Before asking my question, I take this opportunity to encourage women to use the CervicalCheck cancer screening service. CervicalCheck saves many lives every year. On 11 November, I asked the Minister for Health how many legal cases have been issued to date in respect of CervicalCheck. He replied that there had been 164 cases as of that date. That is an incredibly high figure. Each of those cases represents a woman with cancer and a family forced to fight for justice in an adversarial court system. Deputy Catherine Murphy asked the same question two weeks later and was told that there were 231 cases as of 25 November. Again, that is a shockingly high figure given the fact that the Tánaiste, Deputy Varadkar, promised the Dáil that no woman with cancer would have to go through the courts again. The Tánaiste promised that a tribunal would bring this to an end. However, that promise has not been fulfilled. Either the Department made a mistake regarding these figures or, in the two weeks between those questions being asked, almost 70 women initiated legal cases against the State in the context of CervicalCheck. This is an incredible figure and, if it is correct, it represents a massive indictment of the Government.

Patricia Carrick died in November. God rest her. The High Court found, in the context of the case she took, that in 2016 her smear test was read in a manner which was neglectful. Patricia was diagnosed with cancer in 2019, a year after the scandal relating to this matter first broke. I raised her case in the Dáil. Since then, I received a letter from CervicalCheck that was critical of my contribution. I took a meeting with the clinical director of CervicalCheck to try to thrash out these issues and better understand the situation. I was shocked by what was stated at that meeting. During the course of my engagement with it, CervicalCheck made its position clear. It disagrees with the decisions of the Supreme Court, with the initial apology of the Government and with the payment of compensation to many of these women. These are extraordinary statements in the context of a crisis that has gone on for years and with which many individuals have had such difficulty.

CervicalCheck is an arm of the State. The Government and the Supreme Court are also arms of the State. How can so many organs of the State be in direct contradiction of each other? Does this not put lives in danger?

First, I am not privy to the meeting the Deputy had. Was it with the head of CervicalCheck?

It was the clinical director of CervicalCheck.

I am not aware of what was said because, obviously, I was not at the meeting. I will check the position immediately because we must all uphold the decisions of the Supreme Court and of the courts in general. On the previous Government's decision, those who work for the State can have their views in terms of Government decisions but they must facilitate the execution of those decisions within various services. That remains the position.

Since it entered office, this Government has been doing everything possible to facilitate the establishment of the tribunal in order to create a less adversarial forum to give women who have taken cases to the courts a better alternative. Towards the latter part of the summer, judges were selected and appointed. This was because the judges who had previously been put in place had either been appointed to different positions or had moved on because of Covid-19. There was a pause during the first phase of Covid-19 and we were anxious to get the tribunal operational for women who wanted to lodge claims through their legal representatives at the tribunal. It was important that we got it established.

There were, obviously, ongoing discussions with the 221+ patient support group. It is fair to say it was not satisfied that all the issues it had raised with the Government were resolved, particularly that relating to recurrence and the Statute of Limitations. The Government took a decision a fortnight ago on the Statute of Limitations which, I believe, will ultimately enable that issue to be resolved. Obviously, in the first instance, it will be a matter for the tribunal to decide on any case with which it feels it has difficulty because of the Statute of Limitations. Due to the fact that the tribunal commenced its work later than the women would have expected, there was an obvious delay in terms of their being in a position to lodge their claims.

The issue of recurrence was well-debated in the House during the passage of the legislation. The legal issues raised by the then Minister are the same legal issues that have not enabled the Government to deal with that in the context of the tribunal. There are wide-ranging implications arising from the recurring issue, beyond CervicalCheck. The Government is very committed to seeing through the work of the tribunal and facilitating a less adversarial and confrontational, and more suitable, environment for the resolution of these issues where the laboratories would be joined as third parties, not as core defendants, because negligence has to be established, as the Deputy will be aware. The tribunal follows the work that was initiated by Mr. Justice Charles Meenan. He recommended the framework and then followed through on the Act that was passed by all parties in the House last year. We genuinely believe that the tribunal offers a better, less confrontational alternative to the courts.

The fact that we are talking about the tribunal in the future tense at this stage is incredible. The Patricia Carrick case struck me in a number of ways. How could a Government fight her in the courts, practically up to the end of her life? It was incredible. She was not the only person who has been in that situation. It also struck me that she had taken a number of smear tests before her diagnosis, yet her tests were never part of any review. The reviews commissioned by the Department and the HSE focus only on slides of women who had been diagnosed with cancer. Patricia's slide was not re-examined until it was too late.

It struck me that we are re-examining slides only if the woman has developed cancer, and in many cases, when it is too late. Given the incredibly high number of women who are going through the court system, doctors are saying in some of these cases that the smear tests, when first read, should have been seen in flashing red lights. Given the tragic loss of life to date, does it not now make sense to review a sample of the slides of the asymptomatic women to see if we can catch these cancers while we can still treat them?

In the first instance, we should draw a differential between a screening programme and diagnostic procedures in themselves. That is very important, and in some respects, the original cervical screening programme gave a sense that if one had come through the screening programme, one was okay, whereas we know that is not the case. All screening programmes are general population screening programmes-----

What if the court cases find there is a problem?

Where there is a problem and where negligence has been established, of course the laboratories are negligent in that respect. The laboratories gave an indemnity to the State in respect of that, which is why they are still, in the context of the tribunal and of the courts, joined as third parties. In the broader sense, each case can be different. I do not think we can make generalisations in regard to this-----

We know this.

-----or create schemes and frameworks due to subjective analysis of a particular case. CervicalCheck screening has never been, under the older technology, the most precise of screening programmes. I think most people would acknowledge that.

There is a margin of error, but the problem is the court cases are finding that there are also mistakes beyond the margin of error.

Anything beyond the margin of error obviously needs to be pursued and dealt with and compensation should be paid.