The Minister for Health has backed HSE director general Tony O’Brien to see out his term after he “respectfully” declined an invitation to resign over the CervicalCheck scandal.
At a hearing of the Oireachtas health committee, Mr O'Brien was invited by Fianna Fáil TD Stephen Donnelly to stand down over the scandal that came to light from the case of terminally-ill Limerick woman Vicky Phelan.
The HSE chief defended his role in the controversy, saying that he had not been informed of all the circumstances of the Phelan case when CervicalCheck could have told him in advance that scores of women with cervical cancer had not been told that normal smear tests were in fact inaccurate.
Mr O’Brien said it would have been “relatively straightforward” for CervicalCheck to “get themselves off the hook” by saying that they had told the women and there was “no particular benefit in not doing so.”
He repeated his intention to continue on in his position until his contract expires in July “in order to address all of the issues which are of significant concern.”
Respectful
“I appreciate that you are suggesting that I should resign without prejudice,” he told Mr Donnelly. “I am not 100 per cent sure what that really means but I understand that it is intended to be polite and intended to be respectful.”
Criticising Mr O’Brien’s stewardship of the HSE in light of the scandal, Mr Donnelly said that public confidence in the screening programme had been “rocked.” He noted the large number of women calling the HSE’s helpline who had not received call-backs as another reason for why he should resign.
Dean Sullivan, deputy HSE director general, had told the committee that 11,982 women had called the helpline and that of the 8,150, who had requested a call back, less than half - 3,649 - received a returned call.
Mr O’Brien told Mr Donnelly it would have been “very easy for us to carry out a cosmetic exercise and have an unqualified person make a return call to all of these women which would be of little or no value.”
Instead, the HSE wanted to ensure a “meaningful, complete clinical follow-up with each person who requested one” and that this takes 30 minutes or more in order to be effective.
“So whilst I recognise the concern, I believe that the effort underway to address that concern is appropriate and meaningful,” Mr O’Brien said.
“So I understand your point, I respectfully decline your invitation to resign without prejudice or otherwise.”
‘Absolute confidence’
Meanwhile, Minister for Health Simon Harris, appearing before the committee alongside Mr O’Brien, said he was not aware of any other issues or scandals relating to the CervicalCheck but could not say for certain.
He would know more when Dr Gabriel Scally, the chair of the scoping inquiry the Government has established, submitted an initial report on its findings in three weeks’ time, he said.
“If I had absolute confidence that there weren’t other such issues, we wouldn’t need a scoping inquiry,” he said in response to questions from Labour TD Alan Kelly. “It would be foolish for me to sit here and say that I don’t have more concerns,” he added.
“Until I see that report I can’t go any further than that because after the last two weeks I think that is the prudent course for any Minister to take.”
The committee was told that the fact that more than 1,500 women diagnosed with cervical cancer had not had their cases reviewed by CervicalCheck only emerged five days after the scandal broke was because the screening programme initially gave inaccurate information to the HSE and the Department of Health.
It emerged shortly before Mr Harris addressed the Dáil on Tuesday of last week - after the HSE investigation into CervicalCheck commenced the previous Friday - that the screening programme’s audit did not cover smear tests from cervical cancer cases notified to the National Cancer Registry.
Briefing material supplied by CervicalCheck over the first four or five days of the investigation was “inaccurate,” Jim Breslin, the secretary general of the Department of Health, told the committee.
“At the start of the process we were told one thing and by Tuesday we were told the opposite thing and so that was a specific cause for concern: that we had told the Minister something that turned out to be inaccurate within that very short space of time,” Mr Breslin said.
Mr O’Brien said that the HSE’s investigation had “probably uncovered all that there is to uncover.”
Decent and honest
He said that CervicalCheck was aware of other unaudited cervical cancer cases on National Cancer Registry for years but had not shared this with the HSE or the department in the early stages of the investigation.
“They were aware that the numbers that they had audited only included those cancers that had been notified to CervicalCheck through its own process, which relates to gynaecology clinics and colposcopy clinics,” he said.
In response to questions on whether he had or had not been told about the false smear tests before they came to light, Mr O’Brien told the committee he wanted to quote “that great philosopher Deputy Alan Kelly”.
He cited remarks the Labour TD made on a radio last week in relation to the controversy: “It is so bizarre and unbelievable that it must be true.”
Mr O’Brien said Mr Kelly had the opportunity at another committee hearing last week to question all the relevant people “whose - to use a Monopoly term - ‘Get Out of Jail Free’ card would have been to say that they told me and they didn’t and I’m going in three months.
“They’ve got no advantage by keeping my back other than they are decent, honest people in this regard.”
Confidence
Asked whether he still had confidence in Mr O’Brien, the Minister told the committee that “everyone’s confidence has been shook over the last number of weeks” but he believed it was better for the HSE chief to see out the final weeks of his term.
“Is it better that Mr O’Brien serves out his remaining number of weeks and continues to do what we need him to do, to help get the answers? Yes, it is. That is my judgment,” he told Sinn Féin TD Louise O’Reilly.
“I believe he is best placed to provide answers and help the scoping inquiry and help the process that CervicalCheck needs to undergo now over the next few weeks.”
Mr O’Brien told the committee the CervicalCheck helpline was receiving 900 calls a day and that the calls were being answered in 18 seconds. Calls were being returned “not obviously as fast as we would ideally like, but progressing as well as it reasonably can,” he said.
Divided
The Government is divided over the future of Mr O’Brien.
At Tuesday’s Cabinet meeting, three Ministers – Katherine Zappone, Finian McGrath and Michael Ring – called for Mr O’Brien to stand aside from his role.
It is understood Mr Ring said officials in the HSE needed to be held accountable for the errors that have unfolded over recent days, while Ms Zappone told the meeting she believed it was appropriate on balance for Mr O’Brien to stand aside.
The Independent Alliance also had a pre-Cabinet meeting with Taoiseach Leo Varadkar seeking clarity on the position of Mr O’Brien.
It is understood the Taoiseach advised the political grouping Mr O’Brien’s contract allowed for three months’ notice and said the director general could take a case of constructive dismissal if forced out of his role.
