HSE criticised for drip-feed approach to audit
It will be a long process but the independent review is coming up with recommendations
There were a number of important developments in the ongoing CervicalCheck scandal last week.
First and foremost was the publication of the progress report, by the independent UK doctor charged with carrying out a scoping review, into the failure to inform 209 women diagnosed with cervical cancer, 18 of whom are now dead, of the results of a CervicalCheck audit that showed they had received incorrect results for previous smear tests under the screening programme.
Dr Gabriel Scally's inquiry is examining the facts around the CervicalCheck communication failures and the level of knowledge of various parties including the HSE and the Department of Health about the situation. He is also examining the tendering, contracting, and operation of the labs contracted by CervicalCheck to process the smear tests, and the way the screening programme operates.
While, not surprisingly, he confirmed he would not be able to make the end of June deadline to complete the report, he did make a number of interim recommendations, which have been endorsed by the Government. These include making an immediate ex-gratia payment of €2,000 to the affected women, so they can participate in the inquiry without cost, and reforms to the information women receive when going for cervical screening, including explicit warnings about the limitations of screening.
Dr Scally also proposed that the consent form should guarantee that women will have full and open access to their cervical screening record on request, along with timely and open disclosure on any errors or issues that arise.
Disappointingly, Dr Scally says he has encountered significant delays in obtaining requested information from the HSE, including contracts and tender documents relating to the contracted labs. And despite being a full month into the inquiry, many requested documents (4,000 items) were only handed over a few days before his interim report, much of which was "difficult to read" and non-searchable because it was scanned electronically.
Dr Scally also said that around 20 of the affected women had contacted him to date but he wants to talk to more before he completes his report.
Vicky Phelan, the woman terminally ill with cervical cancer who exposed the whole CervicalCheck audit debacle, criticised the failure of the HSE to provide Dr Scally with the contact details of all the 209 women, or their families in the cases of the 18 women who have died, affected by the audit, and the failure to directly inform the affected women of Dr Scally's review and give them his contact details.
During a meeting of the Dail's Public Accounts Committee last Thursday, politicians were critical of the HSE's response to date to Dr Scally's inquiry, and it was revealed that the number of legal cases against CervicalCheck is increasing, with more than 30 cases now listed. So what happens now? Minister for Health Simon Harris and the Taoiseach have both rebuked the HSE over its drip-feed approach to providing information to Dr Scally and have insisted that he be fully co-operated with.
While Dr Scally hopes to deliver his full report by the end of the summer, Minister Harris has confirmed he will set up a commission of investigation into the CervicalCheck scandal in September.
It is striking, however, that an inquiry into a controversy that was largely caused by communication failures is now victim to the same issue.
Meanwhile, the HSE says it plans to advertise for the role of a new clinical director for CervicalCheck in the coming weeks, though this might prove a difficult post to fill given the circumstances.
And Ms Phelan has revealed that the women affected by the CervicalCheck audit and their families have set up a support group among themselves. About 30 women and their families are involved, and she has asked that the HSE contacts the remaining women to give them contact details for the support group.
Ms Phelan has also dismissed claims that the controversy could lead to the introduction of a no-faults payment system for anyone who has received a false-negative result from a screening programme, which would be financially unsustainable and threaten the viability of screening programmes. Ms Phelan said this is not the case as only legal cases can be taken where clearly mistakes have been made, as opposed to false-negatives, and to claim this "adds insult to injury" to her and others who have been victims of medical negligence.
Leading medical oncologist Prof John Crown has now called for all cervical cancer patients for whom this treatment is suitable to have it funded by the HSE.