Irish health service chief steps down amid cervical smear tests controversy

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The director of Ireland’s health service has stepped down amid a deepening controversy over wrongly interpreted cervical smear test results

Health Service Executive (HSE) chief Tony O’Brien, who had been due to retire in the summer, had been facing calls to quit over a furore about the treatment of cancer patients who were wrongly informed their smear results were “all clear”.

Health minister Simon Harris said Mr O’Brien informed him of his decision to step down in a meeting on Thursday night.

“I would like to express my thanks to Tony O’Brien for his many years of dedicated public service,” he said.

“I know that he is standing down from his role today because he believes it is in the best interest of rebuilding public confidence in the wake of the issues which have arisen in CervicalCheck (Ireland’s national screening programme).

“Tomorrow, the Cabinet meeting will again discuss this matter and the further measures which can be put in place to care for and support the women and families affected.”

Last week, it was revealed that an audit by CervicalCheck of 1,482 women diagnosed with the cancer since 2008 had found potential errors in 208 cases, as tests showed no abnormality when they should have been given a cancer warning.

The majority of the 208 women – 162 – were not initially told of the outcome of the audit. Of the 208, 17 have since died.

Mr O’Brien resigned hours after it emerged that an internal HSE briefing note that flagged potential errors in screening tests in 2016 stressed the need for a media strategy to respond to stories of women whose cancer diagnosis was missed.

The memo to HSE bosses from Ireland’s National Screening Service (NSS) also advised a “pause” in the process of communicating to clinicians the findings of the audit of smear test results belonging to women who were subsequently diagnosed with cancer.

A further note, circulated four months later, acknowledged that while the “majority of cancers were detected as early as possible through cervical screening, not all cancers were prevented”.

The HSE forwarded three 2016 memos to the Oireachtas’s Public Accounts Committee on Thursday as members probed the growing controversy around misinterpreted smear tests.

Acting chair of the PAC, Labour’s Alan Kelly, branded the documents “devastating”.

Mr O’Brien told the PAC the 2016 notes had not raised “alarm bells” with him, because they stated that women were being informed of the audit results.

Taoiseach Leo Varadkar was health minister when the first memo was sent to HSE chiefs.

The Department of Health confirmed on Thursday night that the memos were shared with the department.

However, a spokesman said they were only relayed to certain officials and none were brought to the attention of any serving health minister.

The first note, dated March of that year, outlined details of the audit process undertaken by CervicalCheck and that results were to be communicated to patients.

The subsequent two, circulated in July, provided updates on the situation.

In a section titled “next steps”, the first memo stated:
– Pause all letters
– Await advice of solicitors
– Decide on the order and volume of dispatch to mitigate any potential risks
– Continue to prepare reactive communications response for a media headline that ‘screening did not diagnose my cancer’.

It earlier said: “There is always the risk that in communicating individual case reports to clinicians of an individual patient reacting by contacting the media if they feel that ‘screening did not diagnose my cancer’.

“This is a risk that is inherent in having a clinical audit process as part of the national programme.”

Mr Kelly said the HSE appeared more interested in protecting its reputation than communicating with patients.

“This was a strategy to ensure the HSE, the corporate brand, is being protected,” he said.

“This is a devastating document because of the tone and manner in which it is written and also where it focuses on from a communications point of view.”

The controversy was triggered by the case of Vicky Phelan, the terminally ill mother whose legal battle cast light on the issue.

Last month, Ms Phelan, a 43-year-old mother of two from Co Limerick, settled a High Court action for 2.5 million euro after being incorrectly told in 2011 that her smear test had given a negative result for cancer.

In 2014, she was diagnosed with cancer but only told of the false negative last September.

On Thursday, another woman impacted by the false negatives issue – 37-year-old Emma Mhic Mhathuna from Co Kerry – revealed that she had now been diagnosed with terminal cancer – five years after being told her smear tests were normal.

UK health expert Dr Gabriel Scally has been commissioned by the Irish government to lead an inquiry into the misinterpretation of the cancer tests.

A planned away day Cabinet meeting that had been scheduled for Friday has been postponed.

The Cabinet will instead meet in Dublin as Mr Varadkar and Mr Harris continue to deal with the controversy.

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