It's getting harder to trust the HSE with each day
Related Articles
When the investigation into breast cancer screening at Portlaoise Hospital was announced nearly three months ago the message was that women should not be too concerned.
The confident message was that the review would not find anyone had been misdiagnosed. Instead the word was that the consultant radiologist at the centre of the probe was being overly cautious and referring women for further procedures when there was no need. The review was to cover 3,000 mammograms and 2,500 ultrasounds going back to late 2003.
However, it all took a terrible twist last month when a number of local women revealed they had been called for review and found their cancer had been missed after undergoing a mammogram at the hospital.
The Health Service Executive confirmed that as many as seven women who had been given the all clear were now about to undergo treatment for breast cancer. Some had undergone the initial failed tests more than a year ago.
Another two of the remainder of the 3,000 women whose mammograms were reviewed were told this week their cancer had been missed also. The scale of the misdiagnosis in just one hospital left many people shocked but the hope was that the nightmare of watching and waiting for women who had attended the hospital was at least drawing to a close.
However, the shock revelations yesterday that another 97 women who underwent ultrasound examination are now being recalled for further screening came as a bolt from the blue and was delivered in a matter of fact and dispassionate way at an Oireachtas committee meeting.
The insensitivity of delivering such information, which is set to leave scores more women in turmoil is hard to grasp. It shattered the perception that the only area of concern was mammograms and those who had ultrasound examinations did not have to fear.
Soul-searching
After all the soul-searching and undermining of confidence in breast cancer services in recent weeks the decision to choose such a venue to break the news leaves the HSE in the dock again. It only emerged in reply to a series of questions from Fine Gael health spokesperson James Reilly. The devastating news became wedged in between replies on everything from home helps to health service co-ops and A&E delays.
Nobody in the HSE seemed to give much attention to the fact that none of the 97 women had even been contacted and won't know until today.
The HSE insisted yesterday that the review mammograms took precedence because this produces an image which can be re-read. With ultrasound the re-examination is more complex because it involves going through clinical notes. An ultrasound allows a specialist to take a closer looker at areas of the breast after doing a mammogram. It requires a skilled operator who can examine areas through good positioning of the breast.
The women recalled will next week be referred to a special clinic -- dubbed a "one-stop shop" by National Hospitals Office head John O'Brien. Those of this group who give cause for concern will undergo further scans with the possibility their cancer could have been missed.
The HSE's attitude yesterday came across as dispassionate and removed from the emotional and possibly life-threatening fallout of this scandal. Asked if a review of other breast cancer services should be carried out in other hospitals, Mr O Brien ruled it out but gave no concrete reason for the refusal.
The latest blunder came in the midst of yet more statements from HSE officials at yesterday's Oireachtas meeting that people will have to accept that cancer services will be concentrated in eight centres.Quality cannot be compromised for the sake of convenience, they added.
They would gain a lot more public confidence in their plan if they proved they were capable of handling a crisis such as the Portlaoise hospital review properly. It is not the way to inspire trust in the wisdom of rationalisation of services. There remains huge concern that it will not be properly funded and the eight specialist centres which will eventually treat all cancers will not be able to cope with the potential for more poor consequences for patients.
The HSE and Minister for Health Mary Harney insisted yesterday that the new National Director of Cancer Control Prof Tom Keane has been party to the decision to concentrate the services in the eight centres. He has two years to sell the plan to the public. But, just five days in his job today, he is already under pressure due to the HSE's actions yesterday.
It will be interesting to hear his views on how the debacle has been handled.
