CervicalCheck controversy

James Brown

McDonald accuses HSE of cover up over CervicalCheck controversy
Sinn F Leader Mary Lou McDonald said Vicky Phelan's solicitor has described the case as a "cover up" and she is now convinced that is what we are facing by the Health Service Executive...

"It is a scandal that Tony O'Brien is left in his post for those weeks to sail into the sunset with a large pension and hefty gratuity having left a scene of devastation and upset and trauma behind".

She said that "incompetent man should be removed from his position".

The Taoiseach said this is just not about looking for a resignation and heads to roll and this is about women's health.

While McDonald calls for sackings and investigations, it will be very tough to support such suspicions. The former health minister and current Taoiseach deftly brings it to being about the victims. Although an admirable sentiment it's akin to after a mass shooting, not wanting to talk guns, but offer thoughts and prayers instead.

We traditionally don't do accountability. I can't see McDonald getting any proof. At best we may see a lingering limp commission, which Lab's Kelly thinks is a waste of time and I tend to agree with him. I would expect the Health Department to become the new Justice Department, with the department being some kind of rogue entity and any minister heading it getting full confidence. We've talk of the HSE being "dysfunctional" as per Fine Gael TD Kate O'Connell. So it's likely going to be a case of it all being on the HSE as an organisation, with no specific heads rolling and the HSE being some poor relation, a law unto itself, no government can control or be expected to.
One thing for sure is it's not a great advertisement for privatisation, but it's not that we do accountability in our own state bodies anyway.

We can sack all round us every time there is a problem in health.

It wont encourage the staff to open up and admit when there is a problem, it will just lead to more coverups.

Red_Wake

Shoot first and ask questions later is a SF tradition don't you know.

James Brown

Red_Wake wrote: »

Shoot first and ask questions later is a SF tradition don't you know.

More jumping the gun, no? Her flaw here is expecting answers and consequences.

Red_Wake

Matt Barrett wrote: »

Red_Wake wrote: »

Shoot first and ask questions later is a SF tradition don't you know.

More jumping the gun, no? Her flaw here is expecting answers and consequences.

Reactionary sackings in the past have achieved nothing. Putting a new head in charge will change nothing on its own.

A few suggestions for a plan to improve the HSE long term would be much more constructive and beneficial.

Red_Wake

Red_Wake wrote: »

Reactionary sackings in the past have achieved nothing. Putting a new head in charge will change nothing on its own.

A few suggestions for a plan to improve the HSE long term would be much more constructive and beneficial.

That is exactly what needs to be done.

Perhaps as part of the next government formation deal SF might take the post of minister for health?

Chips Lovell

Can't see how McDonald is scoring an OG. She's the one party leader who pretty much from the get go has gotten just how serious this is.

James Brown

Red_Wake wrote: »

Reactionary sackings in the past have achieved nothing. Putting a new head in charge will change nothing on its own.

A few suggestions for a plan to improve the HSE long term would be much more constructive and beneficial.

We need accountability. People in such positions need to know their actions have personal consequences, but I agree, sackings alone won't make much odds.

James Brown

Baron de Charlus wrote: »

Can't see how McDonald is scoring an OG. She's the one party leader who pretty much from the get go has gotten just how serious this is.

She stated there was a cover up. It's a bit early to call that IMO. It's clear there was major incompetent dysfunction, but as to how much, if any was intentional cover up remains to be seen. I can't see Harris or O'Brien or some as yet unnamed HSE person putting their hand up and taking responsibility or responsibility for a cover up. Out sourcing is a great way of passing responsibility too. O'Brien resigning or being sacked won't make any difference, might send a message but the man is due to step down and is a major shareholder in pharmaceuticals state side, so he'll be fine either way.

Chips Lovell

There was a cover-up though. A conscious decision was made not to tell some of the people affected:

The screening programme told doctors in a circular, in July 2016, that the revised test results should be added to the woman’s file. They were told as a “general rule of thumb” that the woman should be told about the results but that clinicians should “use their judgment in selected cases where it is clear that discussion of the outcomes of the review could do more harm than good”. In cases where a woman has died, doctors were told simply to ensure that the result is recorded in the woman’s notes.

James Brown

Baron de Charlus wrote: »

There was a cover-up though. A conscious decision was made not to tell some of the people affected:

We've seen before, 'I didn't think it was important.' works as a defence. I would love to see justice for those affected, but Varadkar is talking redress, which is not the same as conviction for anyone responsible in a criminal court.
We could end up with the tax payer shelling out millions and those responsible getting a long winded list of committee recommendations.

Chips Lovell

The other key piece of information to emerge was that HSE boss Tony O'Brien was warned 10 years ago about the outsourced testing provider:

Speaking to RTE's Morning Ireland, Dr Gibbons explained that, in 2008, some backlog smear samples were outsourced to the US for cervical cancer testing. When the figures of the results were being collected, he became concerned.

Dr Gibbons said the figures from the United States were showing one-third fewer high-grade dysplasias compared with Ireland. High grade dysplasias are smear samples which identify as having pre-cancerous cells.

Gibbons said O'Brien dismissed his concerns. Gibbons resigned.

gctest50

When did Cervical Check start up ?

Quest Diagnostics Ireland Limited was set up on Thursday the 23rd of April 2009

Surely it would have been better to "build up" one of the labs here - it'd always be needed ?

(Nothing wrong with outsourcing if it's a bit of a temporary back log)

Mr.Micro

gctest50 wrote: »

When did Cervical Check start up ?





Surely it would have been better to "build up" one of the labs here - it'd always be needed ?

(Nothing wrong with outsourcing if it's a bit of a temporary back log)

Absolutely. It's not difficult to read cervical smears. It is bizarre that smears and other specimens are still being sent abroad. When are the Government and the HSE going to get their acts together and start looking after the people of Ireland. It's one thing after another with the HSE... A disgrace and not fit for purpose.

James Brown

Mr.Micro wrote: »

Absolutely. It's not difficult to read cervical smears. It is bizarre that smears and other specimens are still being sent abroad. When are the Government and the HSE going to get their acts together and start looking after the people of Ireland. It's one thing after another with the HSE... A disgrace and not fit for purpose.

I wonder was Harney's hubby involved in any decision to outsource? I recall him being a big fan of privatising health.

I think Harris has an opportunity to tear down and rebuild the HSE. Not as big as the one Kenny wasted, but with the public looking for heads to roll on this, Harris could more easily tackle the HSE...if he's in politics to actually make a difference.

nlrkjos

Red_Wake wrote: »

Shoot first and ask questions later is a SF tradition don't you know.

women all over the country scared stiff over this foul-up, my own wife included...and some clown sees it as a chance to stick it into SF ! get real RW.

hatrickpatrick

Baron de Charlus wrote: »

There was a cover-up though. A conscious decision was made not to tell some of the people affected:

In what kind of sick, sick world is this not considered a serious criminal offense deserving of a custodial prison sentence? These people literally have blood on their hands. Sacking isn't enough, they should be receiving a criminal record and being hauled off to a cell for the next few years.

mikep

This is the ideal opportunity to really get to the heart of issues in the HSE, chances are it will be squandered though.
On Mary Lou's call for a head, it seems like she is playing to the populist gallery, it could come back to bite her though if it is perceived that she is playing politics, which is exactly what she is doing.
I'd prefer to see him stay to answer any questions that may arise..if you sack how could you compel him to take part in whatever form of investigation takes place?

James Brown

mikep wrote: »

This is the ideal opportunity to really get to the heart of issues in the HSE, chances are it will be squandered though.
On Mary Lou's call for a head, it seems like she is playing to the populist gallery, it could come back to bite her though if it is perceived that she is playing politics, which is exactly what she is doing.
I'd prefer to see him stay to answer any questions that may arise..if you sack how could you compel him to take part in whatever form of investigation takes place?

It would be cynical to suggest it's only playing politics though. The opposition are often criticised for not putting themselves out there and although she may be a little premature, I'm glad we have politicians calling out government. Varadkars response was, 'the women are the important thing' or something along those lines. True, but it reverts back to getting to the bottom of what happened, ensuring it doesn't again and most importantly consequences, criminal if required, for those involved.
It seems civil servants received quarterly reports on the tests. Historically, this kind of thing can be excused away as, 'wasn't aware' 'not for me to action' 'seen it, but not qualified to give an opinion' etc. so I wouldn't hold my breath in relation to that.

Members of the Government may have been told about almost a dozen claims by women seeking damages as a result of smear tests organised through the CervicalCheck service.

Secretary General of the Department of the Taoiseach Martin Fraser told the Oireachtas Public Accounts Committee on Thursday morning that list of “sensitive” cases involving the State Claims Agency, was provided to the Government quarterly.
https://www.irishtimes.com/news/ireland/irish-news/government-may-have-had-advance-notice-of-smear-check-cases-1.3482751

nlrkjos

nlrkjos wrote: »

women all over the country scared stiff over this foul-up, my own wife included...and some clown sees it as a chance to stick it into SF ! get real RW.

I'm no fan of Sinn Fein, but fair play to them for raising this to the level it deserves.

17 women have died due to incompetence and literally thousands more worried sick that the results they have been given were wrong.

Meanwhile, it looks like Leo has a vested interest in defending Tony O'Brien.
https://www.independent.ie/irish-news/politics/boss-of-us-firm-linked-to-hse-chief-held-event-for-varadkar-campaign-36868730.html

jmayo

Topgear on Dave wrote: »

We can sack all round us every time there is a problem in health.

It wont encourage the staff to open up and admit when there is a problem, it will just lead to more coverups.

If we sacked all the incompetents in our health service it would look fecking bare.
So all the coverups so far are down to people being afraid they will be sacked.

When was the last time someone was sacked for the fookups.

Was someone sacked because they didn't properly monitor nursing homes for the elderly ?

Was someone sacked because they left a poor girl for years in the care of a family with a suspected child rapist ?

Was someone sacked because they didn't properly monitor Aras Atracta ?
Oh yes the staff left when their appalling behaviour was exposed on prime time TV. :rolleyes:

Was someone sacked because they let a man die in Cavan through misdiagnosis and sent him home ?
And there are multiple similar episodes of misdiagnosis.

Was someone sacked because they left a woman to die due to complications in child birth ?

How long did it actually take for a doctor to be struck off because he was carrying out unnecessary caesarian hysterectomies and ruining womens' lives ?

Was someone sacked because of the poor treatment of pregnant women in Portiuncla, Ballinasloe ?

Red_Wake wrote: »

Reactionary sackings in the past have achieved nothing. Putting a new head in charge will change nothing on its own.

A few suggestions for a plan to improve the HSE long term would be much more constructive and beneficial.

What fooking reactionary sackings ?

One suggestion might be to fire a good chunk of the medical staff as l;azy overpaid incompetents.
Get rid of half the management and admin staff.

We spent a fortune on a health system that often has results no better than a third world system.

Baron de Charlus wrote: »

Can't see how McDonald is scoring an OG. She's the one party leader who pretty much from the get go has gotten just how serious this is.

I normally can't stand her or her party, but fair dues if she is shouting about this.

Mr.Micro

jmayo wrote: »

If we sacked all the incompetents in our health service it would look fecking bare.
So all the coverups so far are down to people being afraid they will be sacked.

When was the last time someone was sacked for the fookups.

Was someone sacked because they didn't properly monitor nursing homes for the elderly ?

Was someone sacked because they left a poor girl for years in the care of a family with a suspected child rapist ?

Was someone sacked because they didn't properly monitor Aras Atracta ?
Oh yes the staff left when their appalling behaviour was exposed on prime time TV. :rolleyes:

Was someone sacked because they let a man die in Cavan through misdiagnosis and sent him home ?
And there are multiple similar episodes of misdiagnosis.

Was someone sacked because they left a woman to die due to complications in child birth ?

How long did it actually take for a doctor to be struck off because he was carrying out unnecessary caesarian hysterectomies and ruining womens' lives ?

Was someone sacked because of the poor treatment of pregnant women in Portiuncla, Ballinasloe ?



What fooking reactionary sackings ?

One suggestion might be to fire a good chunk of the medical staff as l;azy overpaid incompetents.
Get rid of half the management and admin staff.

We spent a fortune on a health system that often has results no better than a third world system.



I normally can't stand her or her party, but fair dues if she is shouting about this.

All the above even before we get to the horrendous waiting lists for consultation and procedures of every type ... The HSE not fit for purpose....

James Brown

Mr.Micro wrote: »

All the above even before we get to the horrendous waiting lists for consultation and procedures of every type ... The HSE not fit for purpose....

Sadly this is not news. It's merely another area so bad the minister(s) throw their hands up, agree it's bad and move on. It all comes back to lack of accountability.

jmayo

Matt Barrett wrote: »

Sadly this is not news. It's merely another area so bad the minister(s) throw their hands up, agree it's bad and move on. It all comes back to lack of accountability.

The HSE was invented so that the minister, dept of health and indeed local councilors could not be held accountable.

It is one of the very few cases where the amalgamation of different entities with similar overlapping staff resulted in absolutely no streamlining, no redundancies, but actually the creation of more bureaucrats to oversee the amalgamated mess.

And AFAIK to copper fasten the mess the first head refused to work from it's new HQ and continued to work from his old base.

There are good people working in the system, but it is head wreckingly morale suckingly bad for them to watch how the lazy, the incompetents, and the ar**lickers are tolerated and even promoted.

It has been a joke from day 1 and if we forgot about the enormous wastage of money we might laugh, but then we think of all the victims, all wrecked lives that the fookup has left and continues to leave in it's wake.


Oh and here is another one that AFAIK resulted in no one being fired, anyone remember PPARS.

jmayo

Just noticed that a huge current topic, a huge political discussion point and no one is really discussing this in the Politics Forum, nor the Politics Cafe AFAIK.

IMHO it says a lot about this forum and where this site is heading.

James Brown

jmayo wrote: »

Just noticed that a huge current topic, a huge political discussion point and no one is really discussing this in the Politics Forum, nor the Politics Cafe AFAIK.

IMHO it says a lot about this forum and where this site is heading.

I was reluctant to raise it.

It seems to me, as I said earlier. Like the last financial crash, big events like this, how ever devastating, bring opportunity for good works. We, the state, can dodge and duck on to the next crisis or use the momentum to create real change. Like the financial crash, this is bigger than mere political parties. This is about the people and their well being. We need politicians to step up not talk about worthless toothless committees and paying off the victims to get rid of them.

blackwhite

When the health boards were done away with, and the HSE was being set up, there was an opportunity to start fresh. Instead Bertie went all out to appease the unions - promised nothing would change - and we ended up with basically all the disfunction of the Health boards multiplied.

When the crash happened both Cowen and then Kenny had a chance to use it as an opportunity for serious reform. Neither even tried.

The current scandal is nowhere near the opportunity for reform that we’ve had in the past, so I fully expect nothing to happen. No party is willing to take on the public sector unions in such a major way, despite the fact that such a bold move is 1) exactly what is needed, and 2) might actually win support from voters who aren’t public sector union members.

We have a collection of political parties who all show a willingness to bow to the loudest grouping. The resistance to any meaningful change in the HSE from the vested interests will always be pretty loud - and I have no confidence that any of our political parties will ever have the cojones to ignore those who shout loudest

jmayo

jmayo wrote: »

Just noticed that a huge current topic, a huge political discussion point and no one is really discussing this in the Politics Forum, nor the Politics Cafe AFAIK.

IMHO it says a lot about this forum and where this site is heading.

It can’t be blamed on the Tories though, so no one is interested.

James Brown

Aegir wrote: »

It can’t be blamed on the Tories though, so no one is interested.

We know who did nothing but how many times can ministers or parties use the 'it was like that when I got here' line?
Unions will always fight for their membrs. That's the unions job. Civil servants will fight for civil servants. Politicians are supposed to fight for the tax payer, the well being of the state. Governments can make unpopular moves if it plays to the right people in the hopes a give away here or there will lead to short memories. We need them to pull the same kind of fast one for the benefit of the tax payer. Unlikely well have a genuine political government any time soon, (I don't believe state comes first for past and present politicians).

boombang

Baron de Charlus wrote: »

The other key piece of information to emerge was that HSE boss Tony O'Brien was warned 10 years ago about the outsourced testing provider:



Gibbons said O'Brien dismissed his concerns. Gibbons resigned.

TOB has gone on record saying that Gibbons was correct in terms of the results he stated, but that this referred a configuration of testing at the US labs before they were contracted to provide services for CervicalCheck from 2008 onwards. The contract with CervicalCheck specified a number of criteria which means the pre 2008 comparison is not representative of US lab performance.

Also worth noting, the failure to catch Nicky Phelan's case and others does not represent a systematic failing of screening. The screening test is imperfect and sadly we expect these misses.

boombang

Mr.Micro wrote: »

Absolutely. It's not difficult to read cervical smears.

I'm not a pathologist, but I've seen the smear reading process and I would say that it is difficult to read smears. Check through 10,000 cells on a slide an spot differences in the staining of them. If it's easy to read smears why do we get false negatives and why does it take time to train screeners?

boombang

hatrickpatrick wrote: »

In what kind of sick, sick world is this not considered a serious criminal offense deserving of a custodial prison sentence? These people literally have blood on their hands. Sacking isn't enough, they should be receiving a criminal record and being hauled off to a cell for the next few years.

I think this sentiment must be based on a misunderstanding of what went wrong at CervicalCheck. A lot of people are under the impression that relevant diagnoses were withheld from women in a way that let the disease to progress. This is NOT what happened. The screening errors were discovered AFTER women had received a correct diagnosis for cancer and had start appropriate treatment. It was the diagnosis of cancer following later screenings that followed a review of earlier screening and in some cases it was found that earlier signs of disease had been missed. Given that women had received the correct diagnosis at the time there is no possible way what was not communicated to women could have helped their prognosis.

boombang

Aegir wrote: »

17 women have died due to incompetence and literally thousands more worried sick that the results they have been given were wrong.

17 women have died because a fallible test failed in a predictable and expected way. This isn't due to some terrible failing of CervicalCheck management.

Mr.Micro

boombang wrote: »

I'm not a pathologist, but I've seen the smear reading process and I would say that it is difficult to read smears. Check through 10,000 cells on a slide an spot differences in the staining of them. If it's easy to read smears why do we get false negatives and why does it take time to train screeners?

It is easy for a trained cytologist or technician to read a smear test slide. Such persons know the morphology of cells and will detect any abnormal ones straight away. Not every cell on a slide is looked at, it would take forever.

Problems arise when vast numbers of slides are examined in that, not enough time may be given to each slide, thus missing detection. Other factors, incompetent staff, poor staining procedures, poor training etc.

boombang

Mr.Micro wrote: »

Problems arise when vast numbers of slides are examined in that, not enough time may be given to each slide, thus missing detection. Other factors, incompetent staff, poor staining procedures, poor training etc.

Screening necessarily requires vast numbers of slides to be read quickly and consistently to achieve high sensitivity, specificity and at viable cost. The contracted labs seem to have been achieving this. We could make screening more accurate, but if it takes longer per slide then that's more labour cost and the cost-effectiveness of screening is compromised.

WoollyRedHat

boombang wrote: »

17 women have died because a fallible test failed in a predictable and expected way. This isn't due to some terrible failing of CervicalCheck management.

In over 200 cases it was found that they should of been sent for treatment but because of faiilure of detection this didn't happen

During the tendering process the US lab was found to have a one third lower detection rate of pre-cancerous cells compared to the equivalent labs in Ireland. The US system is designed for annual checks whereas the Irish system is every 3 years. That means the pathologists were handling a larger amount of tests for analysis which increases the likelihood of human error, which in the U.S isn`t as serious because they test every year. We don't.

Furthermore a number of gynecologist staff warned about outsourcing and how it could lead to missed diagnosis due to mismatch of systems. Dr. Gibbons was on the Quality Assurance committee and would of been fully aware of the process. Just because TOB dismissed his claims doesn't make him incorrect. He resigned for good reason. I would like to see the minutes of that meeting.

The level of cover up involving HSE is shocking.. they tried to get Phelan to sign an NDA because they didn't want it to be made public. There`s a reason why the insurance company paid.out to Vicky Phelan. TOB should go and with no pension. An full independent inquiry needs to be established free of HSE. The likes of Harney should be called to give evidence.

WoollyRedHat

boombang wrote: »

Screening necessarily requires vast numbers of slides to be read quickly and consistently to achieve high sensitivity, specificity and at viable cost. The contracted labs seem to have been achieving this. We could make screening more accurate, but if it takes longer per slide then that's more labour cost and the cost-effectiveness of screening is compromised.

Cost-effectiveness and peoples lives, there's your problem right there.

Fann Linn

And I think the consensus is that SF have not scored an og.

boombang

WoollyRedHat wrote: »

Cost-effectiveness and peoples lives, there's your problem right there.

As paradoxical as it may seem if you ignore cost-effectivenes the worse your health system will be. The optimal screening service is not a perfect one. I don't expect many to agree with or understand this perspective.

boombang

WoollyRedHat wrote: »

In over 200 cases it was found that they should of been sent for treatment but because of faiilure of detection this didn't happen

During the tendering process the US lab was found to have a one third lower detection rate of pre-cancerous cells compared to the equivalent labs in Ireland. The US system is designed for annual checks whereas the Irish system is every 3 years. That means the pathologists were handling a larger amount of tests for analysis which increases the likelihood of human error, which in the U.S isn`t as serious because they test every year. We don't.

Furthermore a number of gynecologist staff warned about outsourcing and how it could lead to missed diagnosis due to mismatch of systems. Dr. Gibbons was on the Quality Assurance committee and would of been fully aware of the process. Just because TOB dismissed his claims doesn't make him incorrect. He resigned for good reason. I would like to see the minutes of that meeting.

The level of cover up involving HSE is shocking.. they tried to get Phelan to sign an NDA because they didn't want it to be made public. There`s a reason why the insurance company paid.out to Vicky Phelan. TOB should go and with no pension. An full independent inquiry needs to be established free of HSE. The likes of Harney should be called to give evidence.

The US lab not the HSE sought the NDA.

I would bet money the inquiry will not find against TOB. Not because it will be shoddy, but because he didn't do anything wrong as far as I can see. I watched all 5 hours of the Dáil committee on the issue from Tuesday.

James Brown

boombang wrote: »

The US lab not the HSE sought the NDA.

I would bet money the inquiry will not find against TOB. Not because it will be shoddy, but because he didn't do anything wrong as far as I can see. I watched all 5 hours of the Dáil committee on the issue from Tuesday.

He said he was going to use his remaining time to concentrate on this scandal...then he takes early leave with vacation. Not to mention the company in the US he is a board member of and a share holder in is chaired by a man who chairs the Matter hospital, (not to mention a financial supporter of Varadkar's). So there's conflict of interest there, where else? Can all be dismissed of course. Very reminiscent of the Bertie era.

boombang

Matt Barrett wrote: »

He said he was going to use his remaining time to concentrate on this scandal...then he takes early leave with vacation. Not to mention the company in the US he is a board member of and a share holder in is chaired by a man who chairs the Matter hospital, (not to mention a financial supporter of Varadkar's). So there's conflict of interest there, where else? Can all be dismissed of course. Very reminiscent of the Bertie era.

Yep, but the report will be assessing the CervicalCheck controversy. I doubt he'll be found lacking with regard to it. He might have other questions to answer on other topics, but they are other topics, not CervicalCheck.

James Brown

boombang wrote: »

Yep, but the report will be assessing the CervicalCheck controversy. I doubt he'll be found lacking with regard to it. He might have other questions to answer on other topics, but they are other topics, not CervicalCheck.

It will be interesting to learn about the tendering process, who was involved and why they were picked despite a poorer record than those at home.

boombang

Matt Barrett wrote: »

It will be interesting to learn about the tendering process, who was involved and why they were picked despite a poorer record than those at home.

Again I go back to TOB's point that the evidence put forward by the man who ran a cervical screening service in Ireland was not relevant to the specification of the service that CervicalCheck subsequently purchased from Quest. I will look closely at the error rates that have come from those labs in the CervicalCheck era. Annoyingly the selection of samples that go to the three labs are not done on a randomised basis, so a simple comparison of the rates of high grade lesions found won't be representative as some areas may be taking in higher risk areas than others. CervicalCheck have said that they can't see any of the labs underperforming in the data that they have.

Vicky Phelan's miss does not mean that there's been a systematic problem.

I suspect two of the good reasons why we didn't go with more Irish services is that they apparently didn't have the required capacity and they were more expensive.

James Brown

boombang wrote: »

Again I go back to TOB's point that the evidence put forward by the man who ran a cervical screening service in Ireland was not relevant to the specification of the service that CervicalCheck subsequently purchased from Quest. I will look closely at the error rates that have come from those labs in the CervicalCheck era. Annoyingly the selection of samples that go to the three labs are not done on a randomised basis, so a simple comparison of the rates of high grade lesions found won't be representative as some areas may be taking in higher risk areas than others. CervicalCheck have said that they can't see any of the labs underperforming in the data that they have.

Vicky Phelan's miss does not mean that there's been a systematic problem.

I suspect two of the good reasons why we didn't go with more Irish services is that they apparently didn't have the required capacity and they were more expensive.

What in your view was/is the problem then? Is there a 'scandal' at all?

blanch152

Matt Barrett wrote: »

It will be interesting to learn about the tendering process, who was involved and why they were picked despite a poorer record than those at home.

https://circulars.gov.ie/pdf/circular/finance/2008/22.pdf


The answer may well be found in the detail of Circular 22/2008. I can't find a copy online of the document mentioned.

boombang

Matt Barrett wrote: »

What in your view was/is the problem then? Is there a 'scandal' at all?

Certainly not as large a scandal as the media are making out.

1. Tests fail: sadly this happens, it's screening.

2. Is there a problem of bad labs being hired? Quite possibly, but no strong evidence (yet) to suggest this. Legitimate question to ask though. We need to scrutinise the evidence.

3. Women weren't told that there had been missed previously. Far from ideal, but it was irrelevant to their outcomes at the time it had been discovered. Are CervicalCheck a big disgrace for not telling women: well, they were in the process of doing it in Vicky Phelan's case but got delayed by doctor who didn't comply. The did leave it in the judgement of other doctors, which paternalistic as it is, doesn't seem like any negligence.

4. Terrible terrible explanation from CervicalCheck top staff on what was going on, which then made a information vacuum for HSE and politicians. Very poor communication, but not necessarily active damage to health.

All in all it's certainly not the Irish health system's finest hour, but I don't think it was worth getting everybody THAT concerned about it. Huge numbers of women getting repeat smears is unnecessary. Let's check the stats carefully to see if the US lab is performing worse than the two Irish labs.

James Brown

boombang wrote: »

Certainly not as large a scandal as the media are making out.

1. Tests fail: sadly this happens, it's screening.

2. Is there a problem of bad labs being hired? Quite possibly, but no strong evidence (yet) to suggest this. Legitimate question to ask though. We need to scrutinise the evidence.

3. Women weren't told that there had been missed previously. Far from ideal, but it was irrelevant to their outcomes at the time it had been discovered. Are CervicalCheck a big disgrace for not telling women: well, they were in the process of doing it in Vicky Phelan's case but got delayed by doctor who didn't comply. The did leave it in the judgement of other doctors, which paternalistic as it is, doesn't seem like any negligence.

4. Terrible terrible explanation from CervicalCheck top staff on what was going on, which then made a information vacuum for HSE and politicians. Very poor communication, but not necessarily active damage to health.

All in all it's certainly not the Irish health system's finest hour, but I don't think it was worth getting everybody THAT concerned about it. Huge numbers of women getting repeat smears is unnecessary. Let's check the stats carefully to see if the US lab is performing worse than the two Irish labs.

Your posts read like 'these things happen, therefore it's not such a big deal'.

We have this:

mistakenly cleared at least 208 women who later received diagnoses of cervical cancer.
The 208 women received false negatives between 2010 and 2014. At least 17 of these women have since died.
https://www.nytimes.com/2018/04/30/world/europe/ireland-cervical-cancer-screening-scandal.html

If not for Vicky Phelan it seems it may never have been revealed.

Emails released in the Phelan case showed that the CervicalCheck program had advised some doctors not to tell their patients about the 2014 review, arguing that finding out about the false negatives would not affect their current treatment.

Seems they were deciding what personal medical information patients 'needed' to know.

Speaking on RTÉ's Ray D'Arcy programme on Saturday, Mrs Phelan said she discovered there was a mistake with her smear test results when she was reading her own medical file.

And here lies the case of incompetence, putting admin above patient care IMO;

Detailed tests for Ireland's CervicalCheck screening programme, which has operated for the last 10 years, normally take place every three years but because of a backlog they were outsourced to a US company.

This company normally carries out less detailed tests but does so every year to compensate for that lack of detail.

The US company, however, continued to test Irish samples every three years.

The lower detection rate in the US laboratory was brought to the attention of the country's Health Service Executive (HSE) but appears not to have been acted upon.
http://www.bbc.com/news/world-europe-43961552

It's seems they went with the US option, with the one year review instead of the Irish once every three years, but the US firm did it every three anyway. So we got the less detailed review every three years. I'm wondering was it cost, was there conflict of interest? I'm expecting some form of conflict of interest down the road.

boombang

Matt Barrett wrote: »

Your posts read like 'these things happen, therefore it's not such a big deal.

Pretty much,.

We'd expect there to be false negatives of the order that have occurred. That's just the way it is for the most part. Screening is not perfect and they'd no point in scaring women with sensational headlines. Your still far better if being screened than not.

boombang

Matt Barrett wrote: »

It's seems they went with the US option, with the one year review instead of the Irish once every three years, but the US firm did it every three anyway. So we got the less detailed review every three years. I'm wondering was it cost, was there conflict of interest? I'm expecting some form of conflict of interest down the road.

Not sure I get what you're saying here. The US screens every year, we screen every 3/5. The test spec in the US lab is tailored to our frequency. No informed doctor or health official in Ireland would recommend annual screening.

listermint

Wait is there a poster hear blaming the media for a lab doing incredibly poor work. Awarded a contract under the management of Tony o Brien and the HSE doctors covering up the bad test results with 3 women dead and many others on the way.

And it's the media's fault..



Riiiggghht....