On what is World Cancer Day, I extend my solidarity to Ms Lynsey Bennett and express my deep anger at what we saw yesterday - another woman and family failed by the State, another woman who was forced to go to the courts despite assurances that such would never happen again. It is a scandal. The Tánaiste gave a commitment to these women in 2018 and it is time that it was delivered upon. My thoughts are with Ms Bennett and her family today.

D'fhógair an Rialtas inné nach mbeidh an vacsaín AstraZeneca á húsáid orthu sin atá thar 70 bliain d'aois. Cruthaíonn an bhacainn seo dúshlán mór don Rialtas ó thaobh an phlean chun vacasíní a chur ar fáil don phobal. Tá an cuma ar an scéal anois nach bhfuil plean mar is ceart ag an Rialtas maidir le vacsaín a thabhairt dóibh atá thar 70 bliain d'aois. Níl amlíne ar bith ann agus níl a fhios ag dóibh siúd sa phobal atá thar 70 bliain cén uair a bheidh siad ag fáil na vacsaíne nó cén dóigh. Beidh siad ag brath ar dhochtúirí teaghlaigh ach ní bheidh cumas stórála ag cuid mhór dochtúirí teaghlaigh leis an vacsaín a chur i bhfeidhm gan AstraZeneca. An bhfuil ról ag na cógaiseoirí ina leith sin? Tá soiléiriú agus freagraí de dhíth ar an phobal.

Yesterday, it was announced that the Government had taken the decision that the AstraZeneca vaccine would not be used to vaccinate those over 70 years of age. This vaccine was repeatedly described as a game changer and we all hoped that it would be, but yesterday's development presents major challenges for the roll-out of Covid-19 vaccines throughout the State, not least because this vaccine is far easier to store and the need to roll out other vaccines to over-70s will present major logistical challenges for GPs, who are expected to roll out the vaccination programme in the community. The Taoiseach acknowledged as much yesterday when he stated that it would mean a change in the operation of the plan and would be a significant logistical challenge. However, the Tánaiste stated that it should not delay the roll-out. I find it difficult to believe how it cannot delay the roll-out in respect of over-70s. Timelines and targets were already thrown out the window with the reduced number of AstraZeneca vaccines coming to the State, and now there seems to be no sense of a plan.

What is proposed in respect of the roll-out of the AstraZeneca vaccine? Who will get it? When will they get it? What is the situation facing over-70s? When will they be vaccinated? What is the new ambition in that regard? We do not know how long it will take to vaccinate over-70s without the AstraZeneca vaccine. There is no sense of a new strategy or timeframe.

People are asking questions. For example, can GPs still be to the fore in administering vaccines that are deemed suitable for over-70s, given the major logistical challenges posed by how those vaccines are stored? Many GPs do not have suitable storage systems. Where will the vaccines be administered? Questions remain for pharmacies. When will pharmacists and their staff be vaccinated, when will they be part of the roll-out and what part will they play?

These are genuine questions that people like my mum, who falls into this category, want answered. They are alarmed at the news and want to be assured that the Government has a plan and what it will mean. They saw the advertisements placed in national media saying that GPs would be in contact with them over the next number of days, but now they are questioning what the plan is. Since the news emerged yesterday, there has been no clarity about how the situation will be managed. When will we see the revised targets and when will we have clarity? Will the Tánaiste answer some of the questions on capacity and the logistics involved in rolling the programme out through GPs? What will be the role of pharmacies? When will over-70s be vaccinated as a result of the Government's decision yesterday?

It is important to say that the nation's vaccination programme is well under way. More than 200,000 vaccines have been given. Compared with our peer European countries, we are among the top countries in the EU in terms of getting the vaccines out to people once we have received them. By last Sunday, we had received 207,000 doses, 200,000 of which had been given. The only constraints at the moment are factors that are not in our control - first, supply from the companies and, second, approvals by the European Medicines Agency, EMA.

We have faced setbacks in the past week. We now know that AstraZeneca will provide us with 200,000 fewer doses in February and March than we had anticipated and our public health and scientific advisers have recommended that over-70s be given an mRNA vaccine - the Pfizer or Moderna vaccine - rather than the AstraZeneca vaccine. I should say that all three vaccines are safe and effective, particularly in terms of reducing hospitalisations and deaths, and they have been licensed for all age groups. However, because of the lack of detail and the relatively small number of older people involved in the AstraZeneca study, the recommendation for now - this will probably change - is to give the Pfizer or Moderna vaccine to over-70s where possible. This means that the same number of vaccines will be given over the next couple of weeks as had been intended, but there will need to be some changes as to which groups are vaccinated and in what order. It means that we will still be able to start the vaccination programme for the over-85s in the middle of this month as planned, but they will get the Pfizer or Moderna vaccine rather than the AstraZeneca vaccine. For over-70s, the roll-out may be slower, but it will be faster for healthcare workers and other groups. In total, however, the same number of people will be vaccinated.

GPs can give the mRNA vaccines - the Pfizer vaccine and the Moderna vaccine - but there are logistical challenges to that. They have to be kept at a very low temperature and can then be kept for up to five days at a moderate temperature of between 2°C and 8°C. It is possible for GPs to be the lead players, as it were, in the vaccination programme in respect of over-85s, but it might not be possible to administer vaccines in all surgeries. It may require vaccination centres and particular practices with the necessary infrastructure, but it can be done. GPs are willing to take part, want to be a part of it and believe they can do it. We believe they can do it, too.

As will be the case elsewhere for the next couple of months, we will have to adapt our plans as the situation develops, supplies come in, the science changes and recommendations change, and we will do that. At least 1.2 million doses will still be delivered and given to people by the end of March, but there will need to be changes to the schedule.

My understanding is that pharmacists are part of group 2. They are considered to be healthcare workers who are patient facing. They will be vaccinated starting this month, most likely with the AstraZeneca vaccine for reasons the Deputy will understand.

Gabhaim buíochas leis an Tánaiste for his answers. I ask him in his supplementary reply to address the other point I made to him, which was that in May 2018, when he was Taoiseach, he gave a commitment that no woman would be forced to go to court to seek compensation due to the failures associated with the CervicalCheck scandal. We know that promise has been broken time and time again and it needs to come to an end. No woman should be forced to go to court to seek justice and still not even have an apology from the State or the HSE. I ask the Tánaiste to address this.

The Tánaiste said the vaccine roll-out will be slower for those aged over 70. Will he give an indication of what the timeframe is and when those aged over 70, which is the group that is most at risk, will be vaccinated? The original date was the end of March. What is the new date? Does the Tánaiste have any information on the number of GP surgeries that have the ability to vaccinate using the other two vaccines that have to be stored at lower temperatures of up to -20°C, as he has acknowledged? Will the pharmacists now be involved in the rolling out of the vaccination programme? How will they be able to take part in it?

I thank the Deputy.

When will we get clarity on this? Which group will be availing of the AstraZeneca vaccine, since it will not be given to those aged over 70?

I thank the Deputy. I am advised that the vaccination of those aged over 85 will begin in the middle of February as planned but because we will have to use the Pfizer and Moderna vaccines, of which there is less supply, as opposed to the AstraZeneca vaccine, the roll-out will be slower. I cannot give the Deputy exact timeframes and dates on it at this stage. It will allow us to speed up the vaccine programme for healthcare workers and high-risk people who are under 70. A lot of the details of this have to be worked out. This new development only happened in recent days with regard to the use of the AstraZeneca vaccine for those aged over 70. We will have that detail and share it with people as soon as we have it.

In relation to Lynsey Bennett, my thoughts are with her today also, and with her daughters Zoe and Haley. I do not want to comment too much on an individual case because I do not know the details of the case. I imagine the Deputy does not know either. It is the objective of the State and the Government to settle all cases by mediation where possible. I understand this case was settled by mediation and did not have to go to trial but perhaps it could have been settled earlier. Only the legal teams know that. At the time I made the commitment, as I have explained before, I believed and hoped it would be possible to settle all cases by mediation or negotiation but, unfortunately, that has not proved possible.

I thank the Tánaiste.

It is the case that on occasion, and on more than one occasion, the facts are disputed. Scientists and doctors say they were not negligent.

I thank the Tánaiste.

If the Deputy can come up with a solution to resolve this, I am all ears. Unfortunately, there will be individual cases where the facts are disputed.

I thank the Tánaiste. We are beyond time.

Therefore, there has to be some sort of hearing, hopefully at a tribunal rather than in court.

I thank the Tánaiste. I realise the issue is sensitive but I have to move on.

The Leas-Cheann Comhairle need not worry. I will give the Tánaiste another go on the issue.

The Tánaiste's use of language was a bit unfortunate. This is not a confrontational issue and I think he misspoke when he used the word "trial". They certainly are not trials. My heart dropped, as, I think, did that of everybody in the nation who watched the video of Lynsey outside the court. It was another woman failed by the State over the misreading of her slides. She is 32 years of age. She is fighting for her daughters Zoe and Haley. I have a number of questions and I have put solutions to the Government. Why is she being dragged through the High Court fighting when she should be spending time with Zoe and Haley? Negligence was found here. Why is the Government and, dare I say it, the previous Government continuing to treat women like this? Why, three years after the Tánaiste stated on the "Six One News", which I remember watching live, that women would not have to go through courts are there an estimated 200 more cases lined up?

It is two months since poor Patricia Carrick, may she rest in peace, passed away. I remember the Taoiseach offered yet another apology. Her family had to go into the courts after she passed away to instruct on her payment and get €2.75 million. The landmark Morrissey judgment was appealed by the State. It should never have been appealed and I, and possibly one or two others in the House, opposed but no other party did so. The State lost. That judgment changed the criteria whereby the HSE is liable. I have to ask a question based on the inertia from the Minister, Deputy Stephen Donnelly, and the Government. Is the State Claims Agency literally waiting for women to die because it will be cheaper for the State because of the law, which the Chief Justice has said needs to be amended, whereby the next of kin pursuing cases will not get the same amount of award?

The Tánaiste asked for solutions in his previous contribution. Last September, I sent the Minister, Deputy Stephen Donnelly, a civil liabilities (amendment) Bill to deal with this issue and I said I would work with him. There has not been an iota. The Taoiseach rang me about this and explained it all but not an iota. Not alone this but the Minister, Deputy Stephen Donnelly, could not even engage properly to fulfil the requests of the 221+ group on the CervicalCheck tribunal, which is now out also for an overwhelming majority of women. This is proven by the fact there are almost 200 cases lining up in the High Court.

Will the Tánaiste and the Government direct the State Claims Agency to act in a humane and quick way for all of the women where negligence is not being disputed so that Lynsey and all those who follow her will be treated in a better way and allowed to spend their precious time with their families?

I thank the Deputy very much for raising this issue again. I agree with him that it is not something we should be sparring about. It is too sensitive for that. My thoughts are with Lynsey Bennett today and particularly with her daughters Zoe and Haley. I hope her treatment goes as well as possible and that she gets as much time as is possible with her daughters. I do not know the details of this case because, as the Deputy knows, once things go to law they are handled by legal people rather than politicians. I understand from media reports that the case was settled. I am sorry it was not settled sooner. I do not know whether it could have been settled sooner but it is a good thing that it was settled. The term "trial" is a legal term. It applies to any court hearing but I accept that may not be the way people hear it so I am happy to rephrase and use the term "hearing" rather than "trial" because perhaps it is more sensitive.

Like I have said, I am not familiar with the details of the case and, therefore, I do not want to comment on it. When something goes to law, by law it is handled by the State Claims Agency. That law was passed by the Oireachtas. The answer to the Deputy's question on whether the State Claims Agency can be directed to deal with cases in a humane and quick way where negligence is not disputed is "Yes". I have done this at meetings with the head of the State Claims Agency. I am sure we can emphasise and reiterate this point again. Where negligence is not disputed, these cases should be settled quickly, sensitively and in a humane way. I absolutely agree with the Deputy in this regard. Where a problem will arise is where facts are disputed. That will happen in some cases where the doctors and scientists will say they did not misread the smear, and they are also entitled to have their side of the story heard. We do not want that to happen in courts. This is why we established the CervicalCheck tribunal. This has now been established and it will allow cases to be fast-tracked. It will allow them to be heard in a more sensitive way and, hopefully, it will produce quicker and better outcomes for the women concerned.

The Civil Liability Act is under review by the Government and the options are being considered. It is a complicated legal area, as I understand it, and there are issues about retrospectivity. It is something that is being examined by the Government.

The Tánaiste needs to direct the State Claims Agency to deal with these issues quickly and more sensitively, particularly where negligence has been found. It was found in this case, it has been found in a number of other cases and it will be found in a number of future cases. We will judge the Tánaiste's words over the coming weeks and months. I have drafted a civil liability Bill but I have had no engagement from the Government. Why is this? The tribunal is a waste of time because the 221+ group will not support it.

That is not the answer. If it was the answer, there would not be 200 cases lining up in the High Court as I stand here.

Finally, and more to the point, many women watching that yesterday, and watching Vicky Phelan in the United States at this moment in time, are getting worried. They want to have their smears done but they cannot get appointments. My colleague, Senator Rebecca Moynihan, had to ring around to five GPs to get an appointment. The Well Woman clinics are not taking appointments at the moment. Will the Government, through the HSE, ensure a lessening of this worry and stress and that, on the CervicalCheck website, a list of GPs and clinics that are taking appointments will be put up so the women of Ireland can have some solace that they will be able to get appointments? If they are delayed, we all know the consequences.

I thank the Deputy. As he knows, the Oireachtas some time ago decided that the management of medical negligence cases should be delegated to the State Claims Agency. That is the law. I think it might even have been brought in by Deputy Brendan Howlin as Minister, giving that power to the State Claims Agency to manage medical negligence cases on behalf of the State, so these are not dealt with by politicians or Ministers, and Ministers have no input into how these cases are managed.

I am not sure if the Government even has the authority to make a direction to the State Claims Agency. We have asked it, we have advised it and we have told it - I have done it in meetings with the head of the State Claims Agency - that where negligence is not disputed, these cases should be settled quickly, sensitively and in a kind and decent manner. We will restate that message to it and I can give the Deputy that assurance. I know the Taoiseach feels the same about it.

In regard to women getting their smear tests, I think we all agree. Today is World Cancer Day. We know that cervical screening works and we know it has reduced mortality - the number of women who die from that disease - by nearly 7% year-on-year. It is a very successful programme, notwithstanding the problems that have been encountered. I will certainly take up the issue as to whether we can do that on the website and give women information about which GPs will provide the service.