A personal tragedy compounded by the failings of an impersonal state

What a disgustingly cruel country this can be.

A personal tragedy compounded by the failings of an impersonal state

What a disgustingly cruel country this can be.

Since Wednesday, the country has been captivated by the appalling tragedy that befell 43-year-old Limerick mother, Vicky Phelan.

She is now terminally ill, after a mistake in a smear test taken seven years ago. On the steps of the Four Courts, she settled her High Court action for €2.5m.

Ms Phelan had a smear test in 2011 that showed no abnormalities, but a later review found this conclusion to be incorrect.

The case against the HSE was struck out and the settlement was against the US laboratory, Clinical Pathology Laboratories Inc, Austin, Texas, only.

Outside the court, Ms Phelan stood to address the media. Her statement was a powerful indictment of State failure.

“To know, for almost three years, a mistake had been made and I was misdiagnosed was bad enough, but to keep that from me, until I became terminally ill, and to drag me through the courts to fight for my right to the truth, is an appalling breach of trust and I truly hope some good will come of this case and there will be an investigation in the CervicalCheck programme, as a result of this.”

Ms Phelan broke down in tears as she thanked her husband, Jim, and her family. “To my family and friends and my supporters, who supported my decision to take this case, at a time I really should be concentrating on my health, I would not have been able to do this without you,” she said.

She added: “There are no winners here today. I am terminally ill and there is no cure for my cancer. My settlement will mostly be spent on buying me time and on paying for clinical trials to keep me alive and to allow me spend more time with my children.

“If I die — I truly hope that won’t be the case — the money will provide for my family,” she said, as Jim stood beside her.

“The women of Ireland can no longer put their trust in the CervicalCheck programme. Mistakes can and do happen, but the conduct of CervicalCheck and the HSE, in my case, was unforgivable. To know, for almost three years, that a mistake had been made and that I was misdiagnosed was bad enough. But to keep that information from me, until I became terminally ill and drag me through the courts,” she said.

The poor woman was dealt the cruellest of blows because of a failure, but that failure has been compounded by the insistence that she go to court to get justice.

There was no admission of liability.

Even in the most appalling of failures, the corporate good was still being prioritised over the needs of a patient.

Because the case against the HSE was struck out, the corporate body will see that as a victory and carry on regardless.

Understandably, Ms Phelan’s case dominated the political agenda and what came to light was so pathetically predictable.

There was an apology from the Tánaiste, Simon Coveney, to Ms Phelan. There was one from Health Minister Simon Harris.

There were fine words of condemnation.

Tánaiste Simon Coveney.
Tánaiste Simon Coveney.

Mr Coveney said: “This is a shameful series of events, particularly in terms of information flow. The tragedy and challenges Vicky Phelan and her family are facing, now, have been made all the more difficult, because of the failings in terms of the passing-on of information. And, for that, I want to apologise to her and to her family.”

Politicians began referring to her by her first name, to show they are deeply affected by the case.

Action was promised. A review will take place. Harris said it would be independent, conducted by external experts.

But then came the admission that it would be done under the auspices of the director general of the HSE, so, in truth, it will not be fully independent.

This is important, as the HSE’s record in transparency is laughable. It has been accused of “cover-ups” on the floor of the Dáil within the past year.

Harris, in fairness to him, moved swiftly to address the situation that doctors are not automatically compelled to tell their patients when a missed diagnosis occurred.

That will change immediately, he said, and up to 200 women will be contacted to ensure they know that a previous smear test was declared safe by mistake.

Most of them already know, we are told, but this is being done “to be sure, to be sure”.

But then came the inevitable questions about accountability. Will anyone be held to account? Will anyone be fired over this catastrophic failure, which has handed Vicky Phelan a death sentence?

The response was depressingly familiar: Talk of systems failure, inadequate protocols, of not jumping to conclusions. No-one is being blamed, no-one being sacked. “Did anyone actually do anything wrong here” was the question posed by one minister.

Can you believe it?

Mr Harris said that he has sought to change the practice of the HSE forcing people to court to get justice.

A common complaint of so many people who take action successfully against the State is the trauma of the adversarial legal process foisted upon them by the HSE.

There are echoes here of the case of Grace, who was sexually abused in a foster home for more than a decade, after health officials overturned a decision to remove her.

Despite admitting liability and apologising for the catastrophic failure in her care, Grace and her carers had to go to court to get compensation. It was disgusting that it should ever have gone to the High Court.

Mr Harris conceded the treatment of Ms Phelan was not good enough.

Health Minister Simon Harris.
Health Minister Simon Harris.

“I am the health minister who introduced open disclosure, because I want to see a situation whereby nobody has to go to court to ascertain what happened in relation to their medical experience or their interaction with the health service. I want to provide safe spaces within the health service, where there can be honest exchanges of information between patients and their doctors. That is something we have introduced in recent months. We should never see someone go to the steps of court to establish the truth,” he said.

All too little, all too late, for Vicky Phelan, her husband, and her two children.

Hopefully, the €2.5m does buy some precious time with her loved-ones. It is the very least she deserves, given what happened to her.

Her bravery and courage on Wednesday epitomised the very best of the human spirit, in face of the very worst.

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