Attacks on cancer-screening programme threaten the lives of thousands of women

Politicians, the media and medical negligence lawyers are threatening to put the lives of thousands of Irish women at risk because of their response to the cervical smear controversy.

Unless there is a dramatic change of approach by all concerned the future of cancer screening programmes will be jeopardised and thousands of people now benefiting from early detection of cancer will have their lives dramatically shortened.

The CervicalCheck controversy has arisen because of the tragic consequences for women whose cancer was not detected in the national screening programme.

The reporting of this by the media has encouraged the public to believe that this is all down to negligence on the part of State agencies. Panicked politicians from the Taoiseach down have fuelled that perception by their response.

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That in turn has triggered an avalanche of legal actions against CervicalCheck and Breast Check which if they are successful will make it virtually impossible for the State to undertake national cancer screening programmes in the future.

In the case of CervicalCheck the question, which has not yet been answered, is in how many of the 221 cases currently under review were due to negligence and how many attributable to false negatives which can arise in screening programmes.

Medical negligence solicitors have rushed into the fray to exploit the anguish of women and their families whose cancer was not detected in screening programmes. The virtual silence of health professionals and the failure of the Department of Health and the HSE to set the facts clearly have contributed to public misunderstanding of the issues involved.

Politicians have reacted with a mixture of panic on the part of Government figures, terrified of being blamed for women’s deaths, and opportunism from leading members of the Opposition seeking to exploit the tragedy for political gain.

All are acutely conscious of fate of Michael Noonan who as minister for health in the 1994-1997 period was pilloried by the Opposition and the media for allegedly not caring about the fate of women infected with the Hepatitis C virus.

Noonan was not responsible for the incompetent behaviour of the blood transfusion service, which happened long before his watch, and he ensured that Irish women received the highest payouts in the world.

That did not deter opposition politicians from denouncing him as uncaring, a charge which was uncritically adopted by the media. The result was the legal profession was able to muscle in on the process and in the end obtained a considerable proportion of the €1.1 billion paid out in compensation.

Noonan’s fate

The response of Taoiseach Leo Varadkar and Minister for Health Simon Harris to the eruption of the CervicalCheck controversy has been coloured by Noonan’s fate. They were rightly determined to show compassion for the women affected but in the process they made commitments which were unsustainable.

The Taoiseach’s promise that the State would step in and settle all claims of medical negligence fuelled the perception that all false negative arose because of negligence. The Department of Health only belatedly tried to rectify that perception last week.

The Opposition has to take some responsibility for false perceptions as well. Their knee jerk denunciation of the Government for allegedly not caring about women’s lives was the background against which unrealistic promises were made.

The media too cannot avoid responsibility for the way the public has been left in total confusion. Sunday Business Post health editor Susan Mitchell who has waged an almost lone battle to inform the public of the facts, concluded: "Considerable blame for this confusion rests with the media, which has repeatedly failed to do basic fact checking and has allowed a single narrative to be told by one party: medical negligence solicitors."

It might have been expected that the national broadcaster, RTÉ, would perform its public service function and explain the facts in a calm manner. However, the general trend across the broadcast media has been to focus on the emotional stories of those affected, putting politicians in the dock and presenting lawyers with a clear vested interest as impartial commentators.

It can be no surprise then that there has been a surge in legal actions not just against CervicalCheck but against BreastCheck. If all of the claims are successful there has to be a serious doubt about whether the State can continue screening services whose legal costs threaten to dwarf their budgets.

Legal actions

This raises a fundamental problem about how the health service can continue to operate in a climate where legal actions of all kinds against medical professionals have mushroomed. Ireland is now the most litigious country in the world after the United States for medical negligence claims.

There are a variety of reasons for this, including absurdly high awards by some judges, and the Government has set up a task force to investigate what, if anything, can be done.

In the meantime the month of August should provide a period of calm reflection from politicians and the media as they await the report of Dr Gabriel Scally who has been asked to carry out a preliminary inquiry into the 221 cases at the heart of the CervicalCheck controversy.

Hopefully that report will receive the dispassionate analysis which has been so sadly lacking to date.