The publication of this final report by Dr Gabriel Scally on CervicalCheck shows how much has improved since the dark days of 2018.

The significant progress reported in the implementation of the 58 Scally recommendations is encouraging but problems remain.

One of the biggest is the long-awaited Patient Safety Bill to introduce mandatory open disclosure.

Dr Scally makes a significant point about the need for a statutory duty of candour for health professionals and the health organisations they work for.

He chides the Medical Council here for not requiring doctors to report such matters affecting patients. Instead, he says, they advise that doctors "should" report, leaving it to the doctor's judgement as to what, if anything, happens.

Dr Scally says the slow pace of movement in creating a framework that fully supports telling patients the truth about possible errors in their care can be explained partially by the unprecedented collective burden of the pandemic.

But the Health Service Executive has also raised some concerns about the proposed new system.

The HSE has said that under its new process for patient requested reviews, all slides will be disclosed to women.

It is understood the HSE is concerned that under the proposed new law, a request for a slide review in itself would be a notifiable patient safety incident, regardless of whether the slide did or did not differ from the earlier one. So regardless of whether the review is concordant or discordant, in medical terms.

Dr Scally also said today he cannot comment further until he sees any amendments to the Patient Safety Bill.

The 221+ plus group are deeply unhappy with the proposed bill and want urgent enactment of promised mandatory open disclosure.

They would also like to see the return to Ireland of screening with a fully resourced and staffed and accredited laboratory as soon as possible.

Dr Scally says the existing laboratory used in the US is safe and accredited and that it is important to have back-up services in case of problems.

In one of his stronger points, Dr Scally said today that CervicalCheck must acknowledge its past failings, pointing out that "if you can't bring yourself to acknowledge past failings, why would anyone trust you today?"

He also expressed concern that some doctors want to know if women are members of the 221+ support group before agreeing to take on their care.

Finally, it is important to note that cervical screening has changed significantly with HPV screening.

This has dramatically reduced the volume of cytology slides that a clinician needs to view.

The initial screening test, and for most women the only test they will need, is a test for the HPV virus.