Emma Mhic Mhathúna was one of the faces of the State's effort to protect women from cervical cancer, her image a familiar feature of the HSE campaign to promote its vaccination programme. This week, having received the awful news that her own cancer is terminal, she has become a voice of those who feel they have been failed by the State. The 37-year-old mother of five is one of scores of Irish women who were wrongly told they had normal smear tests through the CervicalCheck screening programme, and who were not informed of a later clinical audit into their cases. "They're not actually capable of minding us, and that is their job," she said of the Government in a devastating interview on RTÉ's Morning Ireland on Thursday.
There can be no excuse for withholding critical information from women about their own health. The HSE’s own guidelines require that patients be informed in full and on a timely basis about their medical condition. That did not happen in more than 100 cases. It was a terrible failure.
It would compound the tragedies that have come to light through the stories of women such as Emma Mhic Mhathúna and Vicky Phelan if women were to lose faith in CervicalCheck. False positive and false negative results are inherent features of all health screening programmes. But the false negative rate is especially high in cervical screening, where slides of the woman's smear are placed on a microscope and assessed by the human eye. Since the introduction of the programme, 50,000 women have received treatment after pre-cancerous or cancerous cells have been identified by CervicalCheck. This has brought a seven per cent annual reduction in cervical cancer incidence.
Yet the State must take urgent steps to ensure that the type of ordeal some women are currently experiencing never happens again. A statutory requirement to advise patients on the accuracy of tests and their outcomes – something the Oireachtas rejected not long ago – would help to rebuild trust. More broadly, the crisis has shown up once again the health service's chronic problem in communicating with citizens and in opening itself up to scrutiny. A paternalistic attitude towards patients – particularly towards women – traditionally infused the upper echelons of the medical profession. That may be changing, but it's clear that there's a long way to go.
The fundamental issue is the failure to level with women. Some are dealing with a catastrophic set of circumstances. So far, there have been two resignations at a senior level of the HSE, including that of its director general, Tony O’Brien. And more may follow. While those resignations were important signals of accountability, however, they will count for nothing unless the crisis prompts real, lasting changes to the law and the culture of the health service.