On 3 September during Leaders' Questions, I raised the findings of the review into the provision of gynaecology services in Letterkenny University Hospital with the Minister for the Environment, Climate and Communications, Deputy Eamon Ryan. The report was commissioned after a hard-fought battle by patients and by their families. These were patients who had suffered delays in diagnosis and treatment with devastating consequences for them and for their families. This included family members such as Dr. Margaret MacMahon who lost her sister.

As I said in September, campaigners such as Margaret deserve praise and recognition for their tenacity and determination. The review found that of the 123 cases of endometrial cancer over a ten-year period in Letterkenny University Hospital, one in three women experienced a delay in diagnosis, one in five women suffered serious consequences as a result, and a number of these women have since passed away, some as a result of the delay in diagnosis.

The review uncovered a litany of failures which had devastating impacts and consequences for these women. In September, I put some of the findings of the review on the Dáil record and I wish to do so again. The review stated:

It is clear that the experience for these women, and the service provided to them, was unsatisfactory. All cases, in one form or another, are typified by delay – delay from an urgent GP referral to a gynaecology outpatient appointment; from gynaecology outpatient appointment to urgent diagnostics ... and-or from diagnostics to intervention.

Today we learned that things have gone from bad to worse. A further three cases of delayed diagnosis have come to light in Letterkenny University Hospital, bringing the total number to 41. This begs the question as to how many more delayed diagnoses are we unaware of. It is simply not acceptable under any circumstances. The families affected are rightly demanding answers.

Tá a fhios againn go bhfuil trí chás úr ina raibh moill leis an diagnosis. Ta triúr ban san iarthuaisceart ag ceistiú an muinín agus an trust atá acu i seirbhísí gnólaíochta agus in Ospidéal na hOllscoile Leitir Ceanainn. Tá eagla ar ár máithreacha agus ar ár ndeirfiúracha. Is léir gur theip ar Shaolta agus ar an Roinn Sláinte ó thaobh na mná seo a chosaint. Níl sé maith go leor agus caithfidh an Rialtas gníomhú air seo láithreach.

It was reported in the Donegal News today that many of the families of those who have passed away as a result of this are disgusted with the individual reports into their care received from Saolta. Several families have come forward - some of them have been in contact with myself - to say that the reports they received are inaccurate and lack accountability.

The Saolta group responsible for these services at Letterkenny University Hospital has a lot to answer for. The review itself criticised the fact that during the very time that Dr. Price was carrying out his review, Saolta management, without his knowledge, decided that it in its wisdom would carry out its own audit of the same files. What does that say to the families? It does not exactly inspire confidence in Saolta's handling of all of this.

This requires Government intervention and action. In September, I raised this issue with the Minister, Deputy Eamon Ryan, and was told that this would be followed up on. I want the Tánaiste to tell me what action, if any, has been taken by the Government over the past two and a half months. I specifically asked at that time that the recommendations of the review be acted on and fully implemented. This has not happened. I asked for a review going wider than endometrial cancer in Letterkenny University Hospital. That has not happened. I asked if the Government would consider the independent panel's recommendation for a full audit to be carried out throughout the State to ensure that Letterkenny is not an outlier. There is no evidence that has happened either.

For the families of those women who have passed away as a result of the failure of their treatment in Letterkenny University Hospital, will the Tánaiste give this the priority it deserves? The women of Donegal and, indeed, their families deserve nothing less.

I thank the Deputy for raising the serious issue of the review of gynaecology services in Letterkenny University Hospital where women experienced delayed diagnosis. Obviously, as a result of that, in some cases they did not get the treatment they should have as soon as possible.

I want to express my deep sorrow to any of the women affected and also to any of their families and friends who have faced an adverse outcome because of this.

I am at a little bit of a disadvantage in answering the question in that I have not been briefed about this recently or in a very long time. I do not want to give an answer on a sensitive matter for it to turn out to be wrong. As the Deputy said, the Saolta group is in charge of the hospitals in the west and Donegal and it carried out individual reports into the different cases. I understand from what the Deputy said that some women and families are unhappy with the individual reports they received.

I am not able to answer what actions have been taken in the past two months as I am just not up to date on this. There is a meeting of the Cabinet subcommittee on health this afternoon. I will have a chance to see the Minister for Health, Deputy Stephen Donnelly, then and I will let him know the Deputy raised this serious matter. I am sure he will want to respond to the Deputy directly.

I thank the Tánaiste for his response. I appreciate he may not be fully up to speed with the independent review published in August and its recommendation that there should be a statewide review to ensure Letterkenny is not an outlier. Will the Tánaiste, as a GP, read that report because it is absolutely shocking? People lost their lives. The Tánaiste knows that endometrial cancer, if detected and treated in proper time, is not life-threatening or life-ending. In these cases, however, it is clear from the review, which Letterkenny University Hospital and Saolta accept, women lost their lives directly as a consequence of the failure of the treatment in the hospital. Not only that, the numbers are staggering: 41 out of 130 cases were delayed diagnosis while one in five, or 25 or 26, had serious consequences for their health. For some, that consequence was the loss of their life.

What Saolta and the hospital did was flawed from the very start. There was a review in 2018 by the National Treatment Purchase Fund, which made ten recommendations. There was no evidence that any of its recommendations was implemented. There is a lack of confidence in the service. That is why there is a demand for a proper independent review into this and to widen it beyond endometrial cancer.

I am asking the Tánaiste to take a personal interest in this as well as talking to the Minister.

I thank the Deputy. I will do that and I will read the independent review. When we find failings or shortcomings in any particular hospital it is important to apply scrutiny nationwide. If things are going wrong in one hospital it is wrong to assume that everything is okay everywhere else. Too many times we have learned that failings identified in a particular hospital or service are not confined to that service but are a more widespread problem. We have seen that with other reports in the past. I will take it upon myself to read that report and try to understand it better as well as raising it with the Minister for Health this afternoon when I see him at the Cabinet subcommittee.