Alison O'Connor: Women risk hurting other women when vigilance turns into vitriol

The virtual scalpings would...make someone think twice and expressing a differing opinion, writes Alison O'Connor
Alison O'Connor: Women risk hurting other women when vigilance turns into vitriol

People take part in a protest outside Leinster House against the ownership and governance structure of a new National Maternity Hospital. Picture: PA

The fight is over. The decision taken. It was vicious and intense.

The Government this week finally gave the go-ahead for the move of the National Maternity Hospital (NMH) from Holles St to a site at St Vincent’s, Elm Park, in Dublin.

The risk to women of ‘self harm’ during this controversy was high. As a result, the entrails are worth examining, in the hope we learn from it all.

There were a number of times — in recent weeks — when the words of the UK’s Michael Gove, came to mind. In the run up to the Brexit referendum, when he was then lord chancellor, he declared that the people in Britain “had enough of experts”. We know where that ended up.

The NMH saga is not the first time Irish women have ultimately acted against themselves in recent years. It has also happened with the CervicalCheck controversy.

And there have been similarities between the nature of this recent NMH ‘discussion’ and the ongoing trans debate. It is what happens if you dare to be seen to go against the ‘consensus’, at which point, the ‘chop-off-her-head’ troops kick off on social media.

A model of the proposed new National Maternity Hospital on the St Vincent's campus. Picture: Gareth Chaney Collins
A model of the proposed new National Maternity Hospital on the St Vincent's campus. Picture: Gareth Chaney Collins

It is important to note that, when you’re someone privileged to have the forum of a column, or to have your opinion sought on radio or television, it is entirely reasonable that other people, without that broad platform, should be able to make their feelings known on the platforms available to them.

But there is a point where it crosses a line. The virtual scalpings would certainly serve to make someone think twice before expressing a differing opinion in the future. Indeed, perhaps that fulfils the aim for many.

So, on the women ‘self-harming’ front, it can be the issue of a brand new hospital to replace an existing one in rag order or, the issue of national screening programmes that get caught up in crossfire.

There is a long history of Irish women being suspicious of the State when dealing with reproduction-related matters. That suspicion is exceptionally well founded. But when it becomes set in stone — we are in trouble.

Back in 2018, it was revealed that an audit had found that, for hundreds of women diagnosed with cervical cancer, while original results of early smears had been misdiagnosed, most had not been subsequently told. The fallout from that continues.

This column has previously referenced trying to find an appropriate replacement for the phrase "cutting off your nose to spite your face" in reference to smear tests and that CervicalCheck controversy.

This search for an alternative idiom related to the danger we were in of losing our lifesaving screening services and of more Irish women dying who would be saved through screening.

Trust in screening seems to be marginally improving, but a belief still exists that, in offering population screening such as CervicalCheck, the State and many doctors are trying to con women in some way, as opposed to saving lives.

There was massive and understandable damage done during the CervicalCheck controversy, elements of which were handled appallingly. Even the fact that we found out about it during the abortion referendum added fuel to our female rage.

The atmosphere was febrile — the fear being stoked daily by the media — and the anger such that Government politicians were terrified. As a result, they made mistakes, as has been acknowledged.

Anger and fear

As with the National Maternity Hospital debate, there was considerable misinformation which further frightened women.

One of the main mistakes was then Health Minister Simon Harris offering free out-of-cycle smear tests in 2018. He has said he believed this was the correct advice given the exceptional circumstances of the time, which were very frightening for women.

It was a real-life example of how anger and fear, combined with historical context, caused serious damage to the screening service. It could have ruined it.

In April 2019, former CervicalCheck clinical director Gráinne Flannelly told the Oireachtas health committee she had warned senior officials in the HSE not to offer these extra tests to women because it would “fundamentally undermine the screening programme”.

If you look at the CervicalCheck Programme Report September 2017 - March 2020, published in April, it shows how this poor decision-making, brought about by public pressure, nearly broke the programme. 

The laboratories involved were almost overwhelmed. There were delays in colposcopy — done if screening finds abnormal cells — appointments for women.

In fact, there was a drop in screening coverage during that time which meant that no new women were screened. Only a tiny percentage of women got their results letter within four weeks, the stated aim of the programmes.

CervicalCheck usually sees around 300,00 women each year, but last year was busier with more than 330,000 attending. 

This is definitely a positive turn. Just over a year ago, CervicalCheck clinical director Dr Nóirín Russell, and National Screening Service chief executive Fiona Murphy gave a forthright press briefing to journalists outlining how ongoing fallout from the controversy was actually putting the lifesaving programme at risk. 

Similar issues faced the breast screening programme BreastCheck. The purpose of the briefing was to begin a conversation on what exactly population screening is and how many lives it saves.

According to cancer doctors, some women were “turning down proven, evidence-based medicine and therapies that would lead to cure ... choosing to have weird and wacky stuff like vitamin infusions”. 

They reported “palpable anger and mistrust”, reported Dr Russell. This benefits no one.

 A recent National Maternity Hospital protest rally. Picture: Sasko Lazarov/
A recent National Maternity Hospital protest rally. Picture: Sasko Lazarov/

So, in recent weeks, we had the NMH debate where all the medical and legal experts lined up to offer reassurance that women’s reproductive health would be safeguarded in the new hospital. 

We heard that women with very serious conditions, including cancer, renal failure, and cystic fibrosis, would be far safer in the new building than in Holles St, given the inferior conditions and its distance from the acute services, located at St Vincent’s Hospital.

But it just didn’t matter what was said, or what reassurance was given — nothing seemed to be enough. Rather than being listened to, medical and legal experts were even demonised. 

Hyperbolic anger flowed. It could have derailed a project that is hugely important to women and babies. 

Vigilance, given our history, is important, but intransigence is foolhardy.

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