A national director in the Health Service Executive (HSE) has admitted none of the assurance systems in the health service worked to alert them women were not being told about the audits of their cancer smear tests.

HSE and Department of Health staff have appeared before the Oireachtas Committee on Health.

The committee heard there was also a clear failure to escalate the issue within Cervical Check.

Interim head of the HSE, John Connaghan, apologised to the women affected by the scandal.

"It's fair to say, in my opinion, the language in all the briefing notes is very functional and somewhat lacking in empathy for the women who were to be communicated to".

As for who knew what in the Department of Health, chief medical officer Tony Holohan said it was legitimate not to escalate the problem to the minister or secretary-general in 2016.

"It was reasonable because the information provided to the department in briefing notes from the HSE was evidence to us, and interpreted as, ongoing improvements in how the service was being delivered - rather than the identification of problems".

While Stephanie O'Keeffe, the national director for health and well-being, told the committee the HSE also did not know about non-disclosure.

"None of the usual assurance mechanisms that you would have as a national director and a senior manager told me that there was a difficulty between the letters being issued and the communication to patients".

Vicky Phelan, who brought this to light, and Stephen Teap whose late wife Irene got a false negative will both appear before another committee later.