Smear errors not of ‘sufficient scale to notify the minister’
■ Health official says controversy ‘did not need to be escalated’
THE controversy over the decision of CervicalCheck to inform more than 200 women with cancer they had got a mistaken smear test result was not “of sufficient scale” to inform the Health Minister, a top official has claimed.
Jim Breslin, secretary general of the Department of Health, made the shock admission after he was pressed five times to answer the question on why CervicalCheck audits on the women – which were at the centre of intense discussions at the highest level of the health service for several months – were not brought to the attention of either Leo Varadkar or his successor Simon Harris.
“The judgment was made that within the whole gamut of issues that are being managed across the health service, it was not of sufficient scale and was being dealt with in an appropriate fashion according to a good open approach with women and did not need to be escalated,” he said.
Mr Breslin, who was among a group of high-level health officials, was quizzed by Fianna Fáil TD Stephen Donnelly at the Oireachtas Health Committee yesterday.
Chief medical officer Dr Tony Holohan and HSE senior executive Dr Stephanie O’Keeffe, who discussed the CervicalCheck strategy for months in 2016, including a decision to pause their release over a legal threat by Quest Diagnostics lab in the United States, admitted they did not follow up to see if the reports were handed over to the women when they were given to treating doctors by October that year.
Dr Holohan insisted the decision not to tell the minister was “fair and reasonable”.
It emerged only two weeks ago that 162 of the 209 women at the centre of reviews were still not informed and as of yesterday contact was still not made with four of them.
He said the department was not aware the reports were not passed on to women or their next of kin until “this controversy arose” after the High Court case brought by Vicky Phelan, who did not get her review until last September.
Dr O’Keeffe, who had direct line responsibility for overseeing the cervical screening service at the time, said she did not question CervicalCheck at monthly management meetings and accepted reports that women were being told.
“The intent and expectation was that doctors would speak to their individual patients about the reports,” she added.
Blame
The officials laid heavy blame for women being in the dark on their 29 hospital doctors who were given the reviews to hand over the report.
The instruction to doctors from CervicalCheck was to use their own judgment on telling women and just note it on the medical file if a patient had died.
Obstetrician Dr Peter McKenna told the committee the process was flawed because it “imposed a duty on doctors” and they were expected to do something they were not involved in from an early stage.
Asked if he agreed with “conditional” open disclosure, based on the advice to doctors to use their judgment about telling women, Dr Holohan said he believed it amounted to an “honest attempt”.
He said most screening programmes did not tell women about reviews.
The meeting was told that Patrick Lynch, HSE national director of quality assurance and verification who was installed in CervicalCheck to head a special incident team in the wake of the scandal, is now on holiday abroad.
The acting director general of the HSE, John Connaghan, said the leave was booked some time ago.
It also emerged that Mr Lynch was informed in March 2016 of the decision to “pause” the release of the reports to women after the legal threat by the US laboratory.
Meanwhile, nearly 3,000 people who called the CervicalCheck helpline are still waiting for a call back .
Damian McCallion, the HSE executive who is now overseeing the screening service, said the helpline would remain in place and the aim in the future was to have it answered by more clinical staff.
Mr Connaghan said he apologised for the CervicalCheck failures in not informing women and their families and the aim was to restore confidence.