Human regret, to legal fears to spin — the journey of a fluffed apology

Nobody would want later Discovery to reveal their name making such an admission.

MARY HARNEY is to blame and the HSE apology was the worst aspect of the whole thing. That was what they said on the radio programme on Saturday. The apology, they said, was awful because it was so insensitive.

It apologised for the anxiety caused to the women who know — a year after they should have known, a year after treatment should have started — that they have breast cancer. It apologised for the anxiety caused by the news. It didn’t — as the opposition people on the programme sourly noted — apologise for the cause of the anxiety.

As in: “You may actually die of this disease long before your time, because we didn’t tell you about it when we should have told you.”

I’ve nothing to do, directly or indirectly, with the HSE people who crafted that apology. I know nothing about it. But I’d lay money that the process of its creation went something like this.

One of the public relations officers within the HSE would have been asked to produce a draft. He or she would have arrived to a meeting and circulated that draft, for silent serious reading, red pens cocked, by the others.

It would have been honest and direct, that first draft. It would have told the women to whom it was addressed that the HSE knew the mistakes made by its employee in reading their mammograms had endangered their lives, and the HSE was sorry for that. It would not have mentioned that the earlier breast cancer is tackled, the better are the patient’s chances of survival. That’s a given. If any oncologist ever said, faced with incontrovertible evidence of breast cancer, “Tell you what, let’s do nothing for a year and then get down to treating you,” that oncologist would be before the Medical Board before the week was out, since speed, with breast cancer, is of the essence.

The first draft of the HSE apology would have taken cognisance of those realities, while trying not to frighten the women any more than they were. As the participants at the meeting read it, they would have emitted little approving grunts. Not committing themselves to actual enthusiasm, but indicating acquiescence. And then the legal advisor would have spoken.

“Can’t admit to endangering patients’ lives,” the lawyer would have said. “Can’t do it. We’re going to get sued as a result of this cock-up and we’d get taken to the cleaners if that admission were on record.”

“We deserve to get taken to the cleaners,” someone else would have retorted, pointing out that the state, in this instance and through the HSE, had endangered the health, indeed the very life, of these women just as, a decade or so ago, the state had poisoned haemophiliacs with tainted blood.

Some of those around the table might have agreed, but nervously, because the fear of committing your organisation to Something Legal is huge. Nobody would want later Discovery to reveal their name, as a senior manager, making such an admission.

At this point, the legal man or woman would have got into their stride. “Furthermore,” the lawyer would have said, “the employee responsible has rights and we can’t jettison those rights in this apology.”

Around about this phase in the progress towards the inevitable, the person who drafted the original document might have gently reminded everybody that the health service is supposed to put the patient first.

“Well, of course we put the patient first,” some senior executive would have said, just a little impatiently. “That’s not the issue, here. The issue is putting on record the HSE’s position by making a formal apology while not, in the process, abrogating corporate or individual rights or bringing the organisation into disrepute.”

Heads would have nodded, around the table: There speaks the man always spoken of as “a safe pair of hands”. The man who is never overrun by circumstances. Never takes a punt. Never falls foul of the C&AG’s office or causes his organisation to so do. Never showy, never raucous. The man of judgment. The man who, if he wasn’t born in a civil service filing cabinet, was almost certainly incubated in one.

COMMUNICATIONS officers, of course, are never born in a civil service filing cabinet. They go into the civil or public service only when the cares and demands and deadlines of straight media or commercial PR get too much for them. But they go in trailing clouds of human interest. They get emotional about stuff it’s inappropriate (or, to use that great Fine Gael word, “unhelpful”) to get emotional about. (Like human beings harmed by the system.) They get fed up with multi-syllabic strategic thinking and long to be permitted to produce a tabloid headline filled with passion, excitement — and short words.

But, for the most part, they do a mental shrug.

In this instance, the PR officer would have sat in silence as the discussion eddied around them, doing precisely that shrug. Or doodling little riddles to themselves, like:

Q. When is an apology not an apology?

A. Whenever a lawyer is present.

The dynamics of any meeting change radically when a lawyer arrives. Everybody starts to think corporate — and to interpret corporate thinking as being in the interest of the public good. Any individual wounded by any officer of the corporation gets smaller and smaller until, if their case is regarded at all, they appear in tiny perfection, as they would if looked at through the wrong end of a telescope.

Eventually, a document is produced which may not quite meet with unanimous approval, but which does not meet with unanimous disapproval. A few protectionists re-read the final draft, trying to figure out if it will infuriate the boss, render the department livid or put the minister under pressure. The PR person re-reads it to see if a typo has crept in at some point in its iterations and murmurs that of course opposition spokespeople won’t like it.

“Never mind them,” someone says dismissively. “Have we mentioned counselling? We haven’t, have we?”

“What the hell good is counselling going to be for these poor women?” thinks the PR person, while obediently writing down a sentence about the counselling that’s going to be made available.

When the final version gets sent off to newsrooms, nobody has time to parse it. It fits within the story, so it runs. The PR person, if they’re young, goes home imagining the terror the women must have felt when the certainty of survival, of health, of safety, was yanked out from under them.

The PR person, if they’re on the mature side, goes home thinking about media follow-up the following day. Because that’s their job. And they do it to the high standards we expect of public servants.

If other professionals, with more direct responsibility to put the patient first don’t match those standards, there’s nothing the communications people can do about it.