Hit squad leader ‘regrets inaction’
HSE boss knew of concerns of women being left in dark
‘Would have done things differently’
THE HSE boss who oversees Simon Harris’s cervical cancer hit squad has confirmed he was made aware of concerns that cancer victims were being kept in the dark last summer – and regrets not checking assurances this would change. The Health Minister was applauded for his decisiveness last Friday when he announced that he was sending a senior team into CervicalCheck ‘to take charge of the situation’.
The team would report to Dr Colm Henry, the chief clinical officer in the HSE, he said. However, The Irish Mail on Sunday revealed at the weekend that Dr Henry had been written to last July to let him know about a row between the then-CervicalCheck boss, Dr Gráinne Flannelly, and Vicky Phelan’s gynaecologist, Dr Kevin Hickey, over whether all women whose previous smear tests wrongly gave the all-clear should be informed of this. There was also a dispute over who should tell the women about the botched tests.
In June, Dr Hickey wrote to the chief clinical director of Limerick Hospital, Professor Paul Burke, and raised concerns that Dr Flannelly felt just three women on a list of ten should be told. Prof. Burke referred the issue to Dr Henry in July.
A month later, Dr Flannelly wrote to Dr Henry to clarify ‘some of the issues raised’. She wrote that she agreed women should be told.
‘If doubt exists that her disease might have been detected at an earlier time or if she required more intensive treatment than she otherwise might have needed, it is our view that women should be made aware of this rather than simply filing the report in the notes,’ she said. However, she stressed that clinicians should make this decision and should be the ones to tell the women.
‘The clinical context is important in evaluating the need for a close out communication – the treating clinician is best placed to make that judgement call on the concept of possible harm,’ she wrote.
Dr Henry then forwarded Dr Flannelly’s letter to Prof. Burke. Yesterday, Dr Henry said he had no involvement in the screening programme and was simply consulted for advice. He said: ‘At that time, I worked as a clinical adviser. I am in a different role now. I have no involvement with the screening programme… I was consulted for advice.’
He said that after meetings and engagements between lead clinicians and CervicalCheck on September 1, 2017, he was told by the cervical screening programme that its ‘communication policy had changed’.
He said: ‘In retrospect, had I known that this didn’t happen – that patients weren’t being informed – even in my then role as adviser with no authority over these people, I certainly would have done things differently. But I was basing my actions at the time on the assumption that people were following through on what they told me they were doing.’
He added: ‘Of course, as with any issues, as a doctor I have to deal with issues when I am dealing with patients in real time. And then I look back at the way I manage patients, and sometimes I think I could’ve managed them better.’
Dr Henry said he was reassured the clinicians and CervicalCheck ‘were working towards consensus’. He added: ‘I took that reassurance at face value. Do I regret that now? Of course I do.’
When probed, Dr Henry said he ‘had no reason to doubt’ what he was being told. However, he added: ‘As I said to you, if I was going back... with the benefit of hindsight, I regret I didn’t go further. At the time, I acted as best I could.’ This admission from the HSE chief clinical officer came at a testy press conference in Dublin yesterday, where health chiefs said they were endeavouring to address some of the public’s questions.
Dr Tony Holohan, chief medical officer at the Department of Health, said that one of the actions they will be taking now will to be to provide daily updates, as they had this week been accused of drip-feeding information. He said there would be daily information updates from the HSE from now on.
Separately, the head of the Irish Cancer Society, Donal Buggy, accused health chiefs of ‘significant mixed messaging’ on the cervical cancer screening scandal.
Mr Buggy said women in Ireland feel ‘confusion, concern, frustration and fear’. He said he wanted clarity for the 3,000 women diagnosed with cervical cancer in the past ten years and for women involved in the screening programme who had been given negative results.
At the start of the week, it was revealed that an audit by CervicalCheck – the national screening programme – of 1,482 women diagnosed with cervical cancer since 2008 had found potential errors in 208 cases, as tests showed no abnormality when they should have been given a cancer warning.
A majority of the women – 162 – were not initially told of the outcome of the audit. Of the 208, 17 have since died.
It has since emerged that a further 1,518 women with the cancer in the same period have not been audited, but health chiefs stress the number affected by potential errors in this
group is likely to be lower.
Senior health figures remained unable to give numbers yesterday for the second group on how many women have since been audited, found to have potential test errors or contacted regarding this. They said this work is ongoing.
Under questioning, Dr Holohan agreed the screening programme was 99% reliable, with National Cancer Control Programme director Dr Jerome Coffey saying there is a ‘tiny proportion’ of false negatives – less than one in 100.
Dr Holohan said: ‘The evidence that we have before us is not evidence of a clinical failure in relation to the programme.
‘It’s not evidence that people who have been through the programme can have less confidence in what the programme has said about their result.’
He said people with normal smears have no need for an emergency repeat test but will be given one after contact with their GP if they wished.