A PERVERSION OF PRIORITIES
It’s sinister that health off icials put protecting the institutions ahead of the safeguarding of women’s health
ON WEDNESDAY evening, Emma Mhic Mhathúna stood outside her home on the Dingle Peninsula, the sunlit Atlantic at her back, and offered up yet another unforgettable moment in the Cervical Check scandal. Describing her meeting with President Michael D Higgins and his wife Sabina, who had paid her an impromptu visit, she said: ‘He had touching words for me, especially knowing the road I have ahead. It’s made my own journey a little bit easier and he gave some comfort to the children. And he’s on their side.’
The moment was unforgettable because of the contrast it presented with events that very same morning in the stuffy meeting room of the Oireachtas Joint Committee on Health, as one representative after another from the Department of Health and the HSE carried on with their by-now tedious attempts at reputation management.
The visual contrast was marked enough, but the moral contrast was really arresting.
On one side you have a 37-yearold mother of five who wasn’t told that her smear test had been misread and who now has terminal cancer. On the other you have a senior civil servant – secretarygeneral of the Department of Health Jim Breslin – saying that, ‘within the whole gamut of issues that are being managed by the health service’, this particular issue was not judged to be ‘of sufficient scale’ to tell the Minister for Health about it. O N ONE side you have a fatally ill woman who is gracious and resolute, without a hint of bitterness. On the other side you have a phalanx of mealy-mouthed bureaucrats covering their asses. On one side you have Emma Mhic Mhathúna and her little boys singing Irish songs to entertain Michael D and Sabina. On the other side you have a seated row of State officials, eyes round and lips parched with the dread of saying the wrong thing, bandying about terms such as ‘escalation’ and ‘close out’ and ‘I don’t have full information’ and ‘sufficient scale’. It’s tempting to wonder what, exactly, might have been of ‘sufficient scale’ to bring to the minister’s attention, if not a few hundred grievously sick women being kept in the dark as to their own medical records.
After her meeting with Michael D, Emma was also questioned about what she and the President had discussed.
‘I asked for some advice in the reformation of CervicalCheck and how to put confidence back into the programme because it is a programme that women need to have faith in,’ she replied. ‘And he listened to everything I said.’
Amazing, really, is it not, that one of the victims of this wretched mess is still talking optimistically about restoring confidence in cervical screening? And yet here we are, over three weeks into the scandal and over three weeks into a slapdash damage-limitation exercise on the part of the HSE, and far from being restored, confidence has eroded even further. The whole thing stinks more, instead of less.
Such a stack of documentation was delivered to the Public Accounts Committee on Thursday morning that business had to be adjourned for an hour so everybody could have a chance to pore over it. Catherine Murphy TD even speculated that this was part of a ‘management strategy’ by the HSE to frustrate the committee’s work. It did at least make a change, however, from the unsteady trickle of information that’s been coming out since the end of April.
Where we stand now is that we’re watching a superfluity of Oireachtas committees inquiring into this matter, with assorted occupants of the back benches hoping to achieve stardom on the strength of it.
We’ve seen two heads roll away – that of Gráinne Flannelly, clinical director of the CervicalCheck programme, and that of HSE director general Tony O’Brien, who was leaving anyway. Rolling heads are usually the go-to method of making an image problem disappear, but yet it hasn’t disappeared. Instead we’re noticing everybody else involved conspicuously fighting to keep their own heads attached to their necks.
We’re witnessing continual attempts at buck-passing about who should have told whom and when. CervicalCheck expected clinicians to tell their patients. Clinicians thought CervicalCheck should do it. Quite a lot of people, perhaps with an eye to litigation, clearly thought the patients shouldn’t be told at all. Nobody told Tony O’Brien about this disagreement over disclosure. Actually, on mature recollection (the screws having tightened), Tony O’Brien did know. Somebody told Tony Holohan, chief medical officer in the Department of Health. Nobody told the Minister. It wasn’t worth ‘escalating’, it seems. A GAINST our better judgment, we’re being urged to go along with the paradoxical idea that ‘open disclosure’ doesn’t always mean ‘open’ and doesn’t always mean ‘disclosure’. It might mean ‘selective disclosure’, it might mean ‘nondisclosure’, who knows? It seems to depend on how much trouble actual disclosure would cause, and to whom.
Above all we’ve seen more proof – if proof were needed – of a Sovietstyle culture in which massive, powerful institutions protect themselves at all costs, instead of protecting the people they’ve harmed. We’ve now been presented with all but irrefutable evidence that the biggest worry, all along, was not that people would die needlessly without knowing the full facts about their illness. The biggest worry was that the media would get hold of it, which is exactly what happened.
Meanwhile, we’re being given frequent, urgent reminders of the women who brought all this to light, the women who made sure that, despite the exertions of the institutions involved, this whole sorry business began to be exposed, and who themselves will probably not live to see the end of it.
Where we stand now is that everybody is wondering how much more is known, and who knows it, and how long have they known it, and are they going to tell us, and if so when? What else is going to come out, stinking to high heaven, over the coming weeks?
A serious worry is niggling minds all over the land regarding this affair. At the highest level of the HSE and the Department of Health are people supposedly charged with a duty of care to all citizens. And at that highest level there is evidence of either routine concealment or routine incompetence. Which is it? And more to the point, which is worse?