Dr Scally has produced a report that sets a standard. It is most unIrish in that it does not obfuscate, writes Alison O’Connor
IT WAS a leak from a Government led by a Taoiseach to whom the art of political spin is paramount.
As it happened it was over-spin because — perhaps to their own surprise – the report into the CervicalCheck controversy has set a standard for others that will follow it, and graphically highlights the deficits in those that preceded it. Dr Gabriel Scally has produced a report that sets a standard. It is most unIrish in that it does not obfuscate. The author says what he means, and means what he says.
It would have been a disaster for the Government if the publication of this report had been dominated by calls for a tribunal of inquiry. So in common with what we now recognise as the classic Varadkar approach they felt the need to get that line out first — Dr Scally didn’t think an inquiry was necessary. This was regardless of the hurt caused to the women involved and their families by the leak. On Wednesday, the following day, we had the actual publication of the report, and then yesterday the spinning struck again with the strategically placed news that a new Land Development Agency is to be launched — a sterling effort to knock cervixes off the top of the news agenda.
News management by the Government of its many and varied shortcomings aside, this report stands on its own merits and will be quoted from in years to come, and not just in relation to CervicalCheck.
The report uses clear and concise language with a high level of detail that was put together — certainly compared to other such reports— in a short space of time. There is a striking difference in tone between it, for instance, and the Harding Clarke symphysiotomy report or the McAleese report into the Magdalene laundries.
It points out exactly where the problems lie. Most importantly it highlights the overall deficits in how women’s health is officially treated in Ireland; how that has filtered down to male consultants who manage to potently combine their God complexes with misogynistic attitudes. It justly rewards Vicky Phelan and the other women and families who have been so admirably tenacious in the face of such treatment.
In talking about a whole system failure relating to CervicalCheck Dr Scally’s report makes genuinely frightening reading with some of the examples of the internal workings of the health system. There were lack of governance issues, lack of proper reporting, gaps in expertise, including among doctors and management involved and the resulting confusion multiplied risks.
In truth there are huge chunks of this report that you imagine could apply to any and all areas of our health service. Indeed when making the point that screening services are sometimes finely balanced in terms of benefit and harm he said they can act as an early warning sign of wider systemic problems.
So given Dr Scally’s observation that this cervical screening programme was a system doomed to fail at some point it is bordering on the miraculous that more serious, life-threatening deficiencies were not found and that we would appear to have a testing regime that is in line with international standards.
Dr Scally made the interesting point that Cervical Check was launched nationally three days after the State signed the bank guarantee in September 2008 — this time 10 years ago as it happens. So the economy was clearly a factor but there are others. It is tragi-comic to read that there appeared to be little knowledge, for instance, in CervicalCheck of the HSE’s policy on open disclosure. The first knowledge of it may well have been gained because a member of staff got an email on a training event in a local hospital. The 2014 email was only received because that person was formerly on the staff of that hospital and had not been take off their email list even though they left several years previously.
It is curious that Dr Scally went off script in terms of what he had been asked to do when he said there was no need for a tribunal of inquiry. It is equally understandable why many people would have believed before reading his report that one would definitely need to be established to get to the truth. After all we have a long history of not holding anyone responsible for anything serious that occurs in Irish public life. But Dr Scally is correct when he says an inquiry is not required.
It is also interesting to note that Dr Scally did not address the poor political handling of this controversy given how much that fed into the women and families involved feeling there was cover-up and collusion. The absence of clear and accessible information, he states in the report, made it too easy for some women and relatives to speculate that there were conspiracies involving laboratory companies and that collusion has taken place to cover up scandalous failures.
Yesterday Health Minister Simon Harris acknowledged that he had “made mistakes on this issue” and his boss the Taoiseach carries more than a fair share of that blame. At times after this controversy broke they were like headless chickens, fuelling, rather than calming the public hysteria.
Matters were not helped by opposition politicians more interested in making political gain than delivering accurate information. The media has little to brag about in the manner in which it shamelessly fuelled the fear. Add to that the behaviour of some members of the legal profession and it became a total mess.
All of this did enormous damage to future faith in our screening services, in turn doing further wrong to women who have benefitted enormously over the past decade from cervical and breast screening services.
The stakes surrounding the contents of this report were exceptionally high. Government faced a massive problem — politically and financially — if it had been found that women had developed cancer when it was avoidable — both politically and financially. Outside of the spin obsession the Taoiseach and his ministers would do well to reflect on the narrow escape this time, and to think on how to ensure they don’t come this close again.
So we could go on and have a public grilling on this. It could possibly provide short-term satisfaction, but would not actually solve the problem of a rottenness that is at the systemic heart of our wider health services.
We could do far worse than ask the plain-speaking Dr Scally, to now turn his attention to the bigger picture of our health services.
© Irish Examiner Ltd. All rights reserved