The 6,000 women invited to undergo repeat tests will wonder why it’s only happening now, writes
.As a basic tool of modern public health and preventative medicine, CervicalCheck, detector of more than 40,000 high-grade cervical abnormalities, should hold a special place in our hearts.
Instead, anyone in receipt of an envelope with the CervicalCheck logo is left wondering whether to open it, in light of a seemingly never-ending series of cock-ups, some with tragic consequences.
The latest saga to beset the national screening service will see 6,000 women receive letters inviting them to undergo repeat smear tests. This is because for those with low-grade abnormalities, a test should have been applied within a recommended timeframe, to see if they had the human papillomavirus (HPV). While four in five of us carry this virus at some time in our lives, and it may never become an issue, it is nonetheless behind the majority of cervical cancers.
Last November, Quest Laboratories told the HSE that it hadn’t conducted the HPV test within the manufacturer’s recommended timeframe and that this has been happening since secondary HPV screening was introduced in 2015.
Health Minister Simon Harris was told before Christmas, date unspecified.
Next week, which brings us into February, the 6,000 women whose low-grade abnormalities were not tested for HPV within the specified timeframe will begin to receive letters telling them same. They will be invited to attend their GP for a repeat smear “as a precaution”.
Peter McKenna, clinical director of the HSE’s Women and Infants’ health programme, said their clinical review has assured them that “this issue poses little risk to women’s health”. The likelihood is he is right, but at this stage, how many women have any faith left in CervicalCheck?
This latest batch of women let down by the screening programme will also be wondering why on earth they are only finding out now? If the HSE knew last November and the minister since before Christmas, why are they not finding out until February? They did, after all, have “low-grade abnormalities” and trust me, the standout word in that phrase is “abnormalities”. Surely they were entitled to organise a repeat smear ASAP?
This could present another problem. How do you organise an immediate repeat smear at a time when women are waiting at least 22 weeks to get results of smear tests? While the HSE has said these women will be prioritised by the labs, who would be foolhardy enough not to go private in the current climate, especially when you consider that another cohort of women — 1,000 to be precise — also have to undergo repeat testing because initial smear samples had expired before they had been transferred to slides for testing.
This delay was the direct result of the backlog that built up when Health Minister Simon Harris offered free repeat smears to everyone after the CervicalCheck controversy broke, when Limerick woman Vicky Phelan sued the HSE over her misread smears, which she wasn’t told about until three years after her diagnosis. It emerged that at least 221 women were left in a similar position to Ms Phelan, of whom at least 21 have died, most recently Dublin woman Orla Church, who died last week ,and whose case against the HSE and Quest Laboratories was settled in the High Court yesterday.
Mr Harris’ politically expedient decision to offer universal free smears — well-meaning but ultimately disastrous for the operation of CervicalCheck — has been under considerable scrutiny in recent days, following revelations that he acted against the advice of experts, as per documents obtained under Freedom of Information legislation by TheJournal.ie.
It reported a gynaecologist in the Mid-West region warning that the offer of free repeat smear tests was “dangerous” and put the CervicalCheck screening programme at risk. Fianna Fáil is calling on the minister, who is on paternity leave, to publish details of the medical advice he received. Sinn Féin health spokeswoman Louise O’Reilly said the minister needs to clarify when he knew about the latest cock-up. As a woman, her confidence in the screening service is undermined, she said, “as is the confidence of other women”.
“If he knew since December, why did he not instigate a plan of action?” said Ms O’Reilly.
Tánaiste Simon Coveney was defending his missing ministerial colleague in the Dáil in the absence of any one of the numerous junior ministers in the Department of Health.
It was not a resource issue Mr Coveney said, it was a capacity issue with the labs, which reassured no-one.
We are also still awaiting reassurance in relation to the different labs that analyse the smears on our behalf. We’ve been under the impression that individual lab error rates were being looked at for some time now for fear of an outlier, but no information has been forthcoming in this regard.
The upshot of the ongoing negativity around CervicalCheck has to be an alarming loss of faith. As Labour Party leader Brendan Howlin asked in the Dáil: “How much scandal can the screening programme take?”