Cervical smear test errors 'watershed moment for Ireland's health service'

A controversy around wrongly interpreted cervical smear test marks a watershed moment for the management of Ireland's health service, a government minister has said.

Regina Doherty said it appeared that bosses had appeared more concerned about protecting the reputation of the Health Service Executive (HSE) than the cancer patients who were wrongly given the all-clear.

The Minister for Employment Affairs and Social Protection acknowledged the need for a radical overhaul hours after the director general of the HSE resigned amid the deepening crisis.

Tony O'Brien, who had been due to retire in the summer, had been under intense pressure to step down over the furore about the treatment of 209 women who were wrongly informed their smear results were normal.

Dr Jerome Coffey and Chief Medical Officer Dr Tony Holohan from the Health Service Executive clinical expert panel during a press conference to address public concern surrounding Ireland's national cervical screening programme (Niall Carson/PA)
Dr Jerome Coffey and Chief Medical Officer Dr Tony Holohan from the Health Service Executive clinical expert panel  (Niall Carson/PA)

The Cabinet will hold a special meeting at Government Buildings in Dublin on Friday to agree a package of measures to support those affected by the error.

Ms Doherty said there was need for a culture change within the HSE and a move toward more transparency and open disclosure.

"On behalf of the Irish people we are at a watershed moment," she told RTE.

"The management of the services in this country, you would be hard pushed to find anybody who says they have trust or confidence in them.

"And that needs to change, and we need to change that as a government right now on behalf of the Irish people."

An audit by the CervicalCheck screening programme of 1,482 women diagnosed with cervical cancer since 2008 has found potential errors in earlier smear tests in 209 cases, as results showed no abnormality when they should have flagged a cancer warning.

The fact the majority of the patients were not initially told of the outcome of the audit has prompted a wave of public anger.

Of the 209 women, 17 have since died.

Micheal Martin, the leader of main opposition party Fianna Fail, said the response to the crisis had been "shocking". The Fine Gael-led government relies on a confidence and supply agreement with Fianna Fail to stay in power.

When pressed whether his party was now prepared to withdraw that support, Mr Martin said there was a need to establish the facts first.

"We need to find out the truth," he told RTE.

"I am not going to make judgment calls without the truth, I think that's a very basic requirement and accountability, yes, but we need to know the truth."

He added: "The response to the crisis has been shocking in my view, it has been very badly managed."

Mr O'Brien resigned hours after it emerged that an internal HSE briefing note that flagged potential errors in screening tests in 2016 stressed the need for a media strategy to respond to stories of women whose cancer diagnosis was missed.

The memo to HSE bosses from Ireland's National Screening Service (NSS) also advised a "pause" in the process of communicating to clinicians the findings of the audit of smear test results belonging to women who were subsequently diagnosed with cancer.

CervicalCheck programme
Mr O'Brien resigned after it emerged an internal HSE briefing note flagging potential errors in screening tests in 2016 stressed the need for a media strategy to respond to stories of women whose cancer diagnosis was missed (Niall Carson/PA)

The HSE forwarded three 2016 memos to the Oireachtas's Public Accounts Committee on Thursday as members probed the growing controversy around misinterpreted smear tests.

Minister Doherty branded the language in the notes "absolutely outrageous" and "disgusting".

Taoiseach Leo Varadkar was health minister when the first memo was sent to HSE chiefs.

The Department of Health confirmed on Thursday night that the memos were shared with the department.

However, a spokesman said they were only relayed to certain officials and none were brought to the attention of any serving health minister.

The first note, dated March of that year, outlined details of the audit process undertaken by CervicalCheck and that results were to be communicated to patients.

The subsequent two, circulated in July, provided updates on the situation.

In a section titled "next steps", the first memo stated:

- Pause all letters
- Await advice of solicitors
- Decide on the order and volume of dispatch to mitigate any potential risks
- Continue to prepare reactive communications response for a media headline that "screening did not diagnose my cancer".

It earlier said: "There is always the risk that in communicating individual case reports to clinicians of an individual patient reacting by contacting the media if they feel that 'screening did not diagnose my cancer'.

"This is a risk that is inherent in having a clinical audit process as part of the national programme."

The controversy was triggered by the case of Vicky Phelan, the terminally ill mother whose legal battle cast light on the issue.

Last month, Ms Phelan, a 43-year-old mother-of-two from Co Limerick, settled a High Court action for 2.5 million euro after being incorrectly told in 2011 that her smear test had given a negative result for cancer.

In 2014, she was diagnosed with cancer but only told of the false negative last September.

On Thursday, another woman who had been affected by the false negatives issue - 37-year-old Emma Mhic Mhathuna from Co Kerry - revealed that she had now been diagnosed with terminal cancer, five years after being told her smear tests were normal.

UK health expert Dr Gabriel Scally has been commissioned by the Irish government to lead an inquiry into the misinterpretation of the cancer tests.

A planned away day Cabinet meeting that had been scheduled for Friday has been postponed.

The Cabinet will instead meet in Dublin as Mr Varadkar and current health minister Simon Harris continue to deal with the controversy.

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