Cer­vi­calCheck erred in ‘not clos­ing the loop’ with pa­tients

The Irish Times - - Home News - SI­MON CAR­SWELL

Cer­vi­calCheck com­mit­ted an “er­ror in not clos­ing out the loop” when it failed to in­form women about a clin­i­cal au­dit show­ing in­cor­rect false neg­a­tive smear tests, the pro­gramme’s man­ager has said.

John Glee­son was tes­ti­fy­ing dur­ing a marathon hear­ing of the Dáil Pub­lic Ac­counts Com­mit­tee yes­ter­day as TDs ques­tioned se­nior Health Ser­vice Ex­ec­u­tive and Depart­ment of Health ex­ec­u­tives about who knew what and when around the fail­ure to dis­close clin­i­cal au­dits of cases to cer­vi­cal can­cer pa­tients.

Mr Glee­son was asked about in­ter­nal Cer­vi­calCheck memos dat­ing back more than two years which showed the pro­gramme sus­pended let­ters in­form­ing the women’s doc­tors about the in­cor­rect smear tests.

“I know now that the dis­clo­sure didn’t hap­pen,” he said. “I didn’t know at the time it wouldn’t hap­pen.”

The com­mit­tee heard that doc­tors treat­ing only a fifth of the women di­ag­nosed with cer­vi­cal can­cer at the cen­tre of the au­dits were told about the au­dit show­ing a re­vised out­come on past smear tests.

Un­der ques­tion­ing, Mr Glee­son said Cer­vi­calCheck be­lieved that the “best chan­nel” to in­form women was through their clin­i­cians and that it then “tried to deal with any po­ten­tial block­ages to that.”

A year-long row be­tween Cer­vi­calCheck and the women’s doc­tors about who should tell them meant at least 162 were not told until the case of Lim­er­ick woman Vicky Phe­lan re­vealed the scale of non-dis­clo­sure.

“There was an er­ror in clos­ing out the loop,” said Mr Glee­son. “That is a mis­take.”

“That term, ‘clos­ing out the loop,’ doesn’t cut it for those women,” said Sinn Féin TD David Cul­li­nane.

False tests

Deputies raised ques­tions around tes­ti­mony given the pre­vi­ous evening to the com­mit­tee by Ms Phe­lan and Cork man Stephen Teap, whose wife Irene died in 2015 af­ter two undis­closed false neg­a­tive smear tests.

Mr Cul­li­nane noted that Mr Teap said that if his wife had only five min­utes to live, she would have wanted to have the in­for­ma­tion about the false tests and asked whether Mr Glee­son stood over the com­mu­ni­ca­tions strat­egy pur­sued by Cer­vi­calCheck to “pause all let­ters” about the au­dits.

He replied that the memos he wrote at the time were “con­sis­tent” with the guid­ance around open dis­clo­sure, the Gov­ern­ment’s pol­icy since 2013, and the in­for­ma­tion was “bi­ased” to­wards want­ing where pos­si­ble to dis­close the in­for­ma­tion to the women.

Stephanie O’Ke­effe, the HSE’s na­tional di­rec­tor of health and well­be­ing, said she did not know most pa­tients

‘‘ I did not think any­thing was go­ing wrong. Per­haps I should have, but I didn’t

were not be­ing told until the Phe­lan case, de­spite monthly meet­ings with Cer­vi­calCheck man­age­ment and be­ing aware of the le­gal issues with com­mu­ni­cat­ing re­sults to women from Feb­ru­ary 2016.

She told the com­mit­tee that she was re­peat­edly told by the na­tional screen­ing ser­vice that the au­dit process “was go­ing well” and that “im­prove­ments were be­ing made.”

“I did not think any­thing was go­ing wrong. Per­haps I should have, but I didn’t,” she said.

Lis­ten­ing in­tently

In a state­ment to the com­mit­tee, John Con­naghan, in­terim di­rec­tor gen­eral of the HSE, said that he had lis­tened to Ms Phe­lan and Mr Teap’s tes­ti­mony to the com­mit­tee and told them that he was “lis­ten­ing in­tently” to her calls for ac­count­abil­ity.

He said that he wanted to re­as­sure her that he was “de­ter­mined to take on board all the les­sons that are learned from this un­ac­cept­able chain of events.”

Labour TD Alan Kelly said that there was “arse-cov­er­ing” go­ing on within the HSE amid the scru­tiny on the or­gan­i­sa­tion in light of the con­tro­versy.

PHO­TO­GRAPH: AI­DAN CRAW­LEY

Stephanie O’Ke­effe, the HSE’s na­tional di­rec­tor of health and well­be­ing, said she did not know most pa­tients were not be­ing told about issues with smear tests until Vicky Phe­lan’s case emerged.

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