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Ceisteanna ó Cheannairí - Leaders' Questions (Continued)

Wednesday, 20 February 2019

Dáil Éireann Debate
Vol. 979 No. 6

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The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar I acknowledge that the people who built and ran CervicalCheck for a period did a good job. I remember the time before CervicalCheck, when women would present much later with a much more advanced disease than they currently do, and how different it was from the UK at the time. CervicalCheck is a good programme. Those who built it, managed it and worked there for a long time did a good job, saved many lives and made sure that many women had interventions much earlier than would otherwise have been the case. They also made many mistakes, which Deputy Micheál Martin did not say. Among the mistakes they made were a botched audit-----

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin The Department was part of it.

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar -----that had significant retrospection bias, and they did not share the information about the audit with the women who were affected.

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin The chief medical officer and the Department were involved too.

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar I regret that Deputy Martin did not acknowledge that in his comments because, while they did a good job, they did something very wrong in not disclosing that information to patients. I understand that there were different views about whether the out of cycle test should be offered. Some doctors thought it was a good idea. Others called for it. The Chief Medical Officer, who advises the Minister, supported it.

Deputy Micheál Martin: Information on Micheál Martin Zoom on Micheál Martin Did the CervicalCheck team communicate with the officials?

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar I understood they did after the event.

Deputy Mary Lou McDonald: Information on Mary Lou McDonald Zoom on Mary Lou McDonald This morning it was revealed, through the excellent work of "RTÉ Investigates", that nearly 60 families in the west have been issued apologies by the HSE as a result of failings in audiology services provided or not provided to their children. This is not the first time this issue has arisen. Last year, the HSE issued apologies to 49 children in the same region as a result of failings related to paediatric audiology services. At that time, and now, some of the children affected were left with lifelong impairments as a result of the failings of our health service.

The Taoiseach may have heard the story on "Morning Ireland" this morning of 11 year old James from Mayo. His parents were entirely unaware of his hearing impairment until they received a letter from the HSE in recent weeks apologising for the lack of care. Six years ago, James was in junior infants and his parents were reassured that his hearing was fine. He is now in fifth class and in the intervening period, he has had no treatment for his hearing impairment. We can only begin to imagine the impact that that has had on the child, socially, developmentally and educationally. It is shocking. I understand that there is now a look-back review into paediatric audiology services. This is the second such look-back review. At this stage, the parents and families in question have received no indication of how long this process will take to complete and, in any event, they have lost faith in it. They now require an independent inquiry and investigation into this mess. Will the Taoiseach agree to that? It is clear that our health services are failing all of us and our children.

Figures provided to my colleague, Teachta Louise O'Reilly, show the disgraceful delays for children in accessing speech and language therapy and occupational therapy. These waiting lists not only impact on children's lives in the here and now, but they have future implications too. Some of the worst delays for occupational therapy are in Mayo, where there are 138 children under five who have been waiting for more than a year for basic treatment. In Cavan-Monaghan, 523 children are on a waiting list. In Cork, 679 kids over five face delays for care. The window of opportunity for these therapies is short and the significant delays cause additional problems for children in the future and as adults. Will the Taoiseach agree to the inquiry as called for by the parents of James and others? Who is accountable for these waiting lists and delays for our children? Who is answerable? Is anybody answerable for this?

The Taoiseach: Information on Leo Varadkar Zoom on Leo Varadkar The HSE finalised the report of a look-back paediatric audiology services review for the Mayo-Roscommon area for 2011 to 2012 in June last year. It was shared with all 49 affected families in accordance with open disclosure principles. The report and accompanying documentation sent to families from the HSE included an apology for the failures identified and for the anxiety caused to families and those who may have been affected. All 49 children who needed a follow-up as a result of the look-back are either receiving or have already received appropriate necessary care. The HSE has been assisting parents in accessing the necessary health, educational and social protection services, and there has been significant cross-departmental co-operation in that regard.

In December last year, the HSE recalled a further 57 who were identified during the look-back process. The HSE has indicated that this group had an appropriate audiology assessment and the hearing loss was correctly diagnosed. However, they were discharged without appropriate follow-up treatment and a management plan. This group of 57 was not followed up at an earlier stage, as the preliminary risk assessment did not flag them as an area of concern. The group of 49 was seen as the at-risk group and was recalled as a priority. The HSE has advised the Department that of those in the additional group of 57, 35 are under 18 and 22 are over 18, and all 57 have been contacted. To date, 26 have taken up the offer of an appointment. Some 31 did not attend but are being followed up. The priority is open disclosure, which is taking place, and making sure that those who need medical care, educational and social protection supports receive them. We will give an independent inquiry consideration but the priority has to be making sure that affected patients are told and that they receive the medical care and any additional educational and social supports they need.

With regard to other community healthcare areas, only CHO 2 and CHO 5 have had clinical risks identified, requiring a formal look-back review into paediatric cases. The HSE is proceeding with a precautionary recall of children and young adults in CHO 5, the south east area, as part of the quality assurance process. The audits in CHOs 1, 3, 6, 7, 8 and 9 have been completed and were found acceptable. An audit of paediatric cases in the south west, in Cork and Kerry, is also planned.

Deputy Mary Lou McDonald: Information on Mary Lou McDonald Zoom on Mary Lou McDonald I could have added failures relating to autism services to the list that I presented. Cases have come before the courts because of the HSE's consistent failure to comply with the law. The Disability Act provides for children to be assessed within a tight timeframe so that tailored treatment can be identified and started but, yet again, there is delay after delay. Parents are now moved to go to the courts to seek some level of accountability. Open disclosure is very necessary and welcome but there has to be accountability too. Who is responsible for this mess?

Every day, it becomes more and more apparent that the health services are in a crisis and there is a lack of leadership and direction. Deputy Micheál Martin himself spoke this morning about obfuscation. He has raised questions over the truthfulness of accounts given by the Minister for Health on CervicalCheck and the additional smear. Fianna Fáil is nonetheless happy to allow a Minister and Government to evade accountability for the many failures in our services. I have raised specific services where children are being let down today and will be let down tomorrow. Their parents are being misled and fear that their children will be affected now and in the future. I asked the Taoiseach who is responsible for this and I want an answer. Who will be held accountable?


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