The Minister for Health has said he stands over his decision to offer a repeat smear test to women at the height of the CervicalCheck crisis.
Speaking at the Oireachtas Committee on Health, Simon Harris accused Fianna Fáil's health spokesperson Stephen Donnelly of "making false political charges" against him over the decision, which led to a lengthy backlog of women waiting on smear tests results.
Mr Donnelly pointed out that Dr Grainne Flannelly, the former clinical director of CervicalCheck, submitted a letter to the committee claiming that advice was given that the offer of repeat smear test would undermine the programme.
He also asked Mr Harris about newspaper reports that the Chief Medical Officer supported a much more targeted approach.
Mr Donnelly asked the minister to correct the Dáil record given the evidence the committee has received about the decision to offer the free retests.
Mr Harris accused Mr Donnelly of making "false political charges".
He said: "I made the decision. I stand over the decision. I made the decision consistent with the advice of the chief medical officer and there has been no evidence produced to suggest that I didn't."
He cited a letter from the Department of Health to the Ceann Comhairle in response to comments made by Micheál Martin.
It said the minister's decision on 28 April 2018 was consistent with advice received from his officials.
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Mr Harris said that an email from the head of the National Screening Service, Charles O'Hanlon, warning about the risks of offering repeat CervicalCheck screening to women, was not seen by him or by the Cabinet, when it made the decision last year to offer the service.
He said the first time he became aware of the email to his department was in February of this year.
The email, dated 28 April 2018 and released today to the Health Committee, was sent to the Department of Health by Mr O'Hanlon.
Minister Harris told the committee the email was not seen by him, or the Cabinet, when it made the decision to provide free repeat screening.
Mr Harris said this was not a criticism of his officials, as there was nothing in the email that had not been identified by his officials as risks.
The email warned that the key risks of offering repeat screening included:
- The volume of women who might avail of the repeat screening was unknown
- Laboratory turnaround timelines would certainly increase
- It would potentially strengthen the message that the current test was inaccurate
- The service would be very difficult to turn off
The email noted that the screening service took direction from the department as to policy "but it is also important for the above risks to be fully articulated in your deliberations".
The email was received by the department about an hour after the minister had said on social media that repeat screening would be provided.
Today Mr Harris said the decision to offer repeat screening had been the correct one.
Minister discusses health service recruitment
Mr Harris said that an extra 2,000 staff will be working in the health service by the end of the year.
He told the committee there will be more nurses, doctors and therapists.
On the issue of a Health Service Executive recruitment pause, Mr Harris said that aim is not to apply restrictions to any hospital or group which has a plan.
He added that it was important to make sure the areas where recruitment is focused are the areas where it has been determined that extra staff are needed.
Children's hospital board to be strenghtened
Mr Harris has indicated that the National Paediatric Hospital Development Board will be strengthened following the publication of the PWC report into cost overruns at the new children's hospital.
Sinn Féin TD Jonathan O'Brien said the PWC report recommends against a clear out of the board as there will be loss of corporate memory, which could jeopardise the project.
He added that the report does say the board needs to be strengthened by bringing more expertise to it and asked how the minister intends to address this recommendation.
Mr Harris said he is still considering the report but his initial thoughts are that the statutory instrument allows him to alter the size of the board.
He indicated that he will be strengthening the board, changing the governance and bringing more expertise to the it.
He said a new project director will be appointed following the resignation of John Pollock last month.
Mr Harris said the Government has accepted the 11 recommendations of the PWC report and will act on them.
He also said that PWC have found that there was not a massive waste of taxpayers’ money, but there was significant error made in calculating the cost of the project.
Speaking in the Dáil, Fianna Fáil leader Micheál Martin said the Ministers for Public Expenditure and Health were asleep at the wheel when it came to the National Children's Hospital.
He asked where was the accountability of these ministers and he accused senior Government figures of going missing in the aftermath of the publication of the PWC report.
Tánaiste Simon Coveney said the review published yesterday provides a clear explanation of what happened.
Mr Coveney said this was not an overspend or waste of money but rather an underestimating of the costs at the initial stage.
He said there should have been red flags earlier and whether through incompetence or otherwise there was a gross underestimating of the costs.
Sinn Féin leader Mary Lou McDonald said the "fiasco" of cost overruns at the National Children's Hospital has been "overseen by a minister that is clearly incompetent".
She said the PWC report published yesterday "highlights significant issues of governance and oversight, and the non compliance with the public service spending code".
Ms McDonald said: "members of Government need to be reminded that they are not spectators of all of this, they are the authors of this fiasco".
"The real question is, who is accountable for the clear and gross incompetence?"
Responding, Mr Coveney said he understands the frustration that is being expressed.
"We thought we could build a national children's hospital for a lot less than it is going to cost, that's what happened here."
"What this report makes clear is that the majority of the cost increase relates to a gross underestimate that should have been flagged earlier" he said.
"There needs to be a more proactive oversight in projects like this, and more intense scrutiny as projects move ahead and that is where this project has primarily failed."
Mr Coveney said the Government needs to try to ensure that systems are in place to keep the cost within that final estimate.
"People talk about waste and overspend, that money hasn't been spent yet, and yes politicians and the government need to take responsibility" he said.
Independents4Change TD Mick Wallace said he did not see anything in the PWC report that explained why they were recommending that the project should not be retendered.
He said "it doesn't make any sense" not to revisit the project.
Mr Wallace asked the Tánaiste why the Government "gave a crowd of accountants who know nothing about construction the job of reviewing" the cost overruns at the National Children's Hospital.
He said the review should have been carried out by a procurement expert.
Mr Wallace also said external consultants should be held to account.
"There's always risk involved, but you transfer that risk onto the contractor, and the contractor builds that risk into his price".
Mr Wallace said the hospital was being described as a "special project" but it was not special at all. "Hospitals get built every year across Europe" he said.
He said the costs had "gone up, it's out of proportion, and yez (sic) don't know where its going, yez (sic) don't know where its going to land, you don't know what it's going to finally cost because ye have the wrong contract in place and you are not going to revisit it".
He said PwC had not provided any evidence to back up a claim that retendering the contract should not be revisited.
"This doesn't make any sense Tánaiste, ye need to revisit this, this is ridiculous" he said.
Mr Coveney said he did not believe the Government could reduce the cost of the National Children's Hospital by retendering at this stage.
He said he expected that PwC had done their job properly, and when they say that re-tendering the process would likely see an increase in cost or the hospital not being built at all, then the Government had to take note of that.
He said the Government would change procedures on the back of this, to ensure that mistakes made around the issue of cost, would not happen again.
"There should have been red flags earlier in the system during this process that highlighted clear failings on the issue of costs".
Mr Coveney said mistakes were made both with the tendering and estimate process which gave a false picture of what the project was going to cost.