Questions have got us no closer to the vital facts

DESPITE two Oireachtas committee hearings and robust grillings, politicians have failed to get the answers as to who knew what and when in the CervicalCheck crisis.

Tony O’Brien, who has since resigned, and his then leadership team at the Health Service Executive made their first appearance before the Oireachtas Health Committee on May 2. Politicians listened carefully.

Senator Colm Burke, of Fine Gael, framed his questions on the basis of what he was hearing. And what he was hearing was that the CervicalCheck audit was flagged with senior HSE officials in 2017.

Dr Colm Henry, now the HSE’s chief clinical adviser, was informed in July 2017 about a row over who was responsible for telling patients. He consulted a colleague and the consultants involved in the dispute. He was told last September that the whole thing was sorted.

Tony O’Brien told that committee that he became aware of the Vicky Phelan case on a news app at the time the case was settled last month. He said he had no knowledge of a row between consultants and CervicalCheck over who should disclose to patients that some of them had wrongly been given the all-clear. The HSE introduced a policy of open disclosure in 2013.

If only he’d known about the row, if it had been escalated to corporate level “we would clearly have intervened to make sure the objective, which was communication to patients, would have happened”.

Cut to last Thursday and the Public Accounts Committee. Tony O’Brien admitted to receiving memos outlining how CervicalCheck was in the process of disclosing details of audits of cervical smears, how clinicians rather than patients were being told, and warning of headlines such as “screening did not diagnose my cancer”.

It was also clear from the memos that the HSE’s open disclosure policy was not necessarily being followed. Clinicians, not patients, were being told, and it warned of the “risk” involved in affected patients contacting the media.

The memo was also sent to the Chief Medical Officer in the Department of Health, Dr Tony Holohan. He told the PAC that he could not say whether he had seen it. One of the memos was written by John Gleeson, the programme manager at CervicalCheck, on behalf of a member of the HSE’s leadership team, Dr Stephanie O’Keeffe, who is National Director, Health and Wellbeing.

What did the other members of the HSE’s leadership know about these memos that appeared to flout the health service’s stated policy on open disclosure to patients?

Taoiseach Leo Varadkar, a former minister for health, and Simon Harris did not see the memos, nor did the Secretary General of the Department of Health, Jim Breslin.

Who knew what and when will now form part of the scoping inquiry led by public health expert Dr Gabriel Scally, which is due to report by the end of June.

“I am concerned that when we were looking for information, we were very much focused on 2017,” said Senator Colm Burke this weekend.

“That’s because we were led to believe that people became aware of the issue in 2017.”

That does not now seem to be the case.