CervicalCheck controversy

Viewpoint2

And Knipex you are on the side of iamwhoiam and blanch152 too. I dont agree we need more nurses we need less of them! If you were in hospitals like I have been I could tell you there is too many of them tripping over each other and walk down wards and childrens wards at evening time and you will see them sitting around for an hour at desk b4 shifts changeover leaving patients to wait! Too many nurses and top heavy administration are bossing the doctors. So no we dont need any more nurses we need less and ones who are efficient and have not an attitude and we need matrons. No matrons anymore so nurses not accountable especially at night when no managers around! The managers are not accountable either! The nurses and the admin are overpaid with what they have done to patients!! As for the doctors there are some good ones but some ones in the hospitals especially consultants who leave people waiting and are doublejogging working privately while on public list too so they are paid enough if they dont want t work here buzz off! Again you see its lack of accountability and no supervision in the hospitals thats causing the mess! Also ul see hospital floors not cleaned ul see the food caterers with a chip in their shoulders! The HSE is hell. Heaven is staying out of hospital if can and die naturally at end of life! Hell is getting sick and been unfortunate to end up in kip HSE place where the HSE staff dont care most of them!!!

Viewpoint2

Matt Barrett I agree with you! There are people on this forum who are out t defend the HSE and the government. They we hope are in the minority or else a lot of evil minded people in this country who dont care about the women that were misdiagnosed and all the babies that died in traumatic births in hospitals! The HSE are downright EVIL and giving them anymore funding is akin to funding Satan and Evil.

iamwhoiam

Viewpoint2 wrote: »

Iamwhoiam and blanch 152 ye must be both living in cloud cuckoo land! How dare ye keep sidetracking and ranting about lack of funding and taxes etc. Ye are pro the HSE top heavy Administration ye have to be. Lack of accountability is what caused the screening controversy and deny delay and defend tactics! That wasnt caused by Funding was it?? The maternity scandals all around the hse in this country was that due to lack of funding either or by people not paying more taxes!! Iamwhoiam and blanch152 obviously have no feelings for the people have been misdiagnosed if they are trying to impress that funding and not enough taxes caused the lack of accounrability. Comeon ye are living in fantasy. I am really really asking is there any good people here could create a new rising call it the 2018 rising and keep it up non stop until we get a quality health service in this country for the first time since the foundation of this state!! Any takers?? And to hell with people who are in denial or are hse officials on here deluding themselves! I await if we can do something.

Yeh yeh whatever . Shout and rant and tell me what I think and be boorish . It will win no argument . The last people on earth I would defend are the HSEpowers that be . I will defend the front line staff who keep the whole system from collapsing
. Its quite obvious from my previous posts but sure why would I need to explain that to you ? Can't be arsed with a shouty loud poster to be honest

knipex

Matt Barrett wrote: »

No need for the dramatics. Take responsibility, not shrug it's shoulders or try hide the results. A far cry from tying them to a stake.

Nothing dramatic about it. If you make the lab liable for every false negative on a test that isn't 100% accurate then the courts will bankrupt them. It would be negligence bordering on criminal for any company to sign up to a contract like that.

The state would have no option but to do the testing in house which woudl keep loads of people here happy and would end up spending so much on litigation as to make any screening program nonviable.


The test isn't accurate, there will be false negatives and false positives. Its a fact it happens in every single screening program in the world. If there are an abnormal level of false negatives or false positives due to negligence, incompetence or piss poor quality control then by all means apportion liability.

The screening program and testing isn't 100% reliable so you cannot expect any organization to accept responsibility for every single false positive or negative,

James Brown

knipex wrote: »

Nothing dramatic about it. If you make the lab liable for every false negative on a test that isn't 100% accurate then the courts will bankrupt them. It would be negligence bordering on criminal for any company to sign up to a contract like that.

The state would have no option but to do the testing in house which woudl keep loads of people here happy and would end up spending so much on litigation as to make any screening program nonviable.


The test isn't accurate, there will be false negatives and false positives. Its a fact it happens in every single screening program in the world. If there are an abnormal level of false negatives or false positives due to negligence, incompetence or piss poor quality control then by all means apportion liability.

The screening program and testing isn't 100% reliable so you cannot expect any organization to accept responsibility for every single false positive or negative,

What do you mean by liable? I mean take responsibility. Of course they should. In the least they shouldn't be hiding their result margins. I thought the whole point of outsourcing and privatising was having an entity the state could hold to account and cut ties with if not satisfactory? It's not about taking the shirt off their back it's about professionalism. You don't hire a company and say 'don't worry about quality or your level of dependability lads, go on ahead. Here's money'.
Again with the no test is 100% accurate. Derailing like a straw man effort. They tried to hide their incorrect results.

knipex

Matt Barrett wrote: »

What do you mean by liable? I mean take responsibility. Of course they should. In the least they shouldn't be hiding their result margins. I thought the whole point of outsourcing and privatising was having an entity the state could hold to account and cut ties with if not satisfactory? It's not about taking the shirt off their back it's about professionalism. You don't hire a company and say 'don't worry about quality or your level of dependability lads, go on ahead. Here's money'.
Again with the no test is 100% accurate. Derailing like a straw man effort. They tried to hide their incorrect results.

Let try this again.

The test isn't 100% accurate so you will have false positives and false negatives. It happens, its not anyone's fault, its the nature of the test..

Can we at least agree on that ??

Liability means that the person who gets the false negative or false positive can sue.

Now are you starting to see the issue here ??

knipex

Matt Barrett wrote: »

What do you mean by liable? I mean take responsibility. Of course they should. In the least they shouldn't be hiding their result margins. I thought the whole point of outsourcing and privatising was having an entity the state could hold to account and cut ties with if not satisfactory? It's not about taking the shirt off their back it's about professionalism. You don't hire a company and say 'don't worry about quality or your level of dependability lads, go on ahead. Here's money'.
Again with the no test is 100% accurate. Derailing like a straw man effort. They tried to hide their incorrect results.

You accuse me of a strawman ???

The HSE knew about the tests and the false negatives.. That's not at issue.

The decision not to tell the affected women was made within the screening program \ HSE.... not the lab. The lab may have had legal advice that they not offer information but the decision was not made by the lab.

James Brown

knipex wrote: »

Let try this again.

The test isn't 100% accurate so you will have false positives and false negatives. It happens, its not anyone's fault, its the nature of the test..

Can we at least agree on that ??

Liability means that the person who gets the false negative or false positive can sue.

Now are you starting to see the issue here ??

No. Any false result rates should be reported openly. Tax payer money funded these tests, therefore the tax payer should be privy to quality levels.
I see your issue.
Mine is they should be vetted and rated by their margin of error. Therefore they should not be hiding findings. Also, they should be held responsible in so much as if performing poor, sanction/sacked.

knipex wrote: »

You accuse me of a strawman ???

The HSE knew about the tests and the false negatives.. That's not at issue.

The decision not to tell the affected women was made within the screening program \ HSE.... not the lab. The lab may have had legal advice that they not offer information but the decision was not made by the lab.

You keep reverting to no tests being 100% accurate. That's no argument I've made. They wanted the errors kept quiet. They wanted Vicky Phelan to sign a confidentiality agreement. This has been covered.

gctest50

The HSE was aware of issues around the testing of cervical smear samples at labs in the US as far back as 2007, when a consultant pathologist in Cork University Hospital sought a review of samples that were given the all clear, despite patients being at risk of cervical cancer.


https://www.irishexaminer.com/ireland/hse-was-aware-of-us-lab-issues-with-smear-tests-in-2007-470773.html

.



https://www.imt.ie/news/us-lab-smear-test-results-questioned-14-09-2007/

iamwhoiam

https://www.rte.ie/news/ireland/2018/0516/964007-emma-mhic-mhathuna/


I hope this link posts . A lovely moment in a tough week for Emma

lillycakes2

It seems to be just like the Bank scandal, no one held account for anything, pathetic country

boombang

lillycakes2 wrote: »

It seems to be just like the Bank scandal, no one held account for anything, pathetic country

We haven't had the enquiries yet, just trial by media. There's not been much clear evidence brought forth and the analysis of that evidence has been poor so far.

James Brown

boombang wrote: »

We haven't had the enquiries yet, just trial by media. There's not been much clear evidence brought forth and the analysis of that evidence has been poor so far.

Who's been blamed and convicted by the media? questions are pointed in varying directions as the facts come out. Looking to O'Brien isn't trial by jury. Pointing out concerns from years ago, not followed up on, isn't media hype.

To be fair, we've had a hell of a lot of posts in this thread about media hype and trial by media. It smells a lot like 'nothing to see here, move along'.

The only reason I can see for trying to close down coverage is the black eye privatisation has gotten. I firmly believe IF FG have any ideas about changing the HSE it involves privatisation in various forms. That's the only logical conclusion one can come to as another health minister wrings his hands and moves on to another department.

Red_Wake

boombang wrote: »

lillycakes2 wrote: »

It seems to be just like the Bank scandal, no one held account for anything, pathetic country

We haven't had the enquiries yet, just trial by media. There's not been much clear evidence brought forth and the analysis of that evidence has been poor so far.

Pretty much.

Same as the Belfast case, there's an overall narrative that the media portray, the public lap it up, and when the process plays out, if the mob doesn't get a few heads then the usual voices pipe up blaming corruption in the system.

James Brown

Red_Wake wrote: »

Pretty much.

Same as the Belfast case, there's an overall narrative that the media portray, the public lap it up, and when the process plays out, if the mob doesn't get a few heads then the usual voices pipe up blaming corruption in the system.

We rarely get even a semblance of accountability, as we rinse and repeat. It's called legitimate frustration. Don't dismiss or shoot the messenger. If you can point out any media lies, link? It's odd for the media to be seen as more of a bias vested interest than the people administrated over this scandal. 'Ah, sure they would say that' won't fly on this one.
Denis O'Brien is the major shareholder in INM not Vicky Phelan. Why we may think Mick Wallace et al. rule the media is nothing more than amusing.

MikeyTaylor

Matt Barrett wrote: »

We rarely get even a semblance of accountability, as we rinse and repeat. It's called legitimate frustration. Don't dismiss or shoot the messenger. If you can point out any media lies, link? It's odd for the media to be seen as more of a bias vested interest than the people administrated over this scandal. 'Ah, sure they would say that' won't fly on this one.
Denis O'Brien is the major shareholder in INM not Vicky Phelan. Why we may think Mick Wallace et al. rule the media is nothing more than amusing.

Hopefully not our next President, but I think I might have jinxed it. :-P

Robert McGrath

Not sure how to post links (or if I am allowed to) but David Grimes has an interesting piece in the Irish Times that indicates a slight swing in the media coverage to explain screening v diagnosis etc

https://www.google.ie/amp/s/www.irishtimes.com/opinion/confusion-over-role-of-screening-is-part-of-cervical-check-crisis-1.3499249%3fmode=amp

Uriel.

Robert McGrath wrote: »

Not sure how to post links (or if I am allowed to) but David Grimes has an interesting piece in the Irish Times that indicates a slight swing in the media coverage to explain screening v diagnosis etc

https://www.google.ie/amp/s/www.irishtimes.com/opinion/confusion-over-role-of-screening-is-part-of-cervical-check-crisis-1.3499249%3fmode=amp

A fantastic read. If only our politicians and other media hacks would also read it.

goat2

Copied and Pasted from link in above post

CervicalCheck gave instructions that a reference to “open disclosure” in letters to doctors, telling them about audits showing patients’ incorrect smear test results, should be deleted in cases where the woman had died.
The template letter that the programme sent to doctors from mid-2016 was disclosed to two Oireachtas committees this week among more than 120 pages of records released by the Department of Health

James Brown

I think the dead women, dying women and pretty much any woman who has a passing familiarity to it, knows the difference between screening and diagnosis.

James Brown

Just to clarify:

Dr Regan said the academy wished to clarify that Irish accredited laboratories that tendered for the cervical screening service in 2007/8 were informed that they had scored highly in all areas (quality and turnaround times) except cost.
https://www.rte.ie/news/politics/2018/0523/965450-oireachtas-health-committee/

I find it odd that the state would outsource, outside the country, when if outsourcing was required, we could have done it within our own jurisdiction. How much did we save? Do the tender winners have any dealing with any Irish person/firm with a conflict of interest?

Robert McGrath

Looks like the BreastCheck administrators are also having to clarify the difference between screening and diagnosis and the potential for litigation to render the screening service unviable at the Oireachtas Health Committee today

boombang

Think it was to do with the number of trained cytopathologists working within a common system at the time. Out capacity was primarily in the public sector if I understand things correctly. Easier to get a large established firm to absorb our requirements than train up a service here. Interesting that a commercial provider was able to establish the required skills base in Ireland over time.

Don't necessarily see why the firm needs to be within the state. I think you should contact with the best quality and price wherever it is. That's not to say that's what was done here as there may be valid quality concerns about the US lab, but if they are valid a good QC system should pick them up.

boombang

Robert McGrath wrote: »

Looks like the BreastCheck administrators are also having to clarify the difference between screening and diagnosis and the potential for litigation to render the screening service unviable at the Oireachtas Health Committee today

I believe there have been successful claims taken against BreastCheck in the past for things missed at screening. It's my guess that things are even less black and white in mammography than cervical cytology.

James Brown

boombang wrote: »

Think it was to do with the number of trained cytopathologists working within a common system at the time. Out capacity was primarily in the public sector if I understand things correctly. Easier to get a large established firm to absorb our requirements than train up a service here. Interesting that a commercial provider was able to establish the required skills base in Ireland over time.

Don't necessarily see why the firm needs to be within the state. I think you should contact with the best quality and price wherever it is. That's not to say that's what was done here as there may be valid quality concerns about the US lab, but if they are valid a good QC system should pick them up.

It reads to me like price was the overriding factor as to why the HSE went to the states. The questions are, how much did we save? Was it worth it?

Dr Irene Regan from the Academy of Clinical Science and Laboratory Medicine told the Oireachtas Health Committee that the decision to move screening to the US means there is a lack of information about the standards of individual labs carrying out the analysis.

"One consequence of this decision to outsource is that the academy does not have access to information from these laboratories and is therefore not in a position to comment on the quality metrics or standards of individual laboratories at this time," she said.

https://www.rte.ie/news/politics/2018/0523/965450-oireachtas-health-committee/

Is there any conflict of interest here?
The suspicious thing about saving money for the tax payer is, as a state, it's not the usual modus operandi.

Red_Wake

boombang wrote: »

Robert McGrath wrote: »

Looks like the BreastCheck administrators are also having to clarify the difference between screening and diagnosis and the potential for litigation to render the screening service unviable at the Oireachtas Health Committee today

I believe there have been successful claims taken against BreastCheck in the past for things missed at screening. It's my guess that things are even less black and white in mammography than cervical cytology.

Genuinely scandalous that the known limitations of screening tests are causing legal liability as well as political liability.

Out of curiosity, would the terms of a screening service not absolve them of legal responsibility for false positives/negatives? I'd have thought it part of the terms of use.

James Brown

Red_Wake wrote: »

Genuinely scandalous that the known limitations of screening tests are causing legal liability as well as political liability.

Out of curiosity, would the terms of a screening service not absolve them of legal responsibility for false positives/negatives? I'd have thought it part of the terms of use.

Another question is why no knowledge of the quality of the metrics or standards adhered to at these laboratories was okay, to allegedly save the tax payer money?

Red_Wake

Matt Barrett wrote: »

Red_Wake wrote: »

Genuinely scandalous that the known limitations of screening tests are causing legal liability as well as political liability.

Out of curiosity, would the terms of a screening service not absolve them of legal responsibility for false positives/negatives? I'd have thought it part of the terms of use.

Another question is why no knowledge of the quality of the metrics or standards adhered to at these laboratories was okay, to allegedly save the tax payer money?

I'd assume there was a minimum standards expected of all labs which would allow them to be eligible for tender. Some labs may have been well over the metrics, some may have just met them.

Don't think this question has been answered officially though. It would be helpful to know how many of the false negatives came from the US lab vs the Irish labs, and what proportion of the overall samples were tested in each lab.

Uriel.

Matt Barrett wrote: »

Another question is why no knowledge of the quality of the metrics or standards adhered to at these laboratories was okay, to allegedly save the tax payer money?

Is there no knowledge though?
The HSE has repeatedly said that all of the labs used fall within the necessary international quality assurance standards. No one has proved otherwise. It's been all hearsay and speculation touted as fact.

Who is making the claims..? Ruth "the private sector is evil" Coppinger and the body that represents Irish medical scientists who want the gov to invest in their membership base... No conflicts of interest there I'm sure.

Either way I will look forward to the Scally report

knipex

Matt Barrett wrote: »

Just to clarify:



I find it odd that the state would outsource, outside the country, when if outsourcing was required, we could have done it within our own jurisdiction. How much did we save? Do the tender winners have any dealing with any Irish person/firm with a conflict of interest?

The state tendered the contract both inside and outside the country and it went to the winner of the tender process. I assume that fact it was an Irish company or not wasn't even part of the consideration.

I do know that the the initial screens that were done in US were done during the pilot program and were done so because of a backlog of screens. The Irish lab could not handle the number of samples being tested.

In 2008 when the initial tender process was run no Irish lab was accredited to the necessary standard. I understand that virtually all the labs achieved the required accreditation within 12 months of the tender closing.

Also from the same source you linked to

Marie Culleton from the Academy of Clinical Science and Laboratory Medicine said it was necessary to wait until the Scally report comes out before being able to identify if there was a problem with one particular laboratory.

"He is doing an in-depth audit and will tell us if there was a problem with one particular laboratory," she said