in mind that these are independent reports. The RCOG is the world-leading body of experts; it is independent and based in a different country. It came in here to do this work. I am not sure if a cytologist, a pathologist or a cytotechnician selected by a solicitor is independent or if one selected by a laboratory is independent. We would have to bear that in mind as well.

Comment on this

The Government can select them.

Comment on this
Leo Varadkar The Taoiseach Fine Gael

However, the judge heading the CervicalCheck tribunal which the Government established is empowered to appoint independent experts who would not be paid by the laboratory or paid through a solicitor. They can, I think, be genuinely independent.

Comment on this

They are open to any process.

Comment on this