Cer­vi­calCheck leaflet took two years

Leaflet to in­form women af­fected by au­dit went through ‘mul­ti­ple it­er­a­tions’ Newly re­leased records show doc­tors were un­happy onus was on them to tell women

The Irish Times - - Home News - SI­MON CAR­SWELL Pub­lic Af­fairs Ed­i­tor

Cer­vi­calCheck was draft­ing a leaflet as re­cently as last March to send out to women with cer­vi­cal can­cer to ask if they wanted to re­ceive de­tails of an au­dit show­ing past in­cor­rect smear tests, new doc­u­ments show.

In a let­ter re­leased to the Dáil Pub­lic Ac­counts Com­mit­tee yes­ter­day, the screen­ing pro­gramme’s then clin­i­cal di­rec­tor, Prof Gráinne Flan­nelly, wrote that the leaflet “took a sur­pris­ing amount of time to sign off” fol­low­ing “mul­ti­ple it­er­a­tions of the leaflet”.

The let­ter shows a leaflet was still be­ing pre­pared two years af­ter Health Ser­vice Ex­ec­u­tive and Depart­ment of Health of­fi­cials were made aware that Cer­vi­calCheck had de­cided to “pause” let­ters to the women’s doc­tors telling them about false smear tests un­cov­ered by au­dits while they sought le­gal ad­vice.

Prof Flan­nelly sug­gested in her let­ter to Lim­er­ick gy­nae­col­o­gist Dr Kevin Hickey, who treated Vicky Phe­lan, who ex­posed the con­tro­versy, that the best place to post the leaflet was on Cer­vi­calCheck’s web­site where it would be “down­load­able and printable”.

Cer­vi­calCheck planned to in­clude a “no­ti­fi­ca­tion slip” that the af­fected woman could tear off and send di­rectly to the screen­ing pro­gramme if they wanted to “opt in” to re­ceiv­ing in­for­ma­tion about false tests.

“This leaflet is de­signed to in­form women about the can­cer review or look back progress and gives them an op­tion to con­tact Cer­vi­calCheck if they would like to be in­formed about any out­come,” Prof Flan­nelly wrote.

No­ti­fi­ca­tion slip

She told Dr Hickey that the woman “would be able to tear off the no­ti­fi­ca­tion slip and send di­rectly to the Cer­vi­calCheck pro­gramme to opt in to re­ceiv­ing this in­for­ma­tion.”

The let­ter was among records shared by the Lim­er­ick hos­pi­tal group to the com­mit­tee while se­nior HSE and depart­ment of­fi­cials were pro­vid­ing tes­ti­mony on the Cer­vi­calCheck scan­dal.

An­other doc­u­ment shows that at least six of 11 women with cer­vi­cal can­cer be­ing treated by the Lim­er­ick hos­pi­tal were not told about the clin­i­cal au­dit until af­ter Ms Phe­lan’s High Court set­tle­ment on April 25th that led to the rev­e­la­tion that at least 162 women were not in­formed about false smear tests.

Two women were in­formed about the au­dit on April 30th while four were told the fol­low­ing day.

Since Ms Phe­lan’s case, it has emerged that at least 162 women were not in­formed of false smear tests.

Prof Flan­nelly wrote to Dr Hickey in re­sponse to a let­ter he wrote on March 1st last set­ting out the his­tory of his dis­pute with Cer­vi­calCheck over who should tell the women: the doc­tors or the pro­gramme.

He wanted to see that changes the screen­ing pro­gramme had agreed to at meet­ings with Cer­vi­calCheck’s “lead col­po­scopists group” on Septem­ber 1st and Oc­to­ber 26th, 2017 – namely that the pro­gramme would in­form cer­vi­cal can­cer pa­tients about the au­dit prior to their di­ag­no­sis – were be­ing im­ple­mented.

“I would be most grate­ful if you could pro­vide me with writ­ten con­fir­ma­tion that these changes are now be­ing im­ple­mented by Cer­vi­cal Check,” wrote Dr Hickey, copy­ing, among oth­ers, John Glee­son, Cer­vi­calCheck’s pro­gramme man­ager.

Labour TD Alan Kelly ex­pressed dis­may that the only achieve­ment in six months since the col­po­scopists’ meet­ing in terms of in­form­ing women about the clin­i­cal au­dit was “a leaflet” for pa­tients.

“Open dis­clo­sure? Opt in? Tear off a slip? Af­ter six months and we now know 80 per cent of women not be­ing told. This was the con­clu­sion,” he said.

The depart­ment re­leased the min­utes of the Septem­ber 1st meet­ing to the com­mit­tee, show­ing that the doc­tors felt it was “not cor­rect” that Cer­vi­calCheck was “putting the onus” to ini­ti­ate the con­ver­sa­tion with the women and that this caused con­cern and “neg­a­tive feel­ings to­wards the pro­gramme from clin­i­cians”.

The doc­tors ar­gued, the min­utes show, that they were be­ing “put at a disad­van­tage” in de­cid­ing who should or should not be of­fered a “close-out meet­ing” – the term they used to de­scribe women be­ing told.

Alan Kelly: ‘Af­ter six months we now know 80 per cent of women not be­ing told’

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