Vicky Phelan: Failure of CervicalCheck Tribunal undermines screening services

The CervicalCheck Tribunal isn’t working. Every day that Government chooses to ignore this inconvenient truth increases the threat to screening services.

The protection of screening services is critical because screening saves lives. The recent positive reports on numbers reporting for cervical screening in March are very welcome given the concerns expressed only a month earlier by the clinical director of CervicalCheck.

Dr Noirín Russell expressed her fear that the future of the screening programme was at risk because of the “current discourse” on screening and an “overwhelming” lack of trust in the programmes.

Last weekend marked the third anniversary of the judgement against the State in my case taken over the failings of CervicalCheck. If asked then, even knowing the numbers of women affected, I would have believed and expected that all similar cases would have been dealt with by now.

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Instead – and this is not a Covid thing – CervicalCheck remains in the news because the State, through the State Claims Agency (SCA) and the HSE, has not dealt with the cases of women and families whose lives have been blighted by the errors of the past – the outsourcing of CervicalCheck and its botched internal audit.

The recurring media coverage of court cases and of the efforts of women with a terminal diagnosis to sustain their lives for the sake of young families is undoubtedly difficult to consume. Its impact on public discourse is unavoidable.

Some of the comments made about how confidence in screening is under threat could be read as a call that those advocating for a hearing of those claims – people like myself and the 221+ Patient Support Group – are part of the “problem”; that it is time for us to go away. That is not how they should be read and that will not happen.

We agree that it is fair to be concerned about a loss of trust in screening and we understand why the screening service would want to move on from the past.

The narrative, however, follows the facts. What happened was a scandal and if the powers that be are uncomfortable with us saying so then I would refer them to Dr Gabriel Scally who conducted the official investigation into what happened. He told RTÉ in February that he had no problem describing what happened as a scandal and that he does not yet feel he has completed the work on addressing the resolution of his findings.

Within the public contributions of recent months, much has been made of the limitations of screening. Dr Russell has also sought to explain the inevitability of interval cancers.

‘Litany of failures’

Those of us living with the personal nightmare of cervical cancer are neither uninformed nor naive to these distinctions. We fully understand the limitations of screening and the reality of interval cancers.

It is absolutely the case, and we accept fully that not everyone who found themselves in the 221+ and RCOG groups suffered negligence.

But many have a sound legal basis to believe they did. Almost half of the affected women and families are availing of the right of every citizen to use the legal system to establish responsibility where they believe they suffered a loss due to negligence on the part of others and where nothing else has been done to address that loss. And nothing has been done!

It is a year and a half since the Taoiseach of the day made an apology on behalf of the State for the failings of CervicalCheck. He acknowledged “a litany of failures” in the operation of the screening programme which Dr Scally had previously found “was doomed to fail”.

We hoped that would mark a turning point. The cruel reality is that it was a false dawn. The tribunal, established to offer a pathway to resolution outside the courts, has not won the confidence of those impacted or their legal teams due to the State’s unwillingness to address a small number of key issues, the most significant of which is the scope for a woman to be allowed to return to the tribunal if she gets a recurrence of cancer.

Within the courts, cases are only being dealt with when women are literally on their death beds, as we have seen again already this year.

Confidence

These are not spurious or misguided cases. In every case that has come to public attention since my judgement, and in others that proceeded without publicity, a settlement has been agreed in favour of the women involved, either because negligence was proven, or because the State has decided it is unable to defend the case presented.

There is no upside for anyone in waiting on and drawing out the process of multiple court proceedings. If there is an opportunity to get the tribunal fit for purpose, then we will of course play our part in support of the women and families impacted.

We all want an active, effective screening programme in which women can have confidence. We want to stand aligned with those providing the screening service to advocate for participation into the future in good faith knowing that the issues of the past have been dealt with.

Confidence comes from actions not words. If an absence of trust continues it is in the absence of action by the State to deal fully with the past. The change that is needed must come from within the system. It is never too late to do the right thing. The discourse will follow.

Vicky Phelan is a mother, women’s health advocate, author and a founder member of the 221+ Patient Support Group