Taoiseach Leo Varadkar has apologised to the women affected by the CervicalCheck controversy but admitted words cannot ease the anguish these women are experiencing.
Speaking after a Cabinet meeting on Friday afternoon Mr Varadkar insisted he first became aware of three memos circulated to HSE management in 2016 on the background to cervical screening audit findings - which in many cases were not passed to the women concerned - when they were released to the Oireachtas Public Accounts Committee on Thursday.
The memos were also shared with the Department of Health.
Politicians are learning about the extent of this at the same time the public is, Mr Varadkar said.
One of the memos was dated March 2016 when Mr Varadkar was Minister for Health. It referred to the audit findings and the need to write to doctors about them, the threat of legal action over them from a laboratory which read the smears and cited next steps as pausing the distribution of letters to clinicians and awaiting the advice of solicitors.
Mr Varadkar said he should have been made aware of the contents of the memos when they were known to the Department of Health.
He insisted none of his advisors were made aware of the memos.
Minister for Health Simon Harris insisted none of his ministerial advisors were informed either.
Mr Varadkar stressed nobody had their cancer diagnosis withheld from them in this whole affair but vital information was concealed from women. It has already been confirmed 209 women could have received earlier intervention in their cancer diagnosis if they had got correct smear test results and that 162 of these women were not informed of the review of their case.
Some 17 of the 209 are dead.
At a press conference in Dublin after the Cabinet meeting Mr Harris was asked if he had concerns about the knowledge of the Department of Health’s chief medical officer Dr Tony Holohan about the memos.
Mr Harris said he was very annoyed that the Department of Health had knowledge but did not inform him.
However, he said it was the job of the scoping inquiry now underway into the controversy to determine who knew what and when.
The Government has meanwhile approved a number of measures aimed at assisting the women affected by the CervicalCheck controversy.
At the Cabinet meeting, Mr Harris asked his colleagues to approve financial assistance for the 209 women or their families, who it has been determined should have received earlier intervention in their cancer diagnosis.
The Cabinet agreed that the State will pay for the medical costs of those women and offer them a free medical card. There are also to be offers of free counselling.
In relation to the 17 women who have died, the Government will make offers of financial assistance to their next of kin. The package is in addition to possible redress the women may receive from the State.
The package includes covering childcare costs for affected women during medical appointments and transport to and from appointments.
Mr Harris said women involved will be exempt from paying prescription charges and those that are using experimental drugs will have those paid for.
Welcome but ‘not enough’
Emma Mhic Mhathúna (37), a mother of five who was given incorrect smear test results and who now has terminal cancer, said the measures announced were “welcome” but “not enough”.
“While it is welcomed, it’s still not enough. Why do we have childcare? Because the mothers are dead or dying. Why do we need to travel somewhere? Because we have cancer. Why do we need experimental drugs or the costs covered? Because you tried to cut corners in the first place.
“It’s great that people are starting to mop up the mess that they made. But still, women are dead. Accountability, accountability, accountability is the answer.”
On the resignation of HSE director general Tony O’Brien, she said his departure on Friday was “the ripping the plaster off the wound”.
“Now, we need to get to the core to make sure this never happens again,” she told she told RTÉ’s Six One news. “The movement we have is because of the Irish people that stand together.
“I’ve always had 100 per cent faith in everyone in Ireland, and it’s great that we’re all standing together saying enough is enough, and the Government realise who they’re supposed to be working for.”
More than 15,000 calls
Meanwhile the HSE said on Friday evening the total number of calls to its helpline set up in the wake of the scandal now stands at 15,480.
Some 1,353 calls to the HSE’s helpline were answered on Friday, while there were 776 requests for a call back.
The HSE has now also made contact with 203 of the 209 women or families affected by the scandal.
Speaking on his way into Cabinet on Friday morning, Mr Harris said he has now ordered a trawl of documents in the HSE and the Department of Health to ensure all information is made available to the non-statutory inquiry into the affair and to Oireachtas committees.
It was “not acceptable” memos like the three released on Thursday were circulating in the Department or the HSE, he said.
Director general of the HSE, Tony O’Brien, stepped down on Thursday night as it became clear the Government would not continue to support him and it appeared likely the Dáil would next week pass an unprecedented motion of no confidence in him.
Mr O’Brien’s position became increasingly tenuous after the dramatic release to the Dáil Public Accounts Committee of three memos he had received in 2016 on the background to the issue of cervical screening audit findings which in many cases were not passed on to the women concerned.
One of the memos released revealed that the HSE was concerned about a risk that communicating individual audit findings to doctors could result in patients going to the media with stories that the cervical screening process did not diagnose their cancer.
Settlement of current cases
Attorney General Séamus Woulfe gave an update to Cabinet on Friday morning on whether the current legal cases in relation to the women can be settled. There are currently 10 outstanding legal cases against the State over false negative smear test results. These are separate to the case of Vicky Phelan, who settled her High Court case with a laboratory in the United States for €2.5 million last month. The case was settled without admission of liability.
It is understood the State will now enter a mediation process with the women to settle the outstanding claims as soon as possible.
The Cabinet also discussed the resignation of director general of the HSE Mr O’Brien. Mr O’Brien will stand aside from his position by close of business on Friday.
He made the decision after the release of the three memos from March and July 2016 showing the HSE was aware of a planned media strategy to respond to patients contacting media outlets to say screening did not diagnose their cancer after they received the results of the audit.
Mr Harris asked the Cabinet meeting to appoint John Connaghan, who is currently the HSE's deputy director general, to replace Mr O'Brien.
“I have now designated John Connaghan to carry out the functions of the Director General of the HSE pending a recruitment process which is to be conducted by the Public Appointments Service. John brings a wealth of senior healthcare management experience at an international level. He will be a tremendous resource in leading the HSE in challenging times. I want to thank John for taking on this interim role,” Mr Harris said.
Mr Connaghan joined the HSE last August as the Deputy Director General and Chief Operating Officer having previously worked for NHS Scotland.
The Cabinet meeting was due to be held in Monaghan but was relocated to Dublin in response to the ongoing controversy.
Mr Harris, Mr Varadkar and Minister for Finance Paschal Donohoe held a meeting late Thursday afternoon to discuss the financial measures and agreement was reached.
GPs seriously concerned
Separately GPs have said they are seriously concerned the Cervical Check screening programme could be undermined in the wake of the current controversy.
The Irish Medical Organisation (IMO) said its GP members were worried about “the lack of clear explanations regarding the benefits and disadvantages surrounding screening programmes”.
IMO GP committee chairman Dr Padraig McGarry said the events of the past two weeks had seriously undermined confidence in CervicalCheck and could lead to reduced numbers of women presenting for testing.
He said it was absolutely correct to have a full review of the programme and the issues around the scandal including the outsourcing of the analysis of smear tests to the US, criteria of testing, frequency of testing and communication issues to patients.
“The tragedy for the women who have gone on to develop cervical cancer cannot be underestimated and they must be offered every support possible by the State
“However we have a duty as medical professionals to encourage all women to continue to attend for both routine screening appointments and to consult with their GP on any concerns they may have regarding previous smear tests,” he said.
The IMO said it had agreed a programme with Government for concerned women to visit their GP and if required to arrange a repeat smear test.
Dr McGarry said: “Screening is not perfect and is not a diagnostic tool but is nonetheless important in terms of the overall health of women.”