'I want women in this country to know that things are changing'
The plight of Vicky Phelan has caused shock but the system is being improved, writes Simon Harris
The image of Vicky Phelan outside the High Court will be a lasting memory in our national consciousness. It was like a collective punch to the gut.
That a woman was not provided with available information about her personal health was appalling. That a woman fighting for her life was fighting for justice for herself and others was inspiring. Her wish for some good to come out of her experience resonated strongly with the whole country and with me as Minister for Health.
Since then my actions have been guided by that wish and I want women in this country to know that things are changing and that more change will come.
First we have ensured that the system has changed so that the information available from CervicalCheck screening audits would be shared automatically with women and a process is now in place to ensure that all women who, like Vicky, were not informed are being contacted.
That women's fears and worries were allowed to build in the period immediately following public awareness of Vicky's case was a grave failure that risked undermining a life-saving screening programme. We must have an inquiry to find the facts and restore confidence in this vital and successful arm of our cancer prevention efforts. After I sent in a senior team to take charge in CervicalCheck at the end of last week, serious progress had been made on identifying the number of women who had been diagnosed with cancer and therefore had earlier screens reviewed but had not been informed of this, in order that they could be contacted.
What came next was shocking. While preparing to account in the Dail on the issue, I was informed that, contrary to previous information I had been given, a further large number of women who had been diagnosed with cancer had not had their smears reviewed. Work immediately began on identifying these women.
I want to be clear here that we are not talking about cases where a woman may have cancer and not know it. What this work is about is reviewing the smear tests of women who have already been diagnosed with cancer and are receiving treatment. The major failing is the way in which these reviews were not communicated to the women affected.
There are serious questions here too for medical professionals and the culture which could allow this to happen. No other consideration should outweigh the moral and ethical responsibility for all medical professionals to advocate for the patient and inform them of any errors if they exist. I acknowledge the Government has further work to do as well and we will. We have taken a series of actions on CervicalCheck including the establishment of two clinical reviews by international experts - one of the individual cases of women whose screening results were reviewed and who weren't told; and one which to conduct an audit of all previous screening results of every woman diagnosed with cancer in the past 10 years.
All of the work under way as a result of these actions will, of course, feed into a wider inquiry on this matter. This week I will bring a proposal to Government on a scoping inquiry which will led by an international expert and which I hope could conclude in June.
This approach can establish some basic facts which can be quickly put in the public domain, while also identifying issues for a full statutory investigation and developing its terms of reference.
I want to say that it is my clear intention that this process will include engagement with Vicky Phelan and other women who may wish to have an input. It will also clearly look at other screening programmes and the implications for them.
I am also bringing to Government a Patient Safety Bill to provide for mandatory open disclosure of serious events. My proposals are in line with UK Duty of Candour legislation and will include mandatory notification of serious incidents to the relevant regulator such as Hiqa and the Mental Health Commission. While there is undoubtedly much more work to be done, we have been making progress in driving openness and transparency to improve patient safety. Monthly maternity and hospital patient safety statements are now published.
Last year, we introduced the National Patient Experience Survey to capture the voice of patients and I am progressing a Patient Safety Licensing Bill to provide for statutory regulation of public and private hospitals. Through the Civil Liability Act, passed last year, which covers all patient safety incidents, we have taken away any fears that doctors may have to being open and apologising to patients. There is no longer room for excuses. The patient has a right to know and should be told.
I believe we must do as Vicky wishes and ensure some good comes out of all of this. The issues in CervicalCheck will be fixed. Confidence in the programme must and will be restored. A light has been shone again on broader systemic patient safety challenges but we have the plan to address them.
The Government will make further decisions this week to provide a clear way forward.
Simon Harris is Minister for Health