Government faces task of restoring faith in cervical screening service

Analysis: Timescale needed for introduction of mandatory disclosure of serious incidents

Minister for Health Simon Harris speaks to journalists on Monday at Government Buildings about the Cervical Check controversy. Photograph: Gareth Chaney/Collins
Minister for Health Simon Harris speaks to journalists on Monday at Government Buildings about the Cervical Check controversy. Photograph: Gareth Chaney/Collins

The controversy surrounding the cervical screening service has led to widespread fear and concern among women across the country.

The case of Vicky Phelan, the mother of two from Co Limerick who was given incorrect cancer test results in 2011 and is now terminally ill, shocked the nation. She was diagnosed with cancer in 2014 but told of the false negative in the earlier smear test only in September 2017.

The revelation that a retrospective audit of women diagnosed with cervical cancer found that more than 200 others should have received earlier intervention than they did has added to anxiety .

At the same time the move by Minister for Health Simon Harris to publicly express a lack of confidence in the management of the Cervical Check programme, leading to the departure of its clinical director late on Saturday night, fuelled the belief that something genuinely unusual and alarming was going on.

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In this context it is perhaps unsurprising that about 6,000 women have since Saturday phoned a helpline set up by the Health Service Executive to field calls from patients on the controversy.

Inquiry

The controversy raises, on a series of levels, concerns – for doctors, the health service in general and the Government – which are likely to be examined by the new inquiry which is to be established.

Since its establishment in 2008, the national cervical cancer screening programme has undoubtedly led to many lives being saved

It is accepted that the screening test for cervical cancer is not 100 per cent accurate. However, given that the HSE has had a national policy on open disclosure in place since 2013, the fact that 165 women were not given details of the findings of audits of their cases is staggering.

While there will undoubtedly be a lot of focus in the immediate future on who knew what and when about the cervical screening controversy, the most important responsibility for the HSE and the Government will be to restore the confidence of women in the screening programme itself.

Since its establishment in 2008, the national cervical cancer screening programme has undoubtedly led to many lives being saved. More than 1.1 million women have undergone screening, leading to about 50,000 high-grade precancerous changes being detected and treated, preventing a significant number of invasive cancers.

The Government, the HSE and the medical profession may also have to show that they have embraced the concept of open disclosure and ensure that patients in future receive details of information and results concerning their health

Overall since the introduction of the screening programme, the incidence of cervical cancer has fallen by about 7 per cent per year.

New tests and technology hold out the prospect of the number of women contracting the condition being reduced even further in the years ahead.

An information campaign to highlight the benefits of the screening programme may now have to be considered.

The Government, the HSE and the medical profession may also have to show that they have embraced the concept of open disclosure and ensure that patients in future receive details of information and results concerning their health.

The Government delayed in the past on introducing mandatory open disclosure. It now says it will do so for serious incidents. It should set out a timescale for this measures to be put in place.