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Joint Committee on Health debate -
Wednesday, 27 Nov 2019

Business of Joint Committee

With regard to a meeting we are proposing to have on the Royal College of Obstetricians and Gynaecologists, RCOG, review, we have received a letter from the Secretary General of the Department of Health, Mr. Jim Breslin, to say that they would be available to meet the committee on 17 or 18 December.

The Dáil is not sitting then.

Does Deputy Kelly have some comment on that?

I have a deep concern about the RCOG review, which I have flagged numerous times. I flagged it on the day of the apology to the women in the Dáil. I told the Minister and the Taoiseach that they had to get it right. My concern on this has been public for some time. I am very concerned about this letter. I believe that the timelines associated with it are worrying. It is concerning that they want to bring it in here on the final sitting day of the Parliament and release the information at that time.

The letter presents inherent issues. All the individual reports are completed. All of the RCOG reports are done. The letter also says that the aggregate report is now being completed. All the work is done. This was meant to be done by last May, then it was supposed to be done by September and then it was meant to be done by October. It is now done. The letter states:

As individual reports were transferred from RCOG to the HSE, the HSE undertook a detailed verification process to ensure that each report was provided to the right participant. This was necessary given that slides and records were identified by number only during the analysis undertaken by RCOG, to protect the privacy of women and next of kin.

Is that not inherently contradictory? The individual reports "were transferred from RCOG to the HSE". As the reports came back, they went through a filtration verification process. I know all about this process and we will talk about it whenever we have an opportunity to the HSE. When the files were transferred with RCOG, they were given a reference number to protect the privacy of the women and next of kin, yet, when the files came back through the HSE, the privacy for next of kin does not seem to have mattered. How can one have an independent review that has been verified? How can one have an independent review that is anonymous and is then verified by the HSE? Trust me, we are going to get into that detail. That is deeply worrying.

The issue is that the Department is saying it will not bring this forward, even though all the work is done, because all the women need to be communicated with. If the process of verification was so necessary and accurate, then what is the issue? The reports have been done for some time. Why is it taking so long? If the HSE needed to be instrumental in communicating this, and breaking its own rules with regard to privacy, why did it need to use couriers in some cases to find people? Why is there such a delay? Why are we being fobbed off? I have a deep concern over this and over the timelines. The Minister for Health keeps on saying it is coming, and I respect the nuances of what he is saying, but it is being pushed out and I am concerned as to why it is being pushed out. This report is proposed to be brought in to the committee on 18 December or 19 December and then to be released publicly at Christmas time, when scrutiny would not be at the same level it should be for such a serious issue. This is not the way to do business.

The committee will carry out scrutiny of this report. If it takes more than one session, we will certainly do that. We are at the mercy of the Department and RCOG regarding when they can come to give evidence. When the representatives come to the committee, we will give them every opportunity, and members will have every opportunity to interrogate the report. If we do not get satisfaction on the first day, we can have whatever number of meetings is required to examine this report. The Deputy will be aware that we have invited them on a number of occasions to examine this report and we had earmarked 4 December, and then it moved to 18 December. We will have them in on 18 December and we will have them in at a subsequent meeting if we need to.

I have a lot of information relating to this but, with the permission of the committee, can we tentatively pencil in 18 December? We do not know when the Minister will release this information. We do not know when the report will be brought forward. If this report is brought forward earlier than 18 December, we may have to hold an ad hoc meeting, with the co-operation of the members. If the report is released between now and 18 December, we could leave that open, with the permission of the committee.

We will also have the Minister before the committee on 11 December.

Yes. If it is okay with the committee should the report be released between now and then, and if we have other committee meetings on it, we could do a phase two or have another ad hoc meeting. As long as we can leave that open, we could proceed with the 18 December. On 18 December we should also leave open the possibility of a session with the 221+ campaign group as well as the Department, the Minister and the CervicalCheck team. Is that okay?

I agree with all of that. There are some very odd things happening in the background and being done quietly with regard to some of the women who have been affected. These are women who were not in the 221+ patient group, and who clearly should have been. On the back of the RCOG review, they are quietly being invited in. It is the kind of information that might get missed in a session only with officials. It is essential that we have the patient voice in the room. It may be at a separate session on the same day, or perhaps prior to the session with the officials. It is essential that we hear from the women themselves. It is about the 221+ group but the RCOG review was for an additional group of women. They do not have a formal representative group but we might do a bit of thinking about how we can make sure their voices are heard here too.

I am aware of what the Deputy is referring to, and I agree with him.

There are some funny things going on in the background that are being done quietly that would not necessarily percolate through unless we are hearing from the right women.

I agree wholeheartedly with that. We may need to broaden it. It will be tough because there may not be a representative group. It could be possible for the committee to get the information we need by some other means. Perhaps the committee could get a submission. I am not sure how we could do it and it might prove to be tough to do. Without going into the detail, clearly there is an issue that the committee needs to explore. We need to be open minded about how we get that information. It is a broader issue than the 221+ group. There are other issues there and perhaps we could take some advice on how we might get that information. It could be through a submission.

I honestly do not know. There may be a case to be made for considering an alternative to inviting people in.

That is a good idea.

We also need to keep open the idea of having a meeting outside of our normal schedule, perhaps during the evening when this space would be free.

I would like to clarify that we are talking about three groups. The first group comprises the patient representatives who were selected to be on the steering group as part of the RCOG review. That is one group. We know who they are. Obviously, they should be invited. They know the most about all of this because they are intricately involved in it. The second group is the 221+ umbrella group, which we all know about. The third group, which has just been mentioned by my two colleagues, comprises the other women who have been part of this process but are outside of the other two groups. I have spoken to many of them as well as the lads. In the coming weeks, we need to tease out how we can bring them in. There are three different groups. I certainly think that patient representatives are a core group. When we bring in the team from the HSE and the Department, we should bring in the patient representatives for a separate session on the same day.

Okay. Is that agreed?

If we are looking at a second meeting or a second phase of this process, I would love to hear Dr. Scally's view on the RCOG review after it has been published.

I thank the Deputy. I am sure Dr. Scally has a view.

I am sure he has. We might be on the same page.

Is that agreed?

I thank the committee for its indulgence.

That is our schedule of meetings until the end of the year as best we can manage it. If there are no other issues that members wish to raise, we will begin the first session of today's meeting. We will suspend for a few moments to allow our witnesses to take their seats.

Sitting suspended at 9.32 a.m. and resumed at 9.34 a.m.
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