I try to be cool and restrained in these articles. Even when my views are quite inflammatory, my aim is to cast light, not heat, on a subject.
But sometimes stuff happens, things are said, and I find myself shouting at the radio.
So here’s a rant about a couple of topics.
There’s the notion that cancelling Christmas for hospital staff will improve the trolley numbers. Taoiseach Leo Varadkar specifically mentioned consultants in emergency departments (EDs).
It doesn’t make any sense.
On that same day, the trolley count was over 500, and I don’t think it’s Christmas yet.
That day, at 8am, nurses counted over 500 patients, all accepted for admission and still on trolleys. They’ve had the ED stuff done. Why on earth would it help to have more doctors in the ED? It’s nothing to do with the ED. Those patients belong on the wards.
For all his time as a hospital doctor, as Minister for Health, Taoiseach Leo Varadkar has a highly simplistic plan for the trolleys: Work harder.
It’s a complete misunderstanding of the situation.
I bet he doesn’t know that there’s no data on these patients. Here’s why: HIPE coding is not allowed on any patient stuck in the ED.
The only information we have on trolley patients is that they are admitted. All the clever solutions are just guesswork. How can anyone say with a straight face that transferring work to primary care will solve the problem? There’s no data!
As for daft solutions, like building bigger EDs, that’s obviously stupid. It can’t be the answer. The patients are already admitted; they need wards!
Anyway, Taoiseach, trolley numbers go down over Christmas. Elective work stops; hospitals focus on emergencies. Check the facts before blaming the staff.
It was a national tragedy when Emma Mhic Mhathúna died of cervical cancer, leaving five young children.
If you listened to current Minister for Health Simon Harris, and former Minister for Health Micheál Martin, you’d think her needless death happened because of non-disclosure by doctors.
Her solicitor, Cian O’Carroll, put the record straight.
In an interview with Sean O’Rourke on RTÉ, he said “non-disclosure did not kill that woman, failures in a laboratory in 2010 and 2013 did”. Emma’s cervical smears were misread, not once but twice, by Quest Diagnostics in the US. That’s why her cancer was missed. That’s why €7.5 million was paid out.
And it was because of the €2.5 million awarded to Vicky Phelan that the CervicalCheck scandal burst into the open. Her smear was misread by US lab CPL. Her cancer was missed.
The High Court judge said she was the most impressive witness he had ever encountered. I saw it for myself when Vicky addressed a public meeting in Nenagh. She’s a great woman, very clear in her thinking.
She told us about her cytology. Her cancer was diagnosed in 2014. Unbeknownst to her, CervicalCheck reviewed her 2011 smear. The original report was ‘normal’. The CervicalCheck review, of the same slide, said “query squamous carcinoma”.
Think about that. The test is looking for pre-cancer; Vicky already had cancer, and it was missed.
Her medical expert witness said either the slide was not read at all, or read by a person who was not competent. That’s how huge the difference is. It’s not a ‘false-negative’. It is negligence.
So why is the public conversation all about disclosure?
Yes, Vicky Phelan’s doctors made a mistake. She was told CervicalCheck had discovered an error by the US lab. They didn’t explain it was a horrific, life-altering error.
Why didn’t CervicalCheck tell her? I don’t know. Under open disclosure, they’d have to.
This is all on my mind again because of a mega-interview with Tony O’Brien in the Sunday Business Post. Over several pages, the ex-head of the HSE is mighty aggrieved at how he’s been treated over the CervicalCheck scandal. He goes on about non-disclosure a lot.
Funnily enough, he doesn’t mention the US labs much. He doesn’t explain the extraordinary decision to outsource Irish cervical smears to America. That controversial contract, based largely on price, happened when Tony O’Brien was head of CervicalCheck. We know now that he over-ruled specific concerns from the Chairman of his Quality Assurance Committee.
We still don’t know about the labs. We don’t have a ‘heat-map’ of the 221 women caught up in this story. The HSE won’t say which laboratories are involved and how bad the errors are. The Scally Report can’t answer the questions, but it gives a glowing report to the lab in the Coombe.
Personally, I still want to know if cervical smears from Ireland went to the Quest lab in Mexico. I’ve written to Dr Gabriel Scally about it.
Maybe Tony O’Brien has the answer.
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Recently, when conversing with a patient who happens to be an ICU nurse with a lot more qualifications than my goodself, she let me know that whilst working in a well-known Dublin maternity hospital with a relatively newly-qualified NCHD who has since gone on ‘to better things’ she discovered him to be amongst the laziest creatures ever to walk the planet. He had no idea about what the term ‘working harder’ might involve back then. May still not for all I know. But as Francis Urquhart used to say “I couldn’t possibly comment”.
The awarding of the smear contract always puzzled me; I remember it vividly because the hoo-hah about the relative costs of the lowest Irish bid and the American winner. I remember wondering how accuracy and excellence could be delivered at that price, particularly since the decision had a massively negative effect on the service available at home at the time. Now I know; it can’t.
Civil servants, politicians and their ilk generally get a career leg-up (promotion) for thinking cost-saving schemes and other improvements that prove to be mirages in the long run, generally when the beneficiary has long departed the scene and rarely gets to answer for the negative fall-out later on. Mr. O’Brien was most unfortunate to still be in the neighbourhood when the brown sauce hit the fan; I had not been aware of his part in the contract decision. No doubt the Sunday Business Post will give him the time to enlighten us as to the details of the process.
If you check the front page of this edition you may find you need to question Dr. Scally via his underpaid PR people. Plus ҫa change.