ANALYSIS:Little has changed since Drumm and his highly-paid advisers took up their position, writes Paul Cullen
Two years and nine months: the length of time two midlands women were left in the dark about their breast cancer, thanks to a misdiagnosis at their local hospital in Portlaoise.
Two years and nine months: the length of time since Professor Brendan Drumm assumed the role of chief executive of the Health Service Executive (HSE), and a new dawn was promised for health care services.
The reports published yesterday on breast cancer services at the Midland Regional Hospital in Portlaoise show how little has changed since Prof Drumm and his highly paid advisers took up their positions.
Three more reports, another fiasco for which no one individual is to blame, and it's hard to avoid the conclusion that, when it comes to the health service, the more things change, the more they stay the same.
Almost four years after Mary Harney became Minister for Health, it's also difficult to dispute Fine Gael's contention that the HSE remains as dysfunctional as it was when she and Prof Drumm took up their posts.
The lack of progress is there to see in John Fitzgerald's report, with its finding of systemic weaknesses in management, confused and contradictory communications and too many "distracted" people running around the HSE not knowing what their role was.
Meanwhile, the continuing shortcomings of parts of the health service are evident in Dr Ann O'Doherty's report, with its tales of badly processed X-rays, poorly written reports on these X-rays and ageing equipment in Portlaoise.
What comfort can citizens draw from these reports on the way breast cancer services misfired at the hospital? More specifically, what comfort can those women who were give incorrect test results draw from these findings, not to mention the wider group of women who were given needless cause to worry about their tests?
Ms Harney, in a press conference yesterday, promised it would not happen again. A reconfiguration of care services would assure patients of "best possible outcomes" by providing diagnosis and care measured by set standards.
Patients would be told of the results of clinical reviews personally and not through the media or political debates. Errors, while they could never be eliminated, would be minimised. A new protocol to handle serious incidents would be adopted.
"Mañana Mary," hooted Fine Gael's health spokesman Dr James Reilly, "Nirvana is always around the corner, never here."
Not that he made his point to the Minister; at the time, he was stranded at the entrance to the department with a bunch of journalists while the press conference began on the ninth floor of Hawkins House - yet another small systems failure in the department formerly known as "Angola".
The problems surrounding the misdiagnosis of patients at Portlaoise is a complex one, and there are clinical issues around the correct diagnosis of breast cancer from a mammogram.
However, the achievement of clarity was not helped by the fact that three separate reports were commissioned, rather than a single over-arching study.
Two of the three reports were written from within the HSE system, when an independent voice might have been preferable.
The reports also raise issues for the media, something the Minister was quick to seize upon in her press conference. She blamed a "media frenzy" for causing unnecessary anxiety for patients and talked of women having to "run the gauntlet" of journalists as they went to have their mammograms reviewed.
Doubtless the Minister has a point about some media excesses, but when the context is one of continued bungling by the HSE, it is possible to understand the level of public concern driven by the media. This is only one in a series of mishaps to hit cancer services nationally in recent years, so public confidence is understandably low.
On the basis of these reports, it is hard to resist the proposed centralisation of cancer services in a small number of centres across the State. The Midland General Hospital failed to provide cancer care to the standards required nationally; one of the reasons for this was identified as an inability to attract suitably qualified staff.
We can't have it both ways, in the form of large hospitals on our doorsteps providing all forms of specialisation. Local is good sometimes, but it clearly wasn't for the women who were misdiagnosed in Portlaoise.