‘I’m Still Kind Of Flabbergasted’

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RTÉ’s Áine Lawlor; Dr Peter McKenna of the HSE

This afternoon on RTÉ’s News At One.

Journalist Áine Lawlor spoke to Dr Peter McKenna, the clinical director of the women’s and infants’ programme with the HSE – after nobody from the HSE was available to speak to RTÉ’s earlier shows Morning Ireland or Today with Seán O’Rourke.

The lunchtime interview followed it emerging last night that approximately 800 women who had CervicalCheck tests carried out between October 1, 2018, and June 25, 2019, have not received their test results.

This has been blamed on an IT issue at a Quest Diagnostics laboratory in Virginia in the US.

Most of the women affected were getting repeat tests for the human papillomavirus HPV – which can cause cervical cancer – because Quest had previously failed to carry out HPV testing on the women’s initial smears within the 30-day limit.

RTÉ reported last night that the HSE told the Department of Health on Wednesday that it became aware of the IT problem in June.

This lunchtime, Dr McKenna told Ms Lawlor that the HSE knew there was a “computer glitch” in February.

From the interview:

Áine Lawlor: “The lesson on Gabriel Scally’s report about open disclosure and honesty and transparency with the women who are fundamental to the future of CervicalCheck and who depend on CervicalCheck – that lesson has not been learned by the health service.”

Dr Peter McKenna: “I wouldn’t agree with that, in principle. I think that there’s elements of this problem that only emerged to the HSE in the last ten days or so. And the extent of what needs to be communicated with women is not yet currently absolutely certain.”

Lawlor: “OK, well let’s try and establish the facts. So we’re talking about 800-plus women who had repeated cervical smear tests done between October 2018 and June 2019. Is that right?”

McKenna: “Yes, and these are women whose cytology results were known and they had a minor degree of abnormality and in order to see whether they needed to go for coloposcopy or not, an additional test of HPV was carried out.”

Lawlor: “So, in lay person’s language, they had had a previous smear test that had shown some abnormalities related to HPV and this was a repeat smear test to see whether there’d been any changes. Is that right?”

McKenna: “It’s a refinement, it’s a, a papaloma test, rather than a repeat smear test.”

Lawlor: “OK, so it was a more advanced test.”

McKenna: “It was a more advanced test, now, if you…”

Lawlor: “And the computer broke down when?”

McKenna: “No, no, sorry, just to go back even further than that. These 800 women were women who had had a HPV test carried out but, as you may remember, towards the end of last year, it transpired that the tests had been done on an out-of-date kit. I don’t know if that…”

Lawlor: “I think everybody remembers every twist and turn of this unfortunately Dr McKenna. So they had gone for tests again after that, is that right?”

McKenna: “No, so the kit was out of date. And those women that had come back as positive – they were treated as if the result was correct.

“And those women, who the result had come back as negative, it was said ‘no, we should take this seriously and we will repeat the test’. And so, 800 of these women, whose tests have come back as negative initially on the HPV, were then retested.”

Lawlor: “OK. And when did the computer breakdown?

McKenna:It was known in February that there was a computer glitch and…”

Lawlor: “Where was it known exactly, Dr Peter McKenna, because most of us knew nothing about this until yesterday and today. So the question is: this computer failure goes back to February.

Who knew about that back in February? And who has known about that since?

McKenna: “Well, my understanding is that, if I could just finish, that it was known in February and…”

Lawlor: “By whom?”

McKenna: “In whom the tests results altered were informed by CervicalCheck in February. So there was a small number of the 800 women, in whom the results were different, and they were informed directly by CervicalCheck. So the women who were affected were informed as soon as it was known.”

Lawlor: “But who knew about the fail…what does the computer failure involve? When did it happen and who knew about it?”

McKenna: “The computer is designed to…the computer of the labs overseas is designed to communicate with the computer here. And that triggers a, a cascade of letters. It was appreciated that wasn’t working and a manual system was put in place, as far as the HSE knew.”

Lawlor: “OK, it was appreciated by whom? Who appreciated this? And who made the decision to put the manual system in place? And why was none of this made public?”

McKenna: “Right. The answer to the names, I couldn’t give you. I don’t know. But however, it was appreciated within the screening service because the screening service put alternative, manual arrangements in place.”

Lawlor: “And did the HSE know that these computers weren’t working? And that manual arrangements were now being put in place to write to women? And was anybody checking that that was actually happening?”

McKenna: “The service did know that the computers were not speaking to each other – that is absolutely correct and the HSE were reassured by the fact that the women were being written to manually, or sorry, their GPs were being written to manually.”

Lawlor: “So the women’s doctors were being written to, by whom? Who was responsible for…”

McKenna: “By the laboratory.”

Lawlor: “By the laboratory.”

McKenna: “Yeah.”

Lawlor: “So CervicalCheck told the HSE and everybody understood that the laboratories would write to the women…”

McKenna: “Would write to the GPs….”

Lawlor: “Would write to the women’s doctors…”

McKenna: “Yeah…”

Lawlor: “And when did it emerge that this was not happening?

McKenna: This only came to the knowledge of the screening programme and the HSE in early July.

Lawlor:In early July, but a number of months had passed. Had it not occurred to anybody to get back and check, given the sensitivity and, as you say, there have a lot of twists and turns in all of this and we have had the Scally Report which has emphasised the importance of transparency – particularly if women are to go on turning up for smear tests as part of the cervical screening programme.”

McKenna: “I can absolutely understand that question. The HSE and the screening are very disappointed that the arrangement that they thought had been put in place wasn’t working. And this will be investigated as to why this element was not followed through by the contractor.”

Lawlor: “But this is what happened in the first place isn’t it? Somebody thought somebody was telling the women but nobody was?”

McKenna: “No, it’s not quite the same as that. That was the result of an audit. This is probably, in some ways, more important than actual clinical results – there was a delay in communication.”

Lawlor: I’m still kind of flabbergasted. Just one other thing – did the minister know? The minister’s department? We know that the HSE knew about this and understood it was being dealt with by the laboratory, and this only emerged in the last while, that you found out that the letters weren’t happening.

Was the minister’s office across this?

McKenna: “I would not…I don’t know the answer to that. I’m sorry.”

Lawlor: “OK, so you don’t know whether the Department of Health was involved?”

McKenna: “I don’t. No.”

Lawlor: “You said you can understand why women might not have confidence after everything. I mean this comes across like almost like a last straw, doesn’t it, for many women?”

McKenna: “It certainly doesn’t sound good. But I think it’s important to point out that these women have had cervical cytology – they do not have a severe grade of cervical abnormality. If they did they would have been referred directly to colposcopy. This is a delay in communicating the result of a second or a refined test which would indicate whether they should or shouldn’t go on to colposcopy.”

Lawlor: “Well we appreciate you coming on the programme to talk to us today.”

Listen back in full here

Earlier: ‘Why Wait Until An Hour After The Dáil Goes Into Recess To Let The Information Out Publicly?’

Meanwhile…

 

 

21 thoughts on “‘I’m Still Kind Of Flabbergasted’

  1. martco

    summary: they just don’t care

    I guarantee you they put more computational & administrative effort into manipulating the stats than getting things like this right

    this is the Ireland we live in folks, Fine Gael’s Ireland

    load of kak

  2. kellMA

    Very poor management. They should have been ON this like a rash after all the agro over the last few years.

  3. Kolmo

    Out-sourcing to the lowest bidder…is it no wonder we get lowest-bidder performance.. this is actually life and death and they see fit to hand it’s duties over to some for-profit laboratory 4000 miles away, the only thing that was efficient about it was it’s sales pitch to the HSE for it’s services..

    1. steve white

      the performance that needed is somebody in the dept of health/hse checking whether things are being done or not

  4. Paulus

    Many here give out about RTE, and with good reason: but News and Current Affairs has some very incisive presenters/journalists whom I’ve heard conduct some very thorough interviews where they cut through the waffle and evasion. Aine Lawlor, Mary Wilson and Gavin Jennings spring to mind.

  5. V

    How the _ú__ are they still sending samples to Quest
    Or even out of the jurisdiction
    We have the labs here FFS

    Tony O’Brien!!!!! This is on you because this is what you left behind
    With a golden handshake and a pat on the back from Leo

    1. Cian

      This is shocking. And as I said above people should be fired over this.

      To answer your question. I’d say
      1. There is a contract with quest – difficult (expensive) to break – although there should be clauses to escape and quest have probably broken enough items to allow us leave. But
      2. Nobody else would touch Ireland samples – unless Ireland will accept full liability – the insurance would be massive. There would be a huge effort to move to another supplier. And
      3. Longevity. The smear test is old. We are supposed to have moved to HPA testing – that is more accurate than the smears. It’s been delayed since last year – why hasn’t it been rolled out yet?

  6. Hector Ramirez

    So infuriating reading this… what in gods name are we paying over €16bn to HSE/Dept of health for?

  7. george

    The absence of the physical paper letters that needed to be sent out should have raised the alarm. The IT explanation makes no sense.

  8. Ron

    Look at all the people on here, feigning their disgust with what’s happening and then voting for the same dimwits at the ballot box. Lol.

    I don’t understand why people are surprised. This is what happens when you put incompetent daw jawed idiots in charge.

    Again, another fine mess the Irish electorate have caused. but that’s what happens when the electorate is even dimmer than the daw jaws in charge.

    Meanwhile, on Love Island

      1. Ron

        Yes Vanessa, by continuing to vote for the current imbeciles in Leinster house means that appointments to the HSE at the most senior level are made by the imbeciles you elect. When elected imbeciles appoint incompetent people to the most senior of HSE roles that incompetence tends to have a trickle down effect to the level of the daw jaws that is in this interview. But then I don’t need to tell you that because you already know it. Your comment is a poor attempt to troll which is disappointing considering the amount of trolls on here everyday. And you spend a lot of hours every day on here. Seems you have learned nothing

        1. V

          Back up there Ron

          The only appointments Government tangle in are the Board appointments, and the Head would have to be signed off by the Minister
          And you’ll find that the HSE were in fact without a board until very recently

          Every other appointment is in-house
          ask the unions

          As a citizen, I can only vote for who is in front of me
          And as I said to Bebe earlier
          If you want to change how decisions are made
          Or at the very least contribute to the discussions and debates
          And Vote on legislation in the hands of the House of the Oireachtas
          Put yourself on the Ballot
          There’s a General coming up, 500 yoyos and a few signatures

          Don’t blame the Voter
          Don’t blame Democracy

          And don’t you call me that again

  9. GiggidyGoo

    The boy Harris. If he knew this, he should be sacked. If he didn’t know it, he (as many suspect anyway) is far from being on top of his brief and should do the honourable thing and resign.
    And lets not forget Mary Harney in this.

  10. eoin

    “Computer glitch”

    Or, as above “The computer is designed to…the computer of the labs overseas is designed to communicate with the computer here. And that triggers a, a cascade of letters. It was appreciated that wasn’t working ..”

    Seriously, that’s what they’re calling a glitch which has resulted of delays of up to nine months? Isn’t a glitch when Ulster Bank ATMS go down for an hour or two. The Cervical Check IT “issue” isn’t a glitch, it’s a management cock-up. What’s the name of the person responsible?

  11. Bebe

    as martco said first comment above …… they just don’t care. No one will really be held to account. If an investigation of any sort is held it’s narrow remit will ensure zero accountability . If the powers that be; Harris, Varadkar et al do not learn from mistakes even of the recent past repeat them they will again and again.

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