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Savagery Of The Irish Government And Of The Super-Rich Elite It Serves

GOVERNMENT DISSATISFACTION RATE SOARS DUE TO CERVICAL SCREENING SCANDAL

Irish Times:  The net dissatisfaction rate – the difference between those who are satisfied and those who are dissatisfied with the Government – among women is now 29 points, up from just 10 points last month.

While it is not unusual for a government to have a net dissatisfaction rating, this is an extremely large and rare move in one month and coincides with the cervical screening revelations.

The latest Irish Times/Ipsos MRBI shows that the over-all satisfaction rating of the Government has fallen from 44 per cent in the last poll in mid-April – the highest rating for any government since 2011 – to 37 per cent.

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Government Crisis Deepens Due to Cervical Screening Issues

FG Minister Richard Bruton backed by Minister Katherine Zappone Refuse to Follow lead of Taoiseach Varadkar. Both are Declining to Express Confidence in Chief Medical Officer of Department of Health

Irish Independent 12/05/2018: The Taoiseach insisted he wasn’t shown a crucial memo that showed information  on the faulty smear tests was being witheld from women with cervical cancer when he was health minister.

He expressed confidence in Chief Medical Officer Tony Holohan, who did receive the HSE memo in the Department of Health

 

Evening Echo    14.05.2018 13:05

http://www.eveningecho.ie/nationalnews/Latest-Government-ministers-decline-to-express-confidence-in-medical-officer-after-CervicalCheck-scandal-041df3f5-dcad-4c0b-96dd-0319e9596167-ds

Latest: Government ministers decline to express confidence in medical officer after Cervical Check scandal

Update 1.05pm: Two senior government ministers have declined to express their confidence in the State’s Chief Medical Officer in light of the cervical cancer scandal.

Dr Tony Holohan received memos in 2016 showing CervicalCheck had prepared a response for media stories about screenings not diagnosing cancer.

An independent review into the controversy is underway.

Ministers Richard Bruton and Katherine Zappone said they’re not going to say anything about Dr Holohan until the review is finished.

“I think the position is we have to wait and see what the evidence that comes form the inquiry that is being set by Dr Scally,” Mr Bruton said.

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Irish Independent Drops Front Page Headline Story “Varadkar to Blame” from Website. It was only contained in Printed Edition on Saturday 12/05/2018. It was signed by 3 eminent journalists.

Did Independent Newspapers Bow to Government Pressure?

ARTICLE

“Shambolic”: blame shifts to VARADKAR

Eilish O’Regan, Laura Larkin and Cormac Quinn

Cervical Cancer Scandal: Fifteen Days Later, all victims not traced and 4,300  calls not returned.

Taoiseach Leo Varadkar has been forced todefend his handling of the cervical cancer scandal amid accusations it has been “shambolic”.

After 15 days of the crisis , Mr Varadkar continued to flounder, struggling to answer basic questions about the controversy.

The Taoiseach insisted he wasn’t shown a crucial memo that showed information  on the faulty smear tests was being witheld from women with cervical cancer when he was health minister.

He expressed confidence in Chief Medical Officer Tony Holohan, who did receive the HSE memo in the Department of Health

 

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As Minister for Health, Varadkar ran a Department in which the lives and health of women came second! There was No Requirement That Chief Medical Officer of Department to Tell Him of Shockingly Cynical Memo. If there was it would be a disciplinary matter, not a matter for a tribunal!  

Varadkar: ‘Nobody immune from being held to account’(What about himself!-PH)

Sarah Bardon, Martin Wall, Irish Times, Saturday, May 12, 2018, 

The Government believes that further “accountability” will be needed in response to the current cervical cancer screening crisis despite the departure of a number of senior health figures.

Announcing a package of measures aimed at assisting the women affected by the CervicalCheck scandal on Friday, Taoiseach Leo Varadkar and Minister for Health Simon Harris said nobody was immune from being held to account.

Mr Harris said nobody, including officials within his own department, the HSE and other agencies, would be spared. “There are other people who work in the public service and civil service, in jobs that are also well remunerated that also have accountability,” he said.

Meanwhile, The Irish Times has learned the former Health Service Executive director general Tony O’Brien, who resigned on Thursday, will receive more than €140,000 on his departure from office. It is understood Mr O’Brien will continue to be paid his regular salary up until the expiry of his contract at the end of July.

As part of his contract signed in 2012 with the Fine Gael-Labour government, he will also be entitled to an additional payment equal to six months of his €192,000 annual salary.

Government sources confirmed Mr O’Brien’s contractual obligations would be honoured in full and stressed this was not a “golden handshake” but a “legally binding agreement”.

The Government has named John Connaghan interim director general pending the recruitment of Mr O’Brien’s successor.

Level of knowledge

Political pressure, meanwhile, continued to grow on Department of Health officials to outline their level of knowledge of the controversy.

It emerged this week that chief medical officer Dr Tony Holohan received memos two years ago saying women with cancer were not being told about false smear tests.

The Department of Health said on Thursday he received a March 2016 memo which said letters informing clinicians their patients had received incorrect results were being suspended.

Last week, Dr Holohan said he learned that women were not being told about false tests only after last month’s court case taken by Limerick woman Vicky Phelan that exposed the scandal.

The Irish Times understands further documentation has been identified within the Department of Health. It is expected it will be sent to the Oireachtas Public Accounts Committee and the health committee, and to the non-statutory inquiry into the controversy over the coming days.

Mr Varadkar and Minister for Health Simon Harris insisted at a press conference in Dublin that Mr Holohan had their support. “Everyone deserves due process and a fair hearing,” Mr Varadkar said.

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Did Varadkar Know Of The Memo as Well as O’Brien?

It is now agreed that the infamous memo was sent to the Department of Health when Varadkar was Minister for Health.

According to Deputy Burke (FG) on Prime Time ” the memo was not accelerated upwards to ministerial Level” But Tony O’Brien said that too about HSE before the truth came out! He Knew Nothing! The information was known in the HSE But it was “not escalated up to his level”

Did someone in  the Cervical Check section of HSE leak the memo To O’Brien to media to avoid been dumped with the blame?

Will someone in Department of Health implicate Leo for the same reason before the next meeting of PAC?

Media reports say that a search is being made for memos in Department of Health!!!!

Remember Frances Fitzgerald!

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Following Evidence Given to Dáil Committees, I Have Added  Further Refinements The Scheme Below

HSE-Department of Health: An Example of Criminal Capitalist Mis-Governance following Irish Water Ltd, Garda Service etc.

General Plan Designed to Allow Ministers and Governments to Evade Responsibility for Citizens’ Well-Being

1)Set Up Separate Agency To Deliver “Service” to “Customers” (Redress for aggrieved customers only through courts without legal aid)

1a)   Contract out key functions to private companies at home and abroad to achieve efficiencies!

1b) Write into legal contract with private companies that, in return for the business, the company will indemnify the state agency against law suits and that the company will be allowed to demand confidentiality clauses from aggrieved “customers” seeking redress in return for compensation.

2)Head of Agency not required to report on “operational matters” to Minister

3) Induction Programme Tells  recruits to new Agency not to report failures to Head of Agency in writing

3a) Where not already in place introduce this practice into relevant Government         Department

4) When scandal breaks Minister says s/he doesn’t know and is “shocked”.

5) Head of Agency says s/he didnt know

6) Minister and Agency Head cannot be expected to resign because they didn’t know and are now required to “clear up the mess”.

7)They will both set up enquiries and investigations

8) They are both “bloody raging” and “mad as hell”

9) Head of Government, Minister and Head of Agency will now ride to rescue of victims on a White Horse

10) It all happens again 2 years later and points 3 to 9 above resume!

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Health Minister Varadkar Backed Down on Promise to Bring in Legal Requirement To Tell The Whole Truth To Women and Other Patients. Have Women Died as a Result and, like Hero Vicky Phelan,Will More Die Earlier as a Result In Future??

Varadkar, who was health minister at the time, compared the failure to admit mistakes to a hit-and-run. Then he changed his mind.

Susan Mitchell, Sunday Business Post06/05/2018:”In 2015, Leo Varadkar said he would make it “a legal requirement that there be open disclosure and a duty of candour, which I think is just right.”

Varadkar, who was health minister at the time, compared the failure to admit mistakes to a hit-and-run. Then he changed his mind.

The view of the Department of Health was that enacting legislation would be “counterproductive”. Chief medical officer Dr Tony Holohan said he was opposed to the move.”

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HSE-Department of Health: An Example of Criminal Capitalist Mis-Governance following Irish Water Ltd

General Plan

1)Set Up Separate Agency To Deliver “Service” to “Customers” (Redress for aggrieved customers only through courts without legal aid)

1a)   Contract out key functions to private companies at home and abroad to achieve efficiencies!

1b) Write into legal contract with private companies that, in return for the business, the company will indemnify the state agency against law suits and that the company will be allowed to demand confidentiality clauses from aggrieved “customers” seeking redress in return for compensation.

2)Head of Agency not required to report on “operational matters” to Minister

3) Induction Programme Tells new recruits to Agency not to report failures to Head of Agency in writing

4) When scandal breaks Minister says s/he doesn’t know and is “shocked”.

5) Head of Agency says s/he didnt know

6) Minister and Agency Head cannot be expected to resign because they didn’t know and are now required to “clear up the mess”.

7)They will both set up enquiries and investigations

8) They are both “bloody raging” and “mad as hell”

9) Head of Government, Minister and Head of Agency will now ride to rescue of victims on a White Horse

10) It all happens again 2 years later and points 3 to 9 above resume!

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 Head of Cervical Screening Service still in post despite Varadkar’s claim in the Dáil That he Had Been Move Aside

But Head of A&E Trolley Crisis Now Directly Reporting Directly To CEO TONY O’Brien on Screening

Irish Independent-“The head of the HSE’s national screening service, Charles O’Hanlon, remains in his post despite a senior HSE director being appointed to oversee the programme that includes CervicalCheck, it was claimed last night.

A spokesman for the HSE said Mr O’Hanlon had not stepped aside, despite comments in the Dáil by Taoiseach Leo Varadkar indicating this was the case.

However, the HSE confirmed that national director Damian McCallion had been appointed with direct responsibility for the national screening service and he will be reporting directly to HSE chief Tony O’Brien. Mr McCallion is national director of emergency management and is the person currently in charge of the A&E trolley crisis.”

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Stop Press!

HSE director general Tony O’Brien given Permission by Minister Harris to Join US Company and is in line to receive substantial fees and share options this year from his role on the board of a publicly quoted US healthcare company that he joined in January

Evofem BiosciencesTM Website exists to advance the lives of women.We believe this work centers around putting each woman in control of her sexual and reproductive health. By providing innovative solutions, such as woman-controlled
contraception and protection from sexually transmitted infections(STIs), we can move swiftly toward our goal of upholding the purpose each woman chooses for her life.
Will The US  BIOSCIENCES COMPANY  Which Current HSE HEAD Tony O’Brien Has Already Joined  Be excluded from Tendering for the New (HPV) Cervical Screen Test?
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HISTORIC DÁIL DEBATE ON  CRIMINALLY DISASTROUS NEGLECT OF WOMENS’ HEALTH BY PRESENT AND PAST IRISH GOVERNMENTS

ALL Opposition Contributions to Dáil Debate Further Down

Listen Here   https://www.facebook.com/seamus.healy/videos/1708168625918273/

(Paste into top Line)

Seamus Healy TD Calls For Abolition of HSE and the Absorption of its Functions back into the Department of Health. This is the only way that Governments and Ministers for Health Can Be Made Responsible for The Protection of the Health of Women and Citizens Generally in Future

Seamus Healy;I commend the bravery and determination of Vicky Phelan. Without her courage, we would be still in blissful ignorance of this scandal.

This is another shocking and shameful episode in the history of this State. Women have been again badly failed. On this occasion, 162 women had medical information withheld from them and, sadly, 17 have passed away. The scandal is the result of a toxic culture of dishonesty, cover up and concealment. It is a profound ethical failure and an appalling breach of trust. What is worse is that this policy of deliberate deceit was signed off on and agreed by the senior management of CervicalCheck. It was not the decision of an individual. The policy agreed by that committee deprived women of their absolute entitlement to know their medical conditions. It was also fraudulent because it deprived women of their entitlement to claim compensation if they so wished.

We must have accountability. The entire senior management team of CervicalCheck must resign or be removed. This scandal is the result of the neo-liberal policies of the Fianna Fáíl-Progressive Democrats Government and successive Governments since then. These policies were initially implemented by the extreme capitalist free marketeer and then Minister for Health, Mary Harney, supported by the then Taoiseach, Bertie Ahern, and then Minister for Finance, Charlie McCreevy. The policies have been continued to this day by successive Governments and Ministers.

The HSE was established specifically to allow Ministers to evade responsibility for our health services, including debacles and scandals such as this one. It was never fit for purpose. It should never have been set up and must be abolished forthwith. Its functions should be reabsorbed into the Department of Health, and the Department and Minister made responsible for the health services.

ALL OTHER OPPOSITION CONTRIBUTIONS 

Deputy Louise O’Reilly(SF):   At the outset, I commend the bravery of Ms Vicky Phelan. Without her determination and fight, this scandal probably would never have come to light and those affected and their families may never have known the truth.

Truth, compassion, and honesty should be evident at all levels of our health service, and even more so at the higher institutional levels of our screening programmes, our hospitals, and the HSE. Nobody is saying for a moment that a health service can be run without human error but when a mistake is made, there should be an apology and the relevant parties must be informed. The reality could not have been more different for Ms Phelan and those women affected by misdiagnosis or, indeed, for the potential considerable number of cases only notified to us this evening.

The scale of the problem is still not known. That is outrageous. There are women who are watching this who are very concerned. There are women who are watching us this evening who are not aware of their own medical records. That is outrageous.

When we look at what has happened, we see the response of the State was to fight a terminally ill woman and her family, to force her to give evidence in a courtroom, to talk about her personal life, her health and her sex life in a room full of strangers. It was then to try to force that same woman into a confidentiality agreement so that she could not speak about what had happened. That was the response of the State. The response was for CervicalCheck to tell doctors treating women to exercise their judgment on whether to tell them about the misdiagnosis and to “simply ensure the result is recorded” if any of the women affected by this had died in the meantime. It should not be at the whim of a doctor to exercise judgment in whether to inform a woman where her health is at risk, and even more so in the incidence of a misdiagnosis. We have the right to know.

Where we should have truth, compassion and honesty, we had malice, vindictiveness and dishonesty. How did the scope for this dishonesty materialise? Why is it not mandatory for the health service to disclose errors and to always tell the truth?

We saw it in this House on 8 November 2017. On a vote on Report Stage of the Civil Liability (Amendment) Bill 2017, the Government, in concert with Fianna Fáil, which abstained, voted through amendment No. 31 which ensured that the process for open disclosure would be voluntary and not mandatory. I welcome yet another U-turn on this issue and I hope that we will now see mandatory reporting – voluntary reporting is simply not good enough. We in Sinn Féin opposed making it voluntary. We voted to make it mandatory but we lost.

A year earlier in a Joint Committee on Health debate on open disclosure, I argued forcefully for mandatory open disclosure. Indeed, I argued for it again on Leaders’ Questions with the Taoiseach, Deputy Varadkar, on 21 February last in light of the case of Ms Alison McCormack, who had a breast cancer misdiagnosis. The practice of keeping quiet when things go wrong is often prevalent in our medical culture and only a statutory duty of candour will address the situation. I welcome that the need for mandatory open disclosure with legislative underpinning is now accepted right across this House but it should not take a scandal to achieve this.

The gendered nature of this scandal is not lost on me, my friends, my daughter, my mother or any of the women who are affected by this. In fact, many women who contacted me have said they are not surprised at the failures of the health service and the State as regards how it treats women. The Minister described it as “bizarre”. No woman who has spoken to me about it has described it as bizarre. Unfortunately, it seems to be par for the course. We are not surprised at the gendered nature of this.

Three times in the past six months I have taken Leaders’ Questions and raised significant issues which solely affect women. In November last, I raised the issue of the drug Epilim and the side effects for children born to women who took the drug while pregnant. In January, I raised the transvaginal mesh scandal, and in February, I raised the case of misdiagnosis of breast cancer. Men often talk about historic injustices perpetrated against women in this State but when we women talk about it, we talk in terms of the present day. This scandal reinforces for women why we should be afraid of the gendered nature of our health service and how the State treats us.

The outsourcing of women’s healthcare through testing of smears in the United States was warned against in 2008. Concerns were raised at that time by Dr. David Gibbons, the chair of the cytology-histology group within the quality assurance committee of the National Cervical Screening Programme. I want to know whether complaints were made at that time to HIQA and how HIQA responded to those complaints because when we know that we will be able to judge whether HIQA is, indeed, the correct authority to undertake this investigation. The then CEO of the National Cancer Screening Service, the outgoing head of the HSE, Mr. Tony O’Brien, insisted that it would be possible for doctors to talk to the person who analysed the smear test in the United States through teleconferencing. There is no evidence that this happened and the Minister might be able confirm that for us.

The then Sinn Féin health spokesperson, Deputy Ó Caoláin, criticised the 2008 decision of the Fianna Fáil-led Government to outsource the screening service during a Dáil debate, stating: “The Minister for Health and Children would rather listen to corporate executives in the private health business”. The Deputy went on to state that the “HSE has awarded the contract for cervical cancer tests to Quest Diagnostics, a US company that has an unacceptably high rate of errors and has been convicted of fraud.” Deputy Ó Caoláin has been proved right and the issue of outsourcing must be incorporated into any investigation.

The Minister must explain to this House if any concerns were raised with the Department of Health over the past ten years regarding the outsourcing of these tests and if any internal concerns were raised about the efficacy of the tests. Were any audits carried out on the companies concerned and does Clinical Pathology Laboratories still hold a contract with the State for smear tests or any other screening or diagnostic work?

The Minister says he became aware of Ms Phelan’s case on 17 April. Was he aware of the audits from 2014 and subsequent analysis of the misdiagnosis which was continuing since 2017? Tony O’Brien has said he only found out about the issue when he heard of Vicky Phelan’s case from the media. I find it hard to believe the Minister only found out on 17 April but it is even harder to believe that Mr. O’Brien found out from the media. I do not see it as plausible. The State was being sued for a substantial sum of money. Surely the nature of the case and the cost involved would have sent alarm bells through the HSE, the Department of Health and up to the level of Government.

The Minister articulated his lack of confidence in the leadership of CervicalCheck last week. It will be interesting to ascertain his confidence in Mr. O’Brien and in his role in this scandal. Maybe it is the case that their fortunes are inextricably intertwined and it might account for his reluctance to relieve him of his duties. The general public would also welcome a statement from Eunice O’Raw, general counsel for the HSE, on the decision of the HSE to fight the case of Vicky Phelan and on what information was provided to Ms O’Raw regarding the case by the HSE and what information she provided to the HSE and the Minister.

The toxic culture of concealment and harassment pursued by the HSE and the Government against women who have been wronged by this State is now in full public view. It is a disgrace that the State, the Government and the HSE consistently behave the way they do when such cases arise. It is unacceptable that agents of the State pursue victims of their failures and do so in such an aggressive manner. They behave this way because they take their cue from Government. The Minister must ensure that other affected women are not forced to fight the State through the courts as Vicky Phelan and others have been made to do.

I will finish by saying that in the course of my work before I was elected, I had occasion to represent people who were engaged in a dispute with the HSE. I have seen how vicious and aggressive it is when it pursues people. I have seen people’s lives destroyed by the HSE, some by virtue of the fact they were whistleblowers and others by virtue of the fact that they found themselves on the wrong side of a reported incident and of which they were subsequently found innocent. I have seen what the HSE and the machinery of the State is like when it goes up against an individual. For that reason, I commend Vicky Phelan on what she has done. She should not have had to do it.

Nobody believes the health service can be run without error or risk but they demand that it will show compassion and be truthful and honest. That is not what has happened to date. The people deserve better than this. Vicky Phelan deserves better than this. The victims of misdiagnosis deserve better than this. Not only do the women of the State deserve better, but we demand better than this. I hope for the Minister’s sake that he has the answers the women of Ireland seek this evening.

Deputy Alan Kelly(LAB):   Here we go again – Magdalen laundries, hepatitis C, Brigid McCole, Susie Long, Rebecca O’Malley, a neighbour of mine, Amanda Mellet, who I brought to meet the Minister, and now Vicky Phelan. We have a real problem in this country protecting women’s health. This issue is on the Minister’s watch. He needs to do the right thing. I join with thanking Vicky for her openness and for the way she has put herself in the public spotlight. I am sure she is watching me speak now and is listening to all of us. She has put herself in a very difficult situation out in the open and she is doing it for the betterment of women across Ireland. We need to stand with her and deal with this issue on her behalf because of the bravery she has shown.

The most important thing we need to deal with is the 208 affected women. They need our protection and support, our endeavours and a health system that will support them. Of the 208, 46 have been told, two of whom have passed away, and 162 are in the process of being told, 15 of whom have unfortunately passed away. We need to deal with the bombshell the Minister has just landed tonight, which I was not prepared for. We need to know the number of cases that have not been audited. The Minister has not told us in his speech. It is a bombshell. What number of women have not had their cases audited? Are they recent? Here is the real issue. If they are not recent, what was the basis for not selecting them in the first place from the national cancer register? We will be having questions later, but these are fairly obvious questions and worrying times. This is a very live issue for the people and the women of Ireland. I hope the Minister will be able to answer that in detail because it is concerning. If the Minister has that detail, he has not given it to the House. The shake of his head indicates he does not have it. We cannot get near the detail of this without that information.

We all have a duty to ensure there is public confidence in the screening process for cervical cancer and in the other screening processes. It is a duty we should all honour. The screening process along with the HPV vaccine, which our party has pushed, are essential to prevent women getting cancers throughout their lives. We all have a duty to ensure that confidence is maintained in these.

I met with officials from the Minister’s Department for an hour and 20 minutes recently. What did his Department know about the issue? What did it know about similar cases? I accept what the Minister is saying, that he did not find out until 16 April. Was no human being in the Department of Health aware of this case or any similar case or issue preceding that? It is an answer the Minister will have to give. The words that jump out of the memo are: “The SCA is of the view that publicity around the case … is likely.” I do not think this memo would have ever seen the light of day only for the potential publicity that would surround it which we all know now is causing serious issues and worry for women across Ireland. It says a lot to me about the Department of Health. It says a lot to me about the political culture. It says a lot to me about the way in which we administer health in the country that this note was justified on the basis of the potential publicity.

The NCCP has an awful lot of questions to answer. In the briefing note, it says that they do not consider this to be a patient safety incident, which it is not credible. It is not acceptable and it is deeply worrying. That it would put in the memo to Government is far more worrying than the clinical director resigning. I took the trouble this evening to look up the governance of CervicalCheck. We all know about the resignation of the clinical director. She reported to the head of screening, an assistant national director. What is his role in this? Where is the accountability? The people are sick to their back teeth of the lack of accountability. He reports to the national director of the national cancer control programme. What was his role in this and did he have knowledge of it?

Who reports to the recently appointed chief clinical officer who reports to the director general who we now know found out from RTÉ? Does it not say a lot that the Minister knew about this issue before the director general of the HSE did? There has to be accountability for all of the layers. I know that this lady resigned after the Minister had expressed no confidence, but does he have confidence in the structure, in the people in it, or was it just because of weak media performances somebody had to be chosen to go under a bus?

The investigation cannot be led by HIQA. With respect, I completely disagree with Deputy Stephen S. Donnelly. If the Minister goes down this route, he will end up with a commission of investigation. This is a national scandal and, for many reasons, HIQA is not the organisation to carry out the investigation. It has powers to investigate, take documents, go into organisations and seize computers, etc. but under the legislation, it only has limited powers to do so in certain circumstances. It has no powers whatsoever to compel the attendance of witnesses, direct a witness to answer questions or take sworn evidence. Witnesses are given no immunity in giving their evidence. Given what we now know about medical candour and the profession, does the Minister honestly think that unless the witnesses have to do so, they will give all of the information needed? HIQA will not have the capacity to cross-examine personnel, which will mean that in many cases the evidence given will not be able to used in the making of findings. I guarantee, for all of these reasons, that if the Minister, with Fianna Fáil, pushes this through, we will be back in this House looking for a commission of inquiry because the public will demand it. I ask the Minister to, please, listen to me, measure this appropriately and do the right thing because we will soon be back debating this issue. HIQA does not have the powers to deliver. I do not believe it even has the capacity or the resources to do so, even it is the right authority. The Minister needs to change his mind in that regard.

We need to act quickly. General practitioners, GPs, have not been given guidance on what to tell people. We need to ensure the women of Ireland know where to go with their concerns and that when they go to GPs or other medical professionals, there will be a structure in place such that their concerns will be addressed. We also need a guarantee that resources will be available to deal with far more inquiries which will be needed and that all those being screened will have their problems addressed, too. The Minister needs to give a guarantee to the House that all of this is in place and that everyone will have the information they require.

Deputy Bríd Smith(PBP):   On behalf of People before Profit, I salute Vicky Phelan, a national hero, and wish her the very best of solidarity in the struggle she faces so bravely. We know some details of what happened, but we do not know enough. The Minister is conducting an investigation, etc. but the Academy of Clinical Science and Laboratory Medicine has asked him to publish the results of the 2014 audit. When will that happen? It is very important to know.

We know that what happened in 2014 was the result of a policy decision and its consequences were debated and well known in 2008. I am sure all Members have read the Official Report of the debate at the time. There were very articulate cases made to the then Minister, Mary Harney, and the Fianna Fáil-Green Party Government against putting the service out to tender. It did not have to be tendered for. She said it had been put out to tender “for reasons of transparency, fairness and equity to make sure it got the best quality assured service” and that “80% of points were allotted for quality and turnaround time and 20% for price”. We had a political choice in 2008 to invest in several laboratories based in Irish hospitals, using Irish experts and training new scientists in the Irish public service. As in many other cases, however, where we justify privatisation and outsourcing, we use the excuse that the system is in crisis, that there is a backlog, that it takes months to get a result and that we have to go to the wonderful private market. We treated cervical cancer screening, a vital service on which tens of thousands of women rely and for which they understand the need, like every other service or good and organised a tendering competition for it, inviting firms from around the world to bid for it and awarded it to the lowest bidder. That is the logic of the market in privatisation. That was the action of the Fianna Fáil-Green Party Government, with Mary Harney, in 2008. The justification was that market competition and private companies were better than publicly funded and run health services.

In 2008 very definite and reasoned arguments were made in this Chamber against foreign multinational control of this vital service. Many of the arguments were made by the then Fine Gael health spokesperson, Senator James Reilly, and Deputy Jan O’Sullivan of the Labour Party. Their arguments were sound and clear. The firm that won the initial contract, Quest Diagnostic, had been found guilty of repeated episodes of fraud in overbilling; several studies found that the detection rate for higher grade pre-cancers was low, while we know from several sources in Ireland that there were severe and real problems in allowing a US firm such as this to provide screening for cancer. Dr. Gibbons warned that cases would be missed if we outsourced to the United States. The union which represents workers and scientists in laboratories warned that the outsourcing of smear test screening would mean that we would lose the ability and expertise to conduct such screening in this country. Many experts, doctors, scientists and consultants in the field were shouting at Fianna Fáil, the Green Party and Mary Harney that this was bad, that it would cause problems, that women would suffer and that cancer cases would be missed. They were ignored and the political decision was made to pursue tendering and outsourcing. A couple of years later the very people who had railed and shouted against it got into power. When Fine Gael and the Labour Party were in power, Senator James Reilly did nothing as Minister for Health and the subsequent Minsters for Health, Deputy Leo Varadkar, now the Taoiseach, and Deputy Simon Harris, did nothing about the issue about which they were so worried.

The policy of outsourcing has continued and today we are hearing defences from the Taoiseach, the Minister and the HSE on the basis that the problem was not outsourcing but something else and that these things happen. One thing is clear: the privatisation of the health system is ideologically driven by the main parties in the Dáil and in every area where it has been implemented people have suffered, continue to suffer and, worse in this case, women have died and will die as a result. We have no faith or belief the Government can address this crisis. It might succeed in pinning the blame on something else, but the scandal is political and involves the political choices made by various Ministers and those in power. If the Minister was a bus driver and crashed and killed 17 people, or even one person, he would be sanctioned by his employer and before the courts. Heads have to roll in this Dáil for what has happened. It is not good enough to pass the buck. “Something is rotten in the state of Denmark” and, ultimately, somebody will have to take responsibility and take the consequences. 

Deputy Ruth Coppinger(Solidarity):   We have a very patronising attitude to women in this society, as evidenced by the outrageous treatment of the women involved in this case, a paternalistic attitude among doctors to women, and a refusal to allow full disclosure to patients. I want to speak about an issue which some of the parties in this Dáil do not seem to be interested in, namely, privatisation, which has led to this situation. The outsourcing of cervical smear tests in 2008 was part of the privatisation of health services. A critically important part of health services for women was starved of funding and resources. A HSE recruitment ban meant test backlogs inevitably built up and outsourcing became the solution. This is the way in which privatisation is usually forced through.

Individuals must account for themselves but the majority of parties in this Dáil also must account for themselves. In 2008, the then Minister for Health and Children, Mary Harney, was warned by senior people that private testing would be less rigorous and unsuitable for a three to five year frequency, that detection rates on tests carried out by Quest Diagnostics would be lower, at 85% versus 95% in the Irish laboratories, and that Quest Diagnostics had been fined $40 million for fraud and false claims. In response, Mary Harney and the then Fianna Fáil Government opted for value for money and we got the worst of both worlds, with less frequent and low-quality testing leading us to where we are today. Dr. David Gibbons should be heroically saluted for warning about this ten years ago. How prophetic was what he said. It is likewise with Sam Coulter-Smith. The Rotunda Hospital had a world-class testing service and the majority of parties in this Dáil opted for testing on the cheap.

Profiting from health had been good value for Quest Diagnostics. Only two weeks ago, it reported revenue of almost €8 billion and profits of more than €1 billion in 2017. It is a company that carries out 80 to 100 smear tests per staff member per day when a maximum of 50 per day is the National Health Service recommended rate. In Ireland, 30 to 35 tests was the norm but nothing happened. The unusually low percentage of negative results was highlighted but nothing happened. The former Minister for Health and Children, James Reilly, and the then parties in power also did nothing. The test results never reached the 1.8 average which is international best practice, the reason being that the system chosen was not as good as that which pertained in the US never mind in Ireland. This outsourced service was retendered in 2010, 2012 and 2016 but no action was taken by those who were Ministers for Health and Children during that time, including Mary Coughlan and James Reilly. Despite the warning issued by James Reilly to Mary Harney in 2008, he chose not to act. The former Minister for Health and now Taoiseach, Deputy Varadkar, and current Minister for Health, Deputy Harris, also have questions to answer in regard to why they did nothing about the low rate of results. There were many debates in this House on the national screening programme down through the years but the nothing was done because the Government does not support public health services. It continues to underfund them and to look for the next privatisation opportunity. Thanks to this State, MedLab, the company which Vicky Phelan had to sue, has the contract for the privatised bowel screening programme. Does the Minister propose to do anything about this?

The brutal treatment of Brigid McCole by Deputy Michael Noonan was eventually exposed. Despite all of the solemn undertakings, we now learn about the appalling treatment of the women in this case. What will be the next catastrophic failure of privatisation in this country? Will it be the privatised bowel screening programme? Will the Minister stop cutting corners on women’s health and return to a nationalised public testing laboratory system that is adequately staffed and carries out deep screenings? The Minister said in his speech that a further tendering process will take place for testing carried out outside of the public system. Following on from the platitudes we have heard today, this Dáil must ensure that the testing system is returned to public ownership and adequately funded and staffed. It is unbelievable that we do not have two pairs of eyes on every test result, as is standard in other countries.

Deputy Clare Daly(Ind For Change):   Mistakes happen no matter what systems are in place. Tragedies happen and they will continue to happen, but the issue facing us as a society is how we respond to those mistakes and tragedies, how we treat the victims of those mistakes and tragedies and whether we learn the lessons. I find the shock and horror expressed in some quarters a little hard to take. The saddest thing about this latest scandal is that it is just the latest one. It is not new to see the State Claims Agency taking people to war. It has been doing this for a long time. It is not new that the HSE drip-feeds information. Even tonight, the Minister has been put in the unenviable position of coming in here with new information. The Minister is continually being drip-fed and having to clarify information. We need to get to the heart of what is going on. This is the only way that we will serve Vicky Phelan and all of the other victims of our appalling health service.

The Minister correctly said that this issue puts the spotlight on our open disclosure policy, which has been in place since 2013. It has been a policy of the HSE since 2008 that all instances should be disclosed, which is coincidental timing in terms of this issue, but it is long known that this is not the case and that what we have had is not enough. This was known in 2015 when we questioned the then Minister for Health, Deputy Varadkar, on why there had not been a mandatory duty of candour inserted into medical contracts and why, given the weekly medical negligence claims and legal fees, a failure to disclose was not a criminal offence and so on.

It was obvious in the discussions last year around the Civil Liability (Amendment) Bill that there was a problem with open disclosure. Lest anyone is confused, this is only about indemnifying doctors and nurses. This is not an open disclosure policy, it is legal cover. We made the arguments at the Committee on Health and Fianna Fáil was swayed by those arguments and came on board. What happened next? I got more attention from the HSE than I have got in my life. Over the summer, there were emergency calls and meetings arranged with the chief medical officer, all to tell us that we were wrong about our amendments. We had a meeting with the Department of Health and the HSE in which we asked for the evidence to support their argument and we were told that making open disclosure mandatory would make it less rather than more likely that open disclosure would happen. This was the line put forward by the Department of Health and the chief medical officer, the same line that was given to the then Minister for Health, Deputy Varadkar, when he came before the health committee in 2015 and argued for mandatory disclosure. In my opinion, he genuinely put forward that view. He made the point as a doctor that failing to live up to a duty of candour was the equivalent of a motoring hit-and-run. He was fully signed up to mandatory open disclosure.

The health committee, having heard from several stakeholders which said that mandatory open disclosure was necessary, did not recommend it. What happened? The arguments were made, the science and international evidence was produced and previous Ministers, Fianna Fáil colleagues and others supported mandatory open disclosure, yet behind the scenes the HSE went to work and put out the argument that it was not the best way forward. The HSE can dress it up whatever they like, but at the heart of that dressing up is a fear of litigation. The HSE tells Ministers that this and that cannot be done because it will cost the State money. It is symptomatic of problems in that organisation. It gives me no pleasure to say, “We told you so”. We stand over the arguments we made last year. Sadly, if they had been incorporated in the legislation, we would be further down the road and not moving after the horse has bolted.

I am open to a HIQA inquiry in the sense that HIQA is good, but I echo the point that it is limited in its scope to an extent. I think we have to go further. In 1987, the New Zealand Government ordered a full-scale independent judicial inquiry into the deaths of 26 women who died in the 1970s and 1980s from cervical cancer, again a national scandal. This inquiry was an independent inquiry along the lines of the Commission on Nursing in this State, which is what we need if we are to get to the root of this and get to the heart of way in which women’s health and reproductive issues are dealt with, or rather are not dealt with, in the State.   Not too long ago I praised the Minister for Health, Deputy Harris, for his speech on the eighth amendment. I warned the Minister that night that I would not be praising him permanently and I certainly do not praise him tonight. The Minister’s speech tonight is more of a spin than an elucidation of what has happened. Reference was made to Brigid McCole who died in October 1996, just over 21 years ago. There has been time to reason and learn from that. At that time the Office of the Chief State Solicitor, acting for then Minister for Health, Deputy Michael Noonan, warned Positive Action that unless it went quietly to the compensation tribunal it would face “uncertainties, delays, stresses, confrontation and costs,” and so on. The State pursued Brigid McCole almost right up to the day of her death. It said she had tried to sue under a pseudonym in order to keep her privacy. The State also fought that. I do not have to time to go into the details but we could see the full power of the State coming down on the body of a woman, Brigid McCole, and her family. Here we are 22 years later with the same type of spin.

The Brigid McCole case was absolute bullying but what is coming across now is more of a patronising attitude that “we know best”. As a woman, I do not want reassurance. I do not believe that the women of Ireland want reassurance. They would like full information so they can make up their minds on what screening they will access. With regard to this specific issue, the women who are affected need full information. The Minister told the House tonight that information is “emerging” as we speak.

The Minister has given Members a copy of a note in regard to the briefing memo. The Minister’s speech has a mistake in it. On page 2 of the speech, the Minister refers to the note which said that the claim against the HSE was likely to fail or be “dropped in the absence of any bad faith”. That is not accurate. The note had referred to exemplary damages and the advice from the State Claims Agency that the exemplary damages might not succeed because of lack of faith, not that the case would be dropped. The note also mentions that there was no chance of the case settling because – I believe very bravely – the woman in question would not accept a confidentiality clause. The lab had said that it absolutely had to have a confidentiality clause. Deputy Alan Kelly has already referred to the extraordinary aspect that the National Screening Service and Mr. Jerome Coffey, the head of the National Cancer Control Programme had advised the Department in writing that this was not a “patient safety incident”. Perhaps the Minister will explain how anybody could possibly say this was not a patient safety incident.

There is so little time. I do not believe a HIQA investigation is the answer. There are so many questions and to say that HIQA is the answer is certainly, at the very least, premature. We need to establish the full facts and reports on how many women have not been contacted. It is not good enough for the Minister to come to the House tonight to tell us that facts are “emerging”.

I received an email from a person who pointed out that a smear test in 2012 had a result that was interpreted wrongly, or a wrong result given. This happened on two different occasions and radical surgery ensued in August 2015. I understand that this person wrote to the head of the screening programme, but no reply was received.

How many letters have been sent by women throughout the State that have not been replied to? What other legal proceedings have been instituted, settled or are still pending? How many cases have been settled with confidentiality clauses because the women had to cave in given their circumstances? At the very least, all this information should be before the House tonight.

It is extremely worrying to me as a woman when I have heard language being used on the radio over the last week or two, which seeks to reassure us. Reassurance cannot, and should not, be given. That is not our role at this point nor is it the Government’s. It is the Government’s role to give full information and to set up a proper, independent inquiry that, with full information, will give some trust back to the women who have been affected and to the women of Ireland. I do not want any platitudes nor do the women who are writing to me.

Deputy Michael Harty(IND):   It is extremely important that women, not the process of investigation, remain the focus in this regard. While the process is important women should remain the focus. Population health screening is an important part of our health service, and none more so than cervical screening. Confidence must be restored in the cervical cancer screening programme because this programme has identified 1,482 cases of cancer over the past ten years. The majority of those cases have been identified by the cervical screening programme. Many thousands of pre-cancerous changes have also been identified, preventing people from developing cancer and preventing the progression of cancer in some people. The importance of the scheme is without doubt. Hundreds of thousands of consultations take place in general practice each year where sexual health is the subject of the consultation when people attend for screening. This is also very important. There are many aspects of the screening programme that must be maintained and confidence in the programme must be restored.

The cervical cancer screening programme works for the vast majority of women in Ireland who engage on a regular three-yearly cervical screening smear. The regularity is essential – one smear is a case in point. If a woman has a regular smear it adds to the value of those smears.

Like all screening programmes, cervical screening has its limitations and false negatives will arise no matter what the screening programme is. These must be kept to a minimum by having a double reading, by having high-quality screening laboratories and by upskilling those who perform the screening. This will keep mistakes to a minimum.

This scandal is what transpires when mistakes are identified but the information is not transmitted. This is the core issue. The failure of open disclosure of false negatives to patients is unforgivable, and there may be additional false negatives now because we are hearing that not all cases have been audited. It is true that disclosure would not have affected the treatment of these patients’ cancer but that is not the point. Disclosure would have helped the women to deal with their illness. It would have provided them with knowledge and it would have given them the opportunity to take legal action if they felt they had been damaged or injured by the process and if they wished to do so.

The issue now is that the process has trumped the patient. This is so often the case in many health scandals; the process becomes much more important than the patient. Governance and poor judgment are the key to this. Such paternalistic attitudes towards transmitting information have to be eradicated from our health service. In one sense Vicky Phelan was lucky in that she had the capacity, the will and the knowledge to pursue her case. Many of the patients whose false negative results were not transmitted to them have not had that opportunity. This scandal has arisen by not disclosing these issues for fear that the cervical screening programme had something to hide and by not being upfront and honest. Being upfront and honest, admitting that a mistake had been made and transmitting the knowledge would have empowered the programme and the patient. Admitting a mistake is very empowering for the person who admits it but it is also empowering to the patient who receives the information. By not disclosing these issues we now have the current scandal and the lack of confidence in the cervical screening programme. Quite often it is the cover-up of the issue that attracts the attention rather than the original mistake. We have to recognise that it is most likely that the cervical screening programme did not wish to reveal the false negatives for fear of litigation, but now we are in midst of this scandal. Open disclosure is the only way to go and mandatory open disclosure is extremely important.

[Deputy Michael Harty:  ] We have to engage in a root-and-branch review of the cervical cancer screening programme. We have to review outsourcing, the frequency and quality of testing, the governance of the cervical screening programme, the responsibility, and the transparency in it. We have to review open disclosure and have mandatory disclosure. We have to review compensation and try to restore credibility in the service.

Deputy Mattie McGrath(Ind):   Here we are again, debating once more the chronic and apparently unresolvable dysfunction within both the HSE and sections of the health service. We know that at least 17 women have died. We also know that this is far from the end of the matter and that in all likelihood, as time goes on, more women and families will emerge. Children will be and have been robbed of their mothers’ precious love. Young girls and boys will now grow up with no mother to share their concerns and their hopes and dreams. It is an appalling dereliction of care and a catastrophic failure that is making the people of this country sick to the core. The infuriating thing about this is that we never seem to learn our lessons sufficiently well from the previous debacle and mistakes. We all lament the deaths of these women. We all praise and support the courage of Vicky Phelan and her husband and children, who are now enduring a living hell. I salute Mr. Cian O’Carroll, a solicitor from Cashel, too.

All of this was brought to light out of the murky shadows of legal wrangling by a mother who was determined to find answers and to have accountability, on her own. If Vicky had not done this, would we still be living in blissful ignorance of the shocking failures of oversight and governance that have brought us to this situation? I say that we would. The Taoiseach had the gall to say today that we should not call for the head of Mr. Tony O’Brien, head of the HSE, because, the Taoiseach said, “everyone deserves a fair hearing”. My goodness. How many fair hearings must Mr. O’Brien get before he is sacked? What fair hearings have the unfortunate ladies who have died, and their families, got? That is arrogance of the highest order. What about fair hearings and fair procedures for the women and families caught up in this sickening spectacle?

Last week I criticised Uisce Éireann on another matter by saying that it had displayed institutional arrogance. The very same could be said of the HSE. This is institutional arrogance and indeed political arrogance on the most horrifying scale. What hope can any of us place in such a body as the HSE, the most senior management of which seem indifferent to the realities of human life and whose first response is to ring for the barristers at the first hint of trouble. It is continuous and the barristers are creaming it all the way. The person or persons involved are then bombarded with legal challenges and intimidated further, adding to already existing stress. Where is the shame then? Where is the mock rage or sense of outrage then, when we do this daily? I salute the extraordinary courage of Vicky Phelan and all those women and families who have been dragged unwillingly into a scandal of enormous dimensions. Agencies of the State have robbed them of peace and subjected them to an horrific ordeal.

At the very least it is a scandal which demands the resignation of Mr. O’Brien and the Minister, Deputy Harris. The Minister is the head. As I said earlier today, the governance structure of the HSE is absolutely clear. The buck stops with the Minister, Deputy Harris, as the person who has overall responsibility for the leadership of those who direct and control its functions and who manage its business. In light of that, it is completely unsatisfactory for the calls for resignations to be reserved to Mr. O’Brien, the CEO, whom the Minister defended here recently, saying he was right to call parents emotional terrorists. I called the Minister a puppet of the HSE that day, and he is still a puppet. This is disgraceful and the Minister must go. Any objective observer who analyses the Minister’s stewardship of the health service can only conclude that he has been an unmitigated disaster. There are record levels of patients on trolleys, chronic lack of bed capacity, a recruitment and retention policy of front-line staff that has had abysmal outcomes and last but not least a systemically dysfunctional HSE that has caused dozens of lives to be lost. What on earth will it take for the Minister to be sacked or to resign? Has he no shame? Look at Theresa May’s Government. She has lost four Ministers in a short time and nobody died. This is manslaughter at least. The gardaí in any other country would be out arresting people and charging them with manslaughter or worse. This is shameful. It is wilful destruction of people’s lives and families, perpetrated by the HSE ad nauseam. The Minister came to Cashel with me and looked at pristine new building which was empty. This is outrageous. The Minister has to open it and put beds in it. There is still not a bed in it. The Minister has no say whatsoever in the HSE so he should stand aside and let in someone who can stand up and do the job. The Minister is clearly unable, unfit and unwilling to do it. Shame on the Minister and on his colleagues. He must go now and bring Mr. O’Brien with him.

Deputy Róisín Shortall(Social Democrats):   I am sharing time with Deputies Eamon Ryan and Seamus Healy. I pay tribute to Vicky Phelan, who has done this State some service. We know something of this scandal that is unfolding because of her determination and courage. Thanks to her bravery and refusal to sign a confidentiality clause, we are now beginning to find out just what happened behind this whole debacle. Had it not been for that, we might not have known anything about this. We were very lucky that Vicky Phelan is the brave person that she is. This may all have been hidden behind a court case and confidentiality clause.

The priority in all of this has to be the women concerned. We have to ensure that everything possible can be done for them. It has not been done up to now but at this point the Minister has to give an absolute commitment that everything possible will be done for those women in the provision of whatever health services and supports are required. There is also a requirement that the Minister give a commitment that the State will not contest any cases that are in process or that might arise as a result of this scandal. There can be no question of the State pursuing any of these women in the aggressive manner that we saw displayed with Vicky Phelan and many other cases through the years. That has to be a priority.

The other priority has to be all of those women who are now so nervous and are wondering if they will get a phone call. For that reason, I think there was mishandling of this in recent days. The information that was available to the Minister and HSE was not made available and huge uncertainty was allowed to develop over many days. The Minister has made a shocking disclosure to us tonight, that there is a potentially considerable additional number of women who are not subject to audit and we do not have any information about them. It is not acceptable to put all of this into an inquiry where we may or may not get answers in 12 months or longer. Experience with other inquiries and tribunals is that we have been told that an issue is all a matter for an inquiry or tribunal. That is not good enough in this case. We have to get answers now, not in 12 months. The Minister needs to come into this House in a matter of days when he has further information about that shocking disclosure that he made tonight.

There is a fundamental question at the heart of this issue, about how it is that an audit was carried out, not acted on, why there was such a long delay in notifying the clinicians’ concern and, more importantly, why there was such a delay or utter failure to notify the women concerned. We need to know what policy is being pursued. Is the Minister still talking about a situation that is utterly paternalistic where women are kept in the dark? Will the Minister clarify that for us? What is the policy in that respect now? Will the Minister clarify, with regard to the duty of candour, when action will be taken and when the medical and legal professions will be faced down in this regard? We have no more time to waste with that.

Deputy Eamon Ryan(Green):   We owe it to Vicky Phelan, her family and her courage and honesty to correctly set up a means through which to find out what happened, who was responsible, and how we can avoid it happening again. I have listened to various views expressed in that regard. I have a concern about the view that we should opt for a commission of inquiry because all Members know that in spite of constant promises to the contrary such inquiries take years and always have, which would not be in the interests of families caught up in this scandal. I agree with Deputy Clare Daly that perhaps a way to approach this would be to immediately instigate an inquiry by the Health Information and Quality Authority, HIQA, and set up a wider commission which would investigate how to create a patient-centred healthcare system and would consider the key issue of how to avoid a recurrence of what the Minister referred to as the paternalistic approach to medicine displayed in this case. That commission would be key because the scale of the change we must make is huge.

Any inquiry should begin with the question of what happened in 2008. There was a clear Dáil debate on the issue at the time. Dr. David Gibbons and Dr. Sam Coulter-Smith have made clear that at the time they placed on the record real concerns with the policy approach that was taken. I have asked colleagues and friends who were then in Government to recall the Government internal mechanisms around the issue. To the best of our recollection, it was not a contentious issue. Whether it was motivated by a desire to scale up the number of cervical smear tests in order to save lives or, as some have argued, an attempt to save money by contracting out that service must be investigated. I have no recollection of it being the latter rather than the former.

Neither the Taoiseach nor the Minister in his statement addressed the argument of Dr. David Gibbons which I heard yesterday that the divergence between an annual versus a three year screening system may have been the cause of some of the problems. Although that question may have been answered elsewhere, I hope it will be answered here this evening. The Taoiseach clearly stated that there does not appear to be a difference between the various screening processes being used in terms of the level of accuracy and so on but we must have more detail on that issue.

We must have answers to key questions, such as who was involved in the 162 of 208 cases in which the information was not passed on and the reason for that. Which clinicians were involved? Who was responsible for that lack of disclosure? The most numbing and frightening effect for everyone involved in the Irish health system is the question mark over whether a patient can trust that he or she is being told the right thing. We must have further details on that issue.

I listened with interest today to Members I respect and who have much experience in this area, and from them I heard the common theme that the lack of candour or disclosure may have been due to a fear of litigation. That brings me back to the wider commission of inquiry. I raised earlier with the Taoiseach and the Minister for Justice and Equality, Deputy Flanagan, who answered my question on promised legislation, the issue of whether there are plans to move away from a legally based system to a no-fault medical liability system. As Deputy Shortall and others stated, we must ensure that everyone involved in this process of inquiry will not be shut down by the fear of legal action. How can that be done without a shift away from the current system? As the Taoiseach stated earlier, there always will be a small percentage of false negatives or false positives. Given that is the case, surely it would be better for us to move away from this being a legal process towards admitting fault, helping patients and being patient-centred in what we do.

Deputy Seamus Healy(IND-WUAG):   I commend the bravery and determination of Vicky Phelan. Without her courage, we would be still in blissful ignorance of this scandal.

This is another shocking and shameful episode in the history of this State. Women have been again badly failed. On this occasion, 162 women had medical information withheld from them and, sadly, 17 have passed away. The scandal is the result of a toxic culture of dishonesty, cover up and concealment. It is a profound ethical failure and an appalling breach of trust. What is worse is that this policy of deliberate deceit was signed off on and agreed by the senior management of CervicalCheck. It was not the decision of an individual. The policy agreed by that committee deprived women of their absolute entitlement to know their medical conditions. It was also fraudulent because it deprived women of their entitlement to claim compensation if they so wished.

We must have accountability. The entire senior management team of CervicalCheck must resign or be removed. This scandal is the result of the neo-liberal policies of the Fianna Fáíl-Progressive Democrats Government and successive Governments since then. These policies were initially implemented by the extreme capitalist free marketeer and then Minister for Health, Mary Harney, supported by the then Taoiseach, Bertie Ahern, and then Minister for Finance, Charlie McCreevy. The policies have been continued to this day by successive Governments and Ministers.

The HSE was established specifically to allow Ministers to evade responsibility for our health services, including debacles and scandals such as this one. It was never fit for purpose. It should never have been set up and must be abolished forthwith. Its functions should be reabsorbed into the Department of Health, and the Department and Minister made responsible for the health services.

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THE HSE WAS SET-UP PRECISELY TO AllOW MINISTERS TO EVADE RESPONSIBILITY FOR SUCH AS THE CERVICAL SCREENING DEBACLE.
Minister Harris and Taoiseach Varadkar “Didn’t Know” and were not entitled to be told!!!! Full Discussion http://wp.me/pKzXa-KR
Now They Are setting Up enquiries etc etc
But they are not proposing to reabsorb the HSE into the Department Of Health So That They Will Be Entitled to Know in Future and Be Responsible for Protecting Women and citizens generally

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HSE FUNCTIONS MUST BE RE-ABSORBED INTO THE DEPARTMENT OF HEALTH WITH THE MINISTER FOR HEALTH FULLY ACCOUNTABLE FOR THE ACTIONS OF HEALTH SERVICE EMPLOYEES and SUB-CONTRACTORS  AT ALL LEVELS.

Divesting of Responsibility for the Health of the Irish people by Governments, Cuts in Provision of Resources to the health service and Extreme Right Wing MANAGERIALIST Models of Public Governance and Delivery of Services Are the Causes of Current Debacle in Health Services.

THE HSE IS a PROVIDER of SERVICES TO “CUSTOMERS” or “CLIENTS”

Extreme Capitalist Free Marketeer, Minister Mary Harney, put the system in place with the Agreement of Bertie Ahern and Charlie McCreevy in 2004. FG and Labour kept the system in place since 2011.

Health  Bill  Nov 2004  Minister Mary Harney

Martin Ferris (SF) OPPOSING THE BILL: “The main flaw in the Bill is its proposal to increase the centralisation of overall administration and key services in the health sector. This will further the agenda laid down in the Hanly report whereby decisions will be made with no input from democratically elected representatives. While the Bill attempts to gloss over this matter by proposing to establish a national health consultative forum with fora at regional level, these will have no practical role and will merely provide a thin democratic veneer over the reality of centralised dictats.”

The most telling responses from the Minister for Health to questions on the recent debacle highlighted by the bravery of Vicky Phelan were “No. I did not know”. The most senior elected representative of the people of Ireland with responsibility for the health of the Irish people did not know of the deadly danger in which Irish women were being placed.

The only effective accountability to patients is through the courts. After all, under the Harney model, they are like customers of a capitalist business! Vicky Phelan had to put her house on the line to get the truth through the courts. No legal aid was available to her!

CUTS-Failure to Provide Adequate Resources to Health Services in Ireland and Related outsourcing of Key Functions to Capitalist For-Profit Companies at Home and Abroad Were a key Cause of the Debacle!

The cost of smear testing by the  Us company  is one third of the cost of laboratory testing in Irish Laboratories. Detection rates in Us Company is 30% less than in Irish Laboratories. But women in the US are screened every year  whereas Irish women are screened only every 3 to 5 years. Disater for Irish women was inevitable. Due to cuts and under-provision 70 experienced cell scientists(cytologists)  have left Irish Laboratories since 2008. It will be difficult to restart the quality of service being provided prior to outsourcing.

Concerns were raised over outsourcing smear testing in 2008

https://www.rte.ie › News › Health

A former member of the National Cervical Screening Programme has said he raised concerns about outsourcing Irish smear tests to the United States ten years ago. Dr David Gibbons was chair of the Cytology/Histology Group within the Quality Assurance Committee of the National Cervical Screening Centre.

Dr Gibbons said he resigned because they did not listen to his concerns.

He said that in 2008, due to a backlog and under-resourcing at Ireland’s cervical screening programme, some backlog smear samples were outsourced to the US for cervical cancer testing.

Dr Gibbons and his colleagues had pointed out to HSE that rates of detection of pre-cancers by the American testing company were substantially less than those detected in Irish Laboratories !!!!!!

————————————————————

Irish Mirror-University Hospital Galway ‘hid’ trolley patients for Taoiseach Leo Varadkar’s visit

The hospital managed to reduce the numbers of patients by reopening a closed ward in advance of the Taoiseach’s visit

By Ferghal Blaney     15 APR 2018

 

A hospital has been blasted for hiding patients when the Taoiseach visited – to minimise the scale of its overcrowding crisis.

Fianna Fail’s Seanad health spokesman and family GP Keith Swanick said the “massaging of figures” and moving patients to inappropriate areas to mask the extent of the problem was worrying and dangerous.

Trolleywatch figures from the Irish Nurses and Midwives Organisation show the numbers waiting on trolleys at University Hospital Galway fell from 58 on Wednesday to 26 on Thursday, the day Leo Varadkar came to town.

Numbers crept up to 36 on Friday.

The INMO said he hospital hid the scale of the crisis on Thursday by reopening a closed ward in advance of the Taoiseach’s visit and by temporarily housing patients in the Medical Assessment Unit, normally used to ease pressure on the emergency department.

The INMO said the MAU, which had been shut for three weeks, suddenly reopened on Tuesday night – two days before the Taoiseach arrived. Senator Swanick told the Irish Mirror: “It appears the hospital were trying to hide the patients here, but they’re fooling nobody only themselves

“The public are well aware of the core issue here, and that is that there is still a massive problem of overcrowding that doesn’t go away just because the Taoiseach comes to town.

“However, the fact they moved patients into the Medical Assessment Unit is extremely worrying.

“That’s a unit that’s supposed to be used to prevent people having to go into the A&E, it’s meant to be a day unit.

“It is inappropriate because when the MAU is occupied with inpatients, it means GPs can’t access it, which means they have to send them to A&E then.

“They’re massaging figures and compounding the problem.”

 

———————————————————-

CRUEL HOME HELP HOURS CUTS CONTINUE DESPITE STEEPLY INCREASING NUMBER OF OLDER PEOPLE

HOME HELP HOURS REDUCED By 10% Since 2010 as Numbers Over 65 Rise by 91,000
Could FG-LAB-FF Sink Any Lower?

Age Action“There are a million fewer home help hours available in Ireland today than there were ten years ago in 2006. (Number over 65 has risen by 163,100)
Mr Moran (Age Action) continued: “The HSE warned in its service plan for 2016 that services like home care, home help and nursing home beds cannot keep pace with rising demand and our ageing population.”

Increase in numbers of older people

From   2006 to 2016      =  163,100

From   2010   to  2015      =   90,900

FROM Central Statistics Office    Home / StatBank / Annual Population Estimates / PEA01 /

Thousands                   2006             2010                         2015                          2016

 

65 years and over        462.4            515.1                        606.0                          625.5

 

—————————————

After General Election

Home care cuts must be on the agenda of Government talks-AGE ACTION

Published 30/03/2016

 

Following reports that there is no funding for home care packages in many parts of Dublin, forcing older people to stay in hospitals, Age Action has said care supports must be on the agenda of talks around forming the next Government.

Justin Moran, Head of Advocacy and Communications at Age Action, said: “We need immediate and substantial investment in home care and other supports but that is just a temporary solution.
“Without a statutory right to community care the number of older people forced to stay in hospital longer than they need to will only rise.
“The next Programme for Government should include a commitment to introduce a statutory right to community care and to fully implement the National Positive Ageing Strategy.”

FROM AGE ACTION–Before General Election

The HSE warned last year that they were facing increasing challenges in providing care supports.

Mr Moran continued: “The HSE warned in its service plan for 2016 that services like home care, home help and nursing home beds cannot keep pace with rising demand and our ageing population.

“There are a million fewer home help hours available in Ireland today than there were ten years ago in 2006.

“In advance of the General Election every political party told us they were committed to supporting older people to stay at home as long as possible.

“The best way they can prove that is to ensure that how we provide long-term care for older people in Ireland is addressed in the negotiations going on at the moment around the formation of the next Government.”


——————————

Elderly betrayed as million hours cut from home help rotas, says FF TD-Before General Election!!!

Irish Indeependent    25/10/2015

More than a million hours have been slashed from home help rotas in a “deeply unfair” betrayal of older people, a TD has claimed.

http://www.independent.ie/breaking-news/irish-news/elderly-betrayed-as-million-hours-cut-from-home-help-rotas-says-td-34139710.html

More than a million hours have been slashed from home help rotas in a “deeply unfair” betrayal of older people, a TD has claimed.

Statistics provided to the Oireachtas health committee show a consistent declined service by 1.2 million hours over the past five years.

Fianna Fail health spokesperson Billy Kelleher, who obtained the figures, said older people were struggling to cope with staying at home.

The Cork North Central Deputy said: “The cuts to home help hours for older people are nothing short of disgraceful.

“The assistance hours have been slashed by around 10% over the past five years, and as a result of these harsh cuts, older people are finding it increasingly difficult to stay living in their own homes.”

Since 2010, the number of home help hours is down from 11.7 million to a projected 10.4 this year. (There has been a substantial increase in the population over 65 in the last 5 years-PH)

Mr Kelleher claimed older people were being unfairly targeted.

 He added: “The cuts to over 70s medical cards, to home adaptation grants, to the housing aid for older people scheme, to the telephone allowance, the abolition of the bereavement grant, and the five-fold hike in prescription charges have had a serious impact on older people across the country.

“It is deeply unfair for the Government to continue to target older people in this way. It’s also extremely counterproductive.

“By failing to provide the supports needed to allow people to live securely and with dignity in their own homes, the Government is forcing these people onto the already overburdened hospital system and costing the taxpayer more in the long run.”

From Irish Workers Union (IWU)HOME HELPS WORKING IN THE PRIVATE SECTOR

After a meeting with a lot of home helps now called home care assistants in the Private sector (Working for the private companies) it is indeed a very daunting situation to be in and this is where all Homecare is going. First of all, their wages are.
• €11.60 per hour
• No travelling Allowance
• No Sick Pay Conditions
• No increase of hours as your hours are set and that could mean only 10 hours per week or less.
• No guarantee from one week to the next if you will be working or not.
This is where the homecare is going now and to sit in at this meeting last night gave me a great insight into the way those workers are being treated. The H.S.E. will eventually get rid of the Homecare Packages because it is being privatised on a big scale. This also would explain the banking of hours on the Home helps of the H.S.E. Simply the work is being outsourced to the private sector on a big scale but unfortunately it’s the people that are paying for the banked hours are the people who are really paying the price for the Private sector. We here at the Independent Workers Union are now representing the Home care workers working for the Private companies to get them the pay and conditions they should be getting and we are calling on all the workers in the private sector to stand up and get your rights contact Margaret @087-2469079 follow us on twitter @homehelpshealy Please like and share our page .https://www.facebook.com/pages/Homehelpshealy/720716814667004?fref=ts.

NOTE: Legal Minimum Wage: Minimum Wage 2017 : In the summer of 2016 the Low Pay Commission recommended an increase in the national minimum wage of 10 cents per hour – which will bring it to €9.25 per hour. This new rate will take effect from January 2017.

Home Help-South Tipperary-HSE PAGE
Home Helps work with vulnerable people in the community, who through illness or disability are in need of help with day to day tasks. A home help might visit for a couple of hours per day, to help with housework, shopping, or sometime may provide more personal care like help with dressing, bathing etc. You can access this service through your Public Health Nurse at your local Health Centre or Tel: (052) 6177282.


Workers With No Fixed Office Must Be Paid for Travelling Time

https://www.theparliamentmagazine.eu/articles/news/european-court-justice-rules-travel-time-should-be-counted-working-time

European Court of Justice rules that travel time should be counted as working time

Written by William Louch on 14 September 2015 in News

Controversial ECJ ruling receives mixed reaction from employment committee MEPs.

The Luxembourg court ruled last week that for workers with no fixed office, such as care workers and door-to-door salesmen, time spent travelling to work should be counted as working time under the European Union’s Working Time Directive (WTD) rules.

The ruling does not impact on those with long commutes to fixed work places.

The case has divided MEPs in the parliament’s employment and social affairs committee (EMPL) with German committee chair Thomas Handel, welcoming the move saying, “the WTD is designed to protect the health and safety of workers. If these trips were not considered working time, in my view, this would run contrary to the directive, an important example of EU legislation.”

His colleague on the committee, vice-chair Ulla Tournae also supported the ruling, adding, “the WTD clearly states that working time is the time in which the worker is working, at the employer’s disposal and carrying out their activities and duties. The ECJ has upheld this principle in this specific case to a level I am satisfied with.”

The WTD is designed to protect workers’ health and safety; outlining how long employees can work and how much time off they are entitled to.

The case was brought to the ECJ by Comisiones Obrerars, Spain’s largest trade union, against Tyco, a Spanish security company.

The action was prompted by the closure of Tyco’s regional office in 2011 meaning staff had to travel for up to three hours every morning to install the company’s products.

The ruling states, “if a worker who no longer has a fixed place of work is carrying out his duties during his journey to or from a customer, that worker must also be regarded as working during that journey.”

It continues, “requiring the worker to bear the burden of their employer’s choice would be contrary to the objective of protecting the safety and health of workers pursued by the directive, which includes the necessity of guaranteeing workers a minimum rest period.”

The judgment is expected to have a major impact on employers across Europe.  There has been speculation that the ruling could force companies to put wages up to avoid breaking minimum wage legislation.

The decision has also provoked a strong reaction from the business lobby and centre-right MEPs, who have criticised the measures as undemocratic and interventionist.

Adam Marshall, executive director of policy at the British Chambers of Commerce, said, “once again, a faraway court is taking decisions that could impact business prospects, job creation and economic growth in the UK.”

“Companies of all sizes will be dismayed that Luxembourg is once again intervening in a way that stops EU member states from running their own labour markets.”

UK MEP, Anthea Mcintyre also a member of the EMPL Committee, strongly criticised the measures, saying, “this could add significantly to the costs of businesses and interfere with long-established business practices. It could hit smaller firms which would be bad for growth and bad for jobs.”

She added, “we do not need a straightjacket law imposed from Europe. That just shackles employers and workers alike and puts a dead hand on job-creation and growth.”

However, the European Trade Union Confederation’s Veronica Nilsson said, “the European Court of Justice have dealt a blow against the exploitation of workers. This is good news for many home care workers, repair and maintenance staff and other mobile workers.”

 

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  1. Eleanor Thompson
    December 5, 2016 at 5:53 pm

    I believe there are many who know they are dieing and wish it would end. Family’s and friends have to look on hoping it will all finish for the sake of the person concerned. Is it not time where people should be given the option to be allowed to die in peace if they wish?

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