From top: Alan Kelly and Tony O’Brien this afternoon
This morning/afternoon.
Public Accounts Committee
Labour TD Alan Kelly, vice-chair of the Public Accounts Committee, raised a memo sent to HSE chief Tony O’Brien in 2016
Mr O’Brien said that while he learned about the Vicky Phelan case on RTÉ News, he said he was told in the briefing note that a communications process was about to begin to notify patients with cancer about an audit of their smear tests.
“I was aware that an audit was carried out which was good practice. I was aware of a detailed plan to communicate the results of that audit,” he said.
….Mr O’Brien told the committee that he will strive to get a copy of the memo to the PAC today before the meeting concludes…
“When it first broke out, I was like ‘Okay, well, the head of the HSE is surely going to do something’, and he didn’t.
And then I looked to Simon Harris. I was thinking ‘Well, surely the Minister for Health is going to step in and do something’. That’s why we give these people powers, and he didn’t do anything.
So then I was like ‘Surely the Taoiseach is going to do something’. And he just seems to be sticking up for them … they’re all hiding there in the Dáil and they don’t see what I see.
The Government need to go. They’re not actually – and I’m not being insulting, it’s genuine – they’re not actually capable of minding us, and that is their job. To make sure that we’re okay.”
Mother-of–five Emma Mhic Mhathúna (top) to Audrey Carville on RTÉ’s Morning Ireland earlier.
From top: Tánaiste Simon Coveney, Minister for Health Simon Harris and Solidarity-People Before Profit TD Brid Smyth
This afternoon.
In the Dáil.
The CervicalCheck smear test scandal was raised again during Leaders’ Questions which were taken by Tánaiste Simon Coveney who told the Dáil that, this morning, he spoke to the husband of one of the 17 women who died.
Solidarity-People Before Profit Brid Smyth held up a diagram showing who is accountable to whom within the HSE and called for “heads to roll”.
Addressing the Minister for Health Simon Harris, she said she knows of a young health worker who was suspended from her job for two months for criticising HSE spending and the trolley crisis on Facebook.
The following are some points which were raised…
Fianna Fáil’s Dara Calleary told the Dáil:
“For many woman, their first point of contact to get the information was their GP. If they got an appointment with their GP, they found that CervicalCheck only actually formally contacted GPs this morning – eight days later [since Vicky Phelan’s case in the High Court] and they provided a completely innocuous update which provided no new information to the thousands of GPs around the country who are struggling to deal with this. Again, Tánaiste, I ask, why the delay?”
“…Tánaiste, when will the 38 remaining women who have yet to be informed of their audit be informed. Secondly, will all of these women receive medical supports and full medical supports. I’m aware of at least one of these women whose medical card was withdrawn over the past number of weeks, by HSE medical cards, and who is being put through the ringer to provide information. Yet, she was able to get a phone call recently to tell her about her false positive.”
“…The Taoiseach announced that women can have new smear tests undertaken, that is a welcome development. Will these smear tests be audited in a different laboratory from those that are currently being used to audit smear tests?”
“…Vicky Phelan this morning has called for a scoping inquiry, agreed last evening, to be held in public. Will the Government agree to her call?”
“…I want to ask you about comments made by the Secretary General of the Government this morning in the Public Accounts Committee to deputy Marc MacSharry in relation to sensitive cases. Were the Government alerted some months ago about this case in the context of the sensitive cases update?
Tánaiste Simon Coveney said:
“In relation to Tony O’Brien, my understanding from speaking to the health Minister, and I also think it seems to be breaking in the media, he is, he has confirmed to the Health Minister that he will be taking a leave of absence from any involvement outside the HSE between now and when he steps down from the HSE to focus on contributing in a positive manner to the work that needs to be done…”
“In relation to the list of sensitive cases that does get presented to Cabinet from time to time, we have asked the Cabinet Secretary to look at the lists of sensitive cases that had been on that, on that list. And Vicky Phelan’s case was not on the sensitive cases list.That’s my understanding. It is information I’ve been given literally on the way in to the House this evening. But that is my understanding in terms of the confirmation that the Secretary to the Government has provided.”
Irish Solidarity–People Before Profit TD Brid Smyth said:
“I’m not playing politics when I make this point. But we found out yesterday that the State Claims Agency received a request in January for her [Vicky Phelan] files, they then knew in March, the head of the National Screening Programme knew in March that there was a claim going to court.
“He kicked it up the line to the head of National Screening and they kicked it up the line to the department who knew in March. The minister didn’t know.
“Right. I’ll just make it simple for everybody who’s here. That is a diagram of the transitional organisation structure of the HSE. I’ve coloured you in, in blue, to match the colour of your shirt, Minister.
“But this here is the risk committee, answerable to you. This is here is the director general [of HSE] answerable to you. None of them told you but you are the boss. You’re at the head of all of this.
“None of them told you but none of them are fired, none of them are suspended. Go right down the line to where the information first came in. Nobody is in trouble for this.
“I know a young worker, a young hospital worker who was suspended for two months because she criticised HSE spending and the trolley crisis on a Facebook post.
“You have to make heads roll in that department for failing to tell you, for failing to be accountable. If you don’t, you should go minister.
“Because somebody has to go here.
“And I don’t believe you that you didn’t know, I don’t believe Tony O’Brien and I don’t believe that your department isn’t full of people who are trying to cover up and if you believe that they aren’t trying to cover up, that they’re all innocent and they’re all OK, then you are failing to do your job.
“That’s you at the head of the organisation, a fish rots from the head minister and you need to deal with it, or else you need to resign.”
He was speaking after the HSE said 206 women with cervical cancer had been identified as women who should have had an earlier intervention.
Specifically, he said:
“Remember the 206 cases – that ultimately comes from an analysis of cases performed by Med Lab which is the organisation that performed the screening of the smears in the first place.
“So Cervical Check thought it was appropriate to have the clinical audit and lookback performed by the very people who had done such an appalling job at reading the smears in the first place.”
It should be noted Med Lab did not carry out Vicky Phelan’s original screening in 2011 – which returned a false negative.
This was performed by Clinical Pathology Laboratories in Austin Texas – whom Ms Phelan settled her High Court action against for €2.5 million last week.
However.
Med Lab and Clinical Pathology Laboratories are sister companies and have the same parent company, Sonic Healthcare.
Meanwhile…
Last night, on RTE’s Prime Time.
Ms Phelan repeated Mr O’Carroll’s concern about who is carrying out the audit of the smears and the potential conflict of interest.
She raised this concern after the Minister for Health Simon Harris told the Dáil approximately 1,500 women who have been diagnosed with cervical cancer have not had their previous smears audited.
Emma Ní Mhathúna (top) was among a number of women asked by the HSE to promote its HPV vaccine programme in a video posted on YouTube last August.
Emma, a mother-of five, had recently been diagnosed with cervical cancer and urged parents to make sure their daughters took up the vaccination.
However, while filming, Emma was unaware that she had had a delayed cervical cancer diagnosis that went back to 2013 – four years before before the HSE asked Emma to participate in the video
In an interview on Raidió na Gaeltachta‘s An Saol ó Dheas, Emma told host Helen Ní Shé that she had had smear tests every three years since the birth of her daughter Natasha, 15, and that all the results had come back as normal until 2016.
Emma, living in County Kerry said:
The nurse called me and said that something was showing up in the smear, and that I needed to go to the hospital … On 20 September 2016 I got a biopsy done, but the doctor said to me straight out there and then that he didn’t need to wait to get the test results back, you have cancer and we have to act quickly, I’m ordering an MRI for you.
That was Wednesday, and on Monday I got the MRI and the doctor told me I had stage 2B cervical cancer.”
I was saying to myself, how did things get so bad … and I had the letter from (the smear in) 2013 to say everything was fine.”
Emma was treated at St Luke’s Hospital in Dublin. She moved to Kerry six months ago and is now under the care of University College Hospital, Cork.
Emma said:
“Every 4 months I have an appointment with the hospital to check that everything is ok. On the 4 April I was there, and I had the kids with me because we have a game, when I get the all-clear I buy a helium balloon in a shop in Cork and we have a little party … When there’s cancer in the house, the children are always worrying if everything is ok …”
Although everything was clear in Cork in April, Emma explained to Helen that she hasn’t been feeling well recently and that she is now very worried.
“On 15 April, that’s a fortnight ago, I knew there was something wrong with my body again. I went to the doctor and he found something that was more than 1 cm there … I was at the hospital last week and had to get a biopsy done yesterday.
Everything is up in the air now … Séamus is making his confirmation next Tuesday, and I’m very worried about everything, so I asked the church and the school if Mario can make his confirmation as well. He’s in 4th Class. It’s good for me that they can both do it together. I had new clothes bought for them anyway.”
On Sunday, Emma got a call from her doctor in Dublin.
She said:
“He said that he hoped I was reading the stories in the paper about the Cervical Check. He said he didn’t have all my files in front of him, but that I was one of the women involved. I asked him to call Cork and to tell them to take good care of me.”
In a further phone call, Emma recalled:
“The doctor told me that the smear results I got in 2013 were wrong … the first indications of cancer, the cells changing in the body, were there.
If I had got the right results at that time, I wouldn’t be where I am now … I had a kidney infection in January, I have a lung infection now. My life … well I’m not too worried about my life, but the kids are very very young. ”
Of the HSE promotional video, Emma said:
“There wasn’t enough uptake on the HPV vaccine. After what I’d gone through … I said I’d have to take a stand and help people. That video is on Youtube – that’s me and my daughter.”
BREAKING: Harris says “a potentially considerable number of cases” where people have been diagosed with cervical cancer whose cases have NOT been included in a later clinical audit
Should be stressed here: these are NOT cases where women do not know of their diagnosis.
These are women who know they have cancer, but whose cases have not been audited to determine if they were wrongly given the all-clear beforehand https://t.co/FV11JEZcdt
At this stage I really am speechless at just how poorly prepared #CervicalCheck, the HSE and Department of Health were for the questions that were likely (very likely) to follow such a high profile case.
From top: Taoiseach Leo Varadkar; Fianna Fáil leader Micheál Martin
This afternoon.
During Leaders’ Questions.
Taoiseach Leo Varadkar is being asked about the case of Vicky Phelan and the CervicalCheck scandal – ahead of the Minister for Health Simon Harris taking questions on the matter later this evening, after 6pm.
He has told the Dáil that the Health Information and Quality Authority (HIQA) will carry out an inquiry into the matter – and that such an inquiry is the “best way to do it”.
Readers will recall that on April 16, Mr Harris was notified of Ms Phelan’s case via a memo from Department of Health officials. This memo is expected to be published in redacted form this evening.
Fianna Fáil leader Micheál Martin told the Dáil that he and his party’s health spokesman Stephen Donnelly discussed this memo with Mr Harris and some of his officials this morning.
Mr Martin said:
“It was revealed there that there were, there had been intense discussions between department officials and CervicalCheck in advance of this case and in relation to this case. But the Minister wasn’t told anything about those discussions is what I picked up about that.
“We know that in July 2016 the former clinical director of CervicalCheck [Dr Gráinne Flannelly] sent a letter to clinicians outlining a three-point plan. And the last point in that was in cases where a woman has died simply ensure the result is recorded in the woman’s notes.
It was that coldly clinical. One would argue illegal as well – to deprive a family of vital information of that kind which was the intention of that plan…question is: who else was aware of that plan?”
“…the memo to the minister anticipates adverse publicity because a press release is prepared for the minister in the event of the case going public and some of the information in the memo is, to me it appears to be, wrong and inaccurate and false in that the sense is created in the memo that women were informed of their results when, in fact, we now know that the women were not informed of their results…”
Mr Varadkar told the Dáil:
“I am very angry on behalf of the 160 or so women who were not told of the results of the audit, even though it wouldn’t have made a difference in their case in terms of treatment or prognosis or outcome because they had already been diagnosed with cancer at that stage. They still should have been told.
“…In terms of the actions that are now going to take place, first of all, there will be a statutory inquiry, led by HIQA. We believe that’s the best way to do it. It’s the quickest way to do it. We need answers in months, not years. And also they have the skills and the statutory powers to do so…”
Sinn Féin’s Mary Lou McDonald told Mr Varadkar the director general of the HSE Tony O’Brien’s position is “untenable and he needs to go” and that, if he doesn’t resign, Mr Varadkar should “sack him”.
In relation to this, Mr Varadkar said:
“You’ve called for the dismissal of Tony O’Brien. It’s based on an assertion that the decision to outsource these tests to the US in 2008 somehow cost lives. I explained why that is not yet supported by the facts. And I think everyone, even Tony O’Brien, deserves a fair hearing before they’re condemned. And we need to assess as to whether that decision or not was a wrong one. And it may not turn out to be wrong. And I think we need to be fair about that in that regard.”
Journalist Alison O’Connor noted the common thread running through the biggest health scandals in Ireland – namely that they involve the healthcare of women.
The Joint Committee on Health will review the CervicalCheck programme and hear from the Minister for Health Simon Harris, representatives from the HSE, officials from the Department of Health; and representatives from CervicalCheck and the National Cancer Control Programme.
Those interested will be able to watch it live from here or on the Oireachtas TV channel which is on Virgin Media 207 and Sky 574.
It follows confirmation that some 208 women in Ireland had a false negative smear test before being diagnosed with cervical cancer and that 162 of these women – 17 of whom are now dead – were not told of their earlier incorrect test.
The figures emerged after terminally-ill Limerick mum-of-two Vicky Phelan settled her action against a US laboratory, subcontracted by the CervicalCheck to assess the tests, without admission of liability for €2.5million last week.
Ms Phelan was only told last year that a 2011 smear test assessed by the US lab returned a false negative.
She was diagnosed with cervical cancer in 2014 – leading to the 2011 test being reviewed.
During her court action, Ms Phelan refused to sign a confidentiality agreement – giving rise to the information about the 208 women becoming public knowledge.
