CervicalCheck controversy

Milkman.. · 11-05-2018 01:05PM

boombang wrote: »

This can be read different ways. I take the benign view that they were trying to protect the reputation of the programme from a scandal that would compromise women's attendance, which would be for the good of population health.

It could certainly have been to save the HSE litigation costs, which I still feel is somewhat legit if the payouts are just for routine screen failures rather than demonstrated negligence. I would see payouts as being justified in the latter case.

I could simply be system civil servant and political ass-covering. Which isn't justified of course. My sense is that the other two dominate.

Most worrying would be if there is inadequate performance of the US lab and they don't want that coming to light. That would be a huge story. I think we need to see the numbers (interpreted by an appropriate expert) to get the answer to that one. I'm hoping that the review will be clear and definitive on that.

I can't see how a scandal would compromise attendance or negatively affect population health.

Surely the outcome will be the opposite for attendance and health.

Amirani · 11-05-2018 01:05PM

Mr.H wrote: »

Read the other post I just put up regarding the timeline of Vicky phelans case. She was given her retest in 2014 and only got her results last year.

It is claimed by the powers that be Vicky phelan was one of eleven women in the same position. They all needed a retest. Vicky and three others were informed. Seven were not! It now turns out that the figure is actually 200+.

Memos show in 2016 that the HSE knew cervical check was considering it telling women about misdiagnosed.

Hse knew that only 30% of women were being considered to be told. The hse didn't care about helping women but instead wanted to cover their own ass

Your timeline on Vicky Phelan is incorrect. She was diagnosed with cancer in 2014 and started treatment immediately that year.

After she was diagnosed in 2014, an audit was undertaken into her previous smear tests to check for accuracy. It was in this audit that the false negative was identified. When it was identified, she'd already been receiving treatment for her cancer.

Vickie Phelan was not informed of her false negative when it was discovered and only found out about it last year. At this point she'd already been receiving treatment for 3 years.

McMurphy · 11-05-2018 01:05PM

Amirani wrote: »

Yep, that's exactly it. Fair play to you on the above post clarifying the understanding - many other posters before you haven't done this.

As you point out, there is still a sour taste in the mouth over this, I agree. There is a culture of cover up around this and probably face-saving from people in the HSE. This cover-up may have been for a variety of reasons; but it is this that needs to be criticised and focused on. Many in the media and the likes of Mary Lou McDonald are being completely disingenuous suggesting that the actions of those in the HSE have caused the deaths of women, and this is what's causing confusion and causing people to throw accusations of "attempted murder" around.

I think the way forward on this is probably to full open disclosure, regardless of consequences. Patients should receive all information on their case, even if this results in litigation or undermines the system.

Did she do that?

I heard her on Newstalk this am, and she seemed to clarify what she said, and Shane Coleman (who was interviewing her) seems to have concurred.

It's on the newstalk website if you wish to listen back.

11-05-2018 01:06PM

mikep wrote: »

I think what is getting lost in the finger pointing and calls for a head, instigated in the main by Mary Lou, is the call for true reform of the HSE, and in fact all public services as the behaviour in the Gardai being exposed in the disclosures tribunal shows the disdain for standards and accountability is rife and widespread.

Its far easier to call for heads and condemn the government parties than it is to try and fix a pressurised system that has complicated problems and that may have politically unpopular solutions.

Amirani · 11-05-2018 01:08PM

Mr.H wrote: »

She did not know of the results of the review until 2017.

Even some of the women now still haven't been contacted.

Absolute nonsense that you think there isn't any wrong doing here

There is something wrong there, but it's not what you're making it out to be.

Amirani · 11-05-2018 01:12PM

Johnny Dogs wrote: »

Did she do that?

I heard her on Newstalk this am, and she seemed to clarify what she said, and Shane Coleman (who was interviewing her) seems to have concurred.

It's on the newstalk website if you wish to listen back.

https://twitter.com/MaryLouMcDonald/status/993877078637514753

boombang · 11-05-2018 01:15PM

Johnny Dogs wrote: »

Did she do that?

I heard her on Newstalk this am, and she seemed to clarify what she said, and Shane Coleman (who was interviewing her) seems to have concurred.

It's on the newstalk website if you wish to listen back.

I heard her in the Dáil last week saying that women's health had been damaged by the non-disclosure.

There's also a twitter exchange (that I can't find now annoyingly) between her and Susan Mitchell of the SBP. Mitchell points out that the errors were after diagnosis. MLMcD cops out by saying that Nicky Phelan would disagree. If I find it I'll post it.

boombang · 11-05-2018 01:18PM

Armarni got there first.

https://twitter.com/MaryLouMcDonald/status/993945710868488192

That's the bit in particular I'm talking about.

Playing politics with this f*cking stinks. Tretorn is dead right about Marc McSharry. Made a disgrace of himself. Sometimes events like this allow you to see some politicians for what they really are.

Mr.H · 11-05-2018 01:21PM

Amirani wrote:

There is something wrong there, but it's not what you're making it out to be.

So you don't think there is any chance that someone chose to Mitchell these women because they would have lost their job?

How about ye fact that the memos prove the hse knew that cervical check didn't want to tell women back in 2016?

Fann Linn · 11-05-2018 01:24PM

Mr.H wrote: »

So you don't think there is any chance that someone chose to Mitchell these women because they would have lost their job?

How about ye fact that the memos prove the hse knew that cervical check didn't want to tell women back in 2016?

Catherine Connolly on RTE now making that very point.

boombang · 11-05-2018 01:26PM

Mr.H wrote: »

How about ye fact that the memos prove the hse knew that cervical check didn't want to tell women back in 2016?

They didn't want to tell women that they had previously missed their disease. This isn't good, but it's very different from not telling women they had cancer.

Amirani · 11-05-2018 01:28PM

Mr.H wrote: »

So you don't think there is any chance that someone chose to Mitchell these women because they would have lost their job?

How about ye fact that the memos prove the hse knew that cervical check didn't want to tell women back in 2016?

As I've said, there are questions to be asked about why the women weren't informed of the audit results. The reasons for this need to be made clear, and if it's established that it was done purely for self-protection then action has to be taken against those people. But we don't know this yet because we haven't had an investigation.

However, not informing women of the audit results didn't impact their cancer diagnosis or treatment. The audit came after the diagnosis. This is absolutely crucial.

Mr.H · 11-05-2018 01:32PM

boombang wrote:

They didn't want to tell women that they had previously missed their disease. This isn't good, but it's very different from not telling women they had cancer.

Which is wrong and is the very definition of a cover up. In a matter as serious as Thia I would go as far as to say it is criminal.

Red_Wake · 11-05-2018 01:34PM

Amirani wrote: »

Mr.H wrote: »

So you don't think there is any chance that someone chose to Mitchell these women because they would have lost their job?

How about ye fact that the memos prove the hse knew that cervical check didn't want to tell women back in 2016?

As I've said, there are questions to be asked about why the women weren't informed of the audit results. The reasons for this need to be made clear, and if it's established that it was done purely for self-protection then action has to be taken against those people. But we don't know this yet because we haven't had an investigation.

However, not informing women of the audit results didn't impact their cancer diagnosis or treatment. The audit came after the diagnosis. This is absolutely crucial.

And being completely ignored for the purposes of headlines [the media] and political opportunism[the opposition, including FF].

boombang · 11-05-2018 01:34PM

Mr.H wrote: »

Which is wrong and is the very definition of a cover up. In a matter as serious as Thia I would go as far as to say it is criminal.

I agree that it's wrong. But it didn't harm the health of the women.

Amirani · 11-05-2018 01:35PM

Mr.H wrote: »

Which is wrong and is the very definition of a cover up. In a matter as serious as Thia I would go as far as to say it is criminal.

It is wrong. But, you can't just subjectively call something criminal when there are no laws against it. There's no laws in Ireland that mandate the open disclosure of all health information. Maybe we should have such a law, but until then it's objectively not criminal.

Mr.H · 11-05-2018 01:39PM

Amirani wrote:

However, not informing women of the audit results didn't impact their cancer diagnosis or treatment. The audit came after the diagnosis. This is absolutely crucial.

You see my argument is along the lines of the question, when did they actually know there was an issue?

We already know as fact the hse knew about the cover up in 2016. But is that when the cover up began?

There is potential that people knew about this early enough to save lives. But they chose not to tell anyone.

McMurphy · 11-05-2018 01:40PM

Amirani wrote: »

https://twitter.com/MaryLouMcDonald/status/993877078637514753

That doesn't say what you initially claimed.

Mary Lou McDonald are being completely disingenuous suggesting that the actions of those in the HSE have caused the deaths of women,

Did you say something about disingenuous too

Amirani · 11-05-2018 01:44PM

Johnny Dogs wrote: »

That doesn't say what you initially claimed.

Did you say something about disingenuous too

Mary Lou: "Women's lives were put in jeopardy by the Hse witholding information on false negative smears with the women."

That's disingenuous. Women's lives weren't put in jeopardy and women didn't die because of the HSE not sharing information. Her claim is false and misleading.

blanch152 · 11-05-2018 01:49PM

Mr.H wrote: »

The HSE memos released today were telling employees to not notify patients that they were misdiagnosed. They stopped the release of valuable information so they could "lawyer up". That is a conspiracy. That is a crime. The person who made that call is responsible. The person who is in charge is responsible. The people who knew about this information and kept it quiet are responsible.

You keep asking what conspiracy. My question is do you even know anything about what happened or did you stumble in here thinking we were talking about something completely different?

How can anyone with any bit of a mind even think the words "what conspiracy"?"

What law was broken? If, as you say, there was a crime, then a law must have been broken.

So far that we know, there were false negatives in cervical screening (which is completely normal), these false negatives were discovered when the women later developed cervical cancer (again, completely normal as it isn't a false negative until a positive occurs). From what we have read to date, none of that is an issue unless it can be demonstrated that the false negative levels were unusually high.

Then the trouble starts. A decision was made firstly not to tell patients, and then secondly after some time passed, that discretion should be given to doctors to tell patients. It should have been left to the doctors from the start, as they are the ones best placed to judge what a patient should or shouldn't hear.

Despite some harrowing stories on the radio and television, it does not appear (or there is no evidence to date) that there was any negligence in the diagnosis other than the standard level of false negatives. That isn't any consolation at all for the people affected, but screening is not diagnosis. The wider Irish public do not seem to have grasped this, and are not helped by the media, particularly radio and online media in this regard.

As for conspiracy, you can't have a conspiracy without a crime, so what crime are you accusing these people of committing?

listermint · 11-05-2018 01:49PM

Amirani wrote: »

Your timeline on Vicky Phelan is incorrect. She was diagnosed with cancer in 2014 and started treatment immediately that year.

After she was diagnosed in 2014, an audit was undertaken into her previous smear tests to check for accuracy. It was in this audit that the false negative was identified. When it was identified, she'd already been receiving treatment for her cancer.

Vickie Phelan was not informed of her false negative when it was discovered and only found out about it last year. At this point she'd already been receiving treatment for 3 years.

Vickie Phelan had to go to court to find out about it, Lets not use terms like discovered. It was discovered several years ago. She had to go through the process of a court case to find out the real truth.

That is a core problem here.

kaymin · 11-05-2018 01:49PM

Amirani wrote: »

Mary Lou: "Women's lives were put in jeopardy by the Hse witholding information on false negative smears with the women."

That's disingenuous. Women's lives weren't put in jeopardy and women didn't die because of the HSE not sharing information. Her claim is false and misleading.

It is not misleading because if women (in general) knew the smear tests they had undergone were unreliable then they would most likely arrange to be re-tested - the fact that they won't have done that means cancers will develop in some unknowingly.

blanch152 · 11-05-2018 01:50PM

Amirani wrote: »

Mary Lou: "Women's lives were put in jeopardy by the Hse witholding information on false negative smears with the women."

That's disingenuous. Women's lives weren't put in jeopardy and women didn't die because of the HSE not sharing information. Her claim is false and misleading.

It is typical of the hysterical reaction to these cases. We will never get to the truth if politicians start sounding like tabloids.

blanch152 · 11-05-2018 01:51PM

kaymin wrote: »

It is not misleading because if women (in general) knew the smear tests they had undergone were unreliable then they would most likely arrange to be re-tested - the fact that they won't have done that means cancers will develop in some unknowingly.

Not true, everyone with a basic command of English knew that there was a certain level of unreliability to screening, that is why it is called screening rather than diagnosis.

Mr.H · 11-05-2018 01:53PM

Amirani wrote:

It is wrong. But, you can't just subjectively call something criminal when there are no laws against it. There's no laws in Ireland that mandate the open disclosure of all health information. Maybe we should have such a law, but until then it's objectively not criminal.

OK let's say I am your doctor. I test you for some sort of cancer. I then tell you after a long wait, that you are clear. You have nothing to worry about so go be with your family and enjoy life. Three years later you go for another check with a different doctor. You are told oh have very aggressive cancer and you've had it a while. In the mean time I realise I may have read our results wrong and I can't be sure that you were given the correct result three years ago. If I realised his three years ago you would have been retested. We may have found cancer and began treatment. Three years ago when it is not as aggressive and far along. In fact you may be clear of it by now. But because it doesn't change anything right now I choose to not tell you I made a mistake.

Are you telling me there is no malpractice, no conspiracy and no criminality in those actions?

Yes I would deserve jail time for that.

kaymin · 11-05-2018 01:53PM

blanch152 wrote: »

Despite some harrowing stories on the radio and television, it does not appear (or there is no evidence to date) that there was any negligence in the diagnosis other than the standard level of false negatives. That isn't any consolation at all for the people affected, but screening is not diagnosis. The wider Irish public do not seem to have grasped this, and are not helped by the media, particularly radio and online media in this regard.

At the time a decision was taken to outsource, the QA unit resigned on mass because the outsourced service yielded 1/3 less positives than non-outsourced testing yet their concerns were dismissed. This does not seem to be a normal level of false negatives.

boombang · 11-05-2018 01:54PM

kaymin wrote: »

It is not misleading because if women (in general) knew the smear tests they had undergone were unreliable then they would most likely arrange to be re-tested - the fact that they won't have done that means cancers will develop in some unknowingly.

Smears are inherently unreliable. If they went for a retest it would be with the same unreliable test. It was misleading for MLMcD to suggest that non disclosure damaged health.

Mr.H · 11-05-2018 01:57PM

blanch152 wrote:

As for conspiracy, you can't have a conspiracy without a crime, so what crime are you accusing these people of committing?

I don't claim to know the law inside out. I claim to find it hard to believe no law was broken.

Milkman.. · 11-05-2018 01:57PM

blanch152 wrote: »

What law was broken? If, as you say, there was a crime, then a law must have been broken.

So far that we know, there were false negatives in cervical screening (which is completely normal), these false negatives were discovered when the women later developed cervical cancer (again, completely normal as it isn't a false negative until a positive occurs). From what we have read to date, none of that is an issue unless it can be demonstrated that the false negative levels were unusually high.

Then the trouble starts. A decision was made firstly not to tell patients, and then secondly after some time passed, that discretion should be given to doctors to tell patients. It should have been left to the doctors from the start, as they are the ones best placed to judge what a patient should or shouldn't hear.

Despite some harrowing stories on the radio and television, it does not appear (or there is no evidence to date) that there was any negligence in the diagnosis other than the standard level of false negatives. That isn't any consolation at all for the people affected, but screening is not diagnosis. The wider Irish public do not seem to have grasped this, and are not helped by the media, particularly radio and online media in this regard.

As for conspiracy, you can't have a conspiracy without a crime, so what crime are you accusing these people of committing?

Is it correct to say a false-negative only becomes a false-negative at a later stage and not at the time of reading the slide?

Not saying you're wrong

kaymin · 11-05-2018 01:58PM

blanch152 wrote: »

Not true, everyone with a basic command of English knew that there was a certain level of unreliability to screening, that is why it is called screening rather than diagnosis.

There's no denying its not 100% accurate, however, its the extent of the incorrect results that is of concern and in question. If they were in the normal range that would be expected then the testing clinic would not have a case to answer in the courts - yet they had to pay €2.5m to Vicky Phelan. Experts have said that a reasonably competent person would have detected the cancerous cells in her smear tests.

CervicalCheck controversy

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