An­other day of shock and dis­be­lief over the treat­ment of Ir­ish women

Com­mit­tee is flum­moxed by a del­uge of records and the re­sponse of health of­fi­cials

The Irish Times - - Home News - Si­mon Car­swell

More shock, more in­dig­na­tion, more dis­be­lief – an­other day, an­other Oireach­tas com­mit­tee hear­ing into missed smear tests that should have flagged can­cer warn­ings and the fail­ure to tell women about them.

The Dáil Pub­lic Ac­counts Com­mit­tee was deal­ing with such a del­uge of records that landed overnight from the Depart­ment of Health and Health Ser­vice Ex­ec­u­tive that it had to ad­journ for an hour to ex­am­ine them fur­ther.

“This is, frankly, just dis­grace­ful,” said Labour TD Alan Kelly.

So­cial Democrats TD Cather­ine Mur­phy thought it was part of a “man­age­ment strat­egy” from the HSE to ef­fec­tively ham­per the com­mit­tee’s work.

Their anger set the tone for the meet­ing that car­ried on for most of the day.

As health chiefs sought to ex­plain how they as­sumed (wrongly) as far back as early 2016 that women were go­ing to be told about au­dits show­ing in­cor­rect tests, Sinn Féin TD Jonathan O’Brien zoned in on what Cer­vi­calCheck was telling the fam­i­lies of women who had died of cer­vi­cal can­cer.

Memos cir­cu­lated to the clin­i­cians in 2016 showed Cer­vi­calCheck just wanted the au­dit re­sults added to the women’s med­i­cal records and that fam­i­lies were not go­ing to be told.

Es­ca­late con­cerns

Like the rest of the com­mit­tee, and the pub­lic at large, he was flum­moxed that few, right up to the State’s chief med­i­cal of­fi­cer, never thought to es­ca­late con­cerns about the au­dit.

“It is ab­so­lutely as­ton­ish­ing that there seems to be a lack of com­mu­ni­ca­tion be­tween se­nior man­age­ment, mid­dle man­age­ment, across all of it, all of ye,” O’Brien told Depart­ment of Health and HSE of­fi­cials

“Peo­ple not be­ing in­formed – for me, that is not a co­in­ci­dence. It stinks.”

Dr Stephanie O’Ke­effe, who as the HSE’s di­rec­tor of health and well­be­ing at the time had over­all re­spon­si­bil­ity for the screen­ing pro­grammes, said she had no idea that pa­tients were not be­ing told.

This was de­spite at­tend­ing monthly meet­ings with Cer­vi­calCheck’s man­age­ment, see­ing memos be­ing cir­cu­lated about com­mu­ni­ca­tions strat­egy and be­ing aware of le­gal claims go­ing to the State Claims Agency.

O’Ke­effe said that “the feel­ings” she had from one Cer­vi­calCheck meet­ing was that there were “no sys­temic er­rors aris­ing from the au­dit and that in­for­ma­tion could be in­formed to the pa­tient”.

Fine Gael TD Kate O’Con­nell asked: “Do you base your clin­i­cal judg­ment on feel­ings or science?”

O’Ke­effe ex­plained that she was a psy­chol­o­gist, not a med­i­cal doc­tor, and the meet­ing was so long ago that she could not re­mem­ber what was said but that her feel­ing was there was no con­cern raised.

“In the world of science, we like to sep­a­rate fact and feel­ings,” replied O’Con­nell, who is a phar­ma­cist.

O’Ke­effe re­sponded: “Feel­ings are ex­cep­tion­ally im­por­tant in this world, es­pe­cially about what we’re talk­ing about right now.”

O’Con­nell replied: “Per­haps if feel­ings are so im­por­tant we should have used them when we were try­ing to de­cide how to deal with telling pa­tients.”


The com­mit­tee’s chair, Fianna Fáil TD Seán Flem­ing, was “ut­terly at a loss” as to how O’Ke­effe had met Cer­vi­cal Check “month in, month out” and yet did not ask whether women were be­ing told at a time when 80 per cent of the women af­fected still had not been no­ti­fied.

“It makes a mock­ery of the con­cept of open dis­clo­sure; it was whole­sale ig­nored,” he said.

O’Ke­effe replied: “I feel ab­so­lutely ter­ri­bly, ter­ri­bly sorry with the fact that I didn’t have an op­por­tu­nity to re­spond to it.” She said she be­lieved let­ters were go­ing out to doc­tors.

Kelly, near the end of the meet­ing, sum­marised how he be­lieved the pub­lic viewed it all.

“They don’t un­der­stand why some­body didn’t just shout stop,” he said.

‘‘ Their anger set the tone for the meet­ing that car­ried on for most of the day

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