As members of the CervicalCheck steering committee, Stephen Teap and Lorraine Walsh are determined that previous mistakes will not be repeated, says.
Stephen Teap’s life should, by any yardstick, be happy and uncomplicated.
Not so long ago he had a loving wife, two adorable sons, a good job and a nice home — everything, in fact, that a man could wish for.
But cervical cancer changed all of that — his wife Irene died at the age of 35 in July 2017, because her condition was not identified in time. After two false negative smear tests in 2010 and 2013, her cancer was finally diagnosed in September 2015 after she failed to recover properly following Noah’s birth the previous April. Less than two years later, Stephen was a widower.
“If the cancer had been correctly identified, it would have been a very minor procedure that would not have affected her fertility but it was missed,” says Teap.
His life has changed dramatically. While juggling work with caring for his sons — Oscar, six, and Noah, three — at the family home in Carrigaline, Co Cork, the 38-year-old and business executive is one of three patient representatives on the CervicalCheck Steering Committee, along with representatives from bodies such as the Department of Health, the HSE and the Irish Cancer Society.
“I felt this scandal affected everybody, and it was not just a problem for women, but for everyone they left behind,” says Teap who recalls how, on hearing from the HSE about how Irene’s smear had been misdiagnosed not once but twice, he made contact with Dr Gabriel Scally, who was heading up an independent inquiry into the controversy.
Dr Scally later put Teap’s name forward to the minister as a potential member of the CervicalCheck steering committee, which now meets every two or three weeks. It’s a job the Volvo Car Ireland executive takes very seriously.
“As regards the committee, the job is to oversee everything that’s ongoing in terms of the detail, identifying what has gone wrong.
We have to look at what has to be fixed; at the support packages in place for women, and monitor them to ensure people are getting what they need. A big priority is support for the women and [their] families.
"One of the main priorities for me personally, is to identify all the failures, uncover them all and ensure they can be fixed.
“Gabriel Scally’s inquiry made 50 recommendations, so we want to make sure these are implemented — and ensure they are implemented in a timely manner, which would resolve a lot of the issues.”
In terms of emulating international best practice, he believes the Australian approach to eradicating HPV has a lot to offer — “they have the best screening and best vaccination programmes.”
From his perspective, there’s no fixed end date to the work. “It is simply ongoing and it will be ongoing until we are satisfied that we have a fully functioning screening programme for cervical cancer.
“We aim to restore trust in the programme while also fixing everything that has gone wrong.
“The core of everything we’re trying to do is to restore trust in the screening programme and make sure people are learning from the mistakes made.”
While there are specific timelines for various parts of the projec, its overall work is long-term, explains another committee member, Donal Buggy, head of services at the Irish Cancer Society.
“There are parts of the work schedule such as the introduction for the new HPV/DNA screening which will be introduced by 2020,” he says.
“Each of the individual recommendations of the Scally report will be time-lined.”
It’s likely to be a two- to a three-year programme for the committee, he believes.
“For example, we’re still waiting on the second part of the Scally report — the initial report he produced for the Government will be followed up and that may bring more work to the committee.”
Another committee member, businesswoman Lorraine Walsh, was one of the many to receive
incorrect smear test results. While treatment has saved her life, her fertility has had to be sacrificed.
The 41-year-old, who runs a property management business in Galway with her husband Gary, was also proposed by Dr Scally for the steering committee which held its first meeting in June 2018.
“The remit of the committee from that day has been to oversee the support services to women and their families, oversee the Scally recommendations and keep an eye on the implementation of those recommendations,” she says, adding that she’d like to see a change in the way the support services are structured — liaison officers with clinical backgrounds would be of more support to the women who contact them, she believes.
According to the HSE, most current liaison officers have a nursing or medical background, but Walsh says this should apply to all liaison officers. “The HSE is looking at changing a structure where there would be someone with a clinical background able to provide some clinical advice to women in each of their areas.
Walsh is blunt in her assessment of what needs to be done — but given the mistakes of the past, it’s no longer about blindly emulating international models of best practice, she believes.
“The work of this committee will not be complete until we can ensure that wherever we’re sending the smear tests has to have correct quality assurance procedures and policies in place to ensure that the mistakes that have happened can never happen again.
It is not about finding international models — it’s about going back to basics in quality assurance and ensuring people are doing things right.
“To me, it doesn’t matter whether they go to 100 labs. It’s about labs following correct procedures and correct policies to ensure the job they are doing is done correctly. It’s as straightforward as that.
“It’s also about the HSE ensuring effective audits are carried out on these labs to ensure the lab is doing the job correctly.
“How many more absolute fiascos and disasters will have to happen in Ireland?”
She is angry, she says, because yet again, the issue is around women’s health: “I don’t think this would have happened to men.
“We are all very aware that there is a timeline on the recommendations of the Scally report, but at the end of the day, the Scally remit was not to look at the quality control process of the laboratories. Until they get
control of the quality assurance process of the labs they’re using, we’re wasting our time. That’s the absolute thrust of it.”
Subsequent to this interview, concerns arose that the steering committee was about to be disbanded. This was on foot of a comment by a Department of Health official at a recent meeting of the committee. Health Minister Simon Harris has since made it clear that the committee should not be wound down until all outstanding issues are resolved.