HSE refusal to apologise for cervical smear inaccuracy that led to a woman's death.

No modern orgs admit fault in a settlement. It's half the pleasure of reaching the settlement.

People should not forget the HSE and government's hero of the covid pandemic response, Tony Holohan, was one of those who decided it best not to inform women of their false negative smear test results.

I wonder if he ever thought differently after his own wife passed away due to cancer.

The HSE and Irish dept of health is littered with what they term systemic failures.

Harry Truman would never have worked in either as the buck never seem to stop anywhere in the organisations.

They outsourced the reading of the smears to the US I think, some staff advised against it saying it wouldn't work for us here because we had a different set up. But they wanted to save money and went ahead with it anyway. You know, it's only women at the end of the day. Money's more important. I hate the people that done this.

Lets look at the case of Vichy Phelan which actually was the one that brought all this to light.

Vicky's 2011 smear test, which showed no abnormalities, was found, in a 2014 audit of smear tests on a number of women, to be incorrect.

She was diagnosed with cervical cancer in 2014 but did not learn of the review or audit until 2017.

Here is story about the husband of a lady who died before ever learning their were misdiagnosis of her smear tests.

EVERYONE needs to go and see the documentary film Vicky that puts the spotlight on the CervicalCheck controversy. 

So says Stephen Teap whose wife Irene died from cervical cancer in 2017 having twice received incorrect smear test results. 

The controversy came to light in 2018 after Kilkenny woman Vicky Phelan, who has terminal cervical cancer, settled her High Court case for €2.5m after she was given incorrect smear test results.

She blew the whistle on the scandal, and an inquiry established that Cervical Check and its doctors failed to inform hundreds of women of an audit of their cervical smear tests after being diagnosed with cancer.

Some were already dead, including Irene Teap. The 35-year-old mum-of-two died not knowing she was given false negative test results in 2010 and 2013.

So remind us again hwo they were not informed there had been misdiagnosis of their smear tests?

I never said the women were not told they had cancer.

Most were properly diagnosed years after the misdiagnosis, unfortunately too late for some.

And they were diagnosed when the symptoms were more pronounced.

You're replying to the living embodiment of dunning krueger.

I think the difference is the first screener is reading a slide from a healthy population, one of thousands. The second screener in audit or solicitor request knows the person has cancer so it’s totally different. It’s very easy to see it with that benefit. Called retrospective bias. So it’s not that slides were read wrong, it’s that the circumstances are totally different.

Why should they apologise unless their was evidence of gross misconduct? Smear tests are not infallible, particularly as they are a subjective test.

All analytical work is done to an acceptable level of error. That level of error should be determined by cold hard stats not emotions.

and I mean the idea of settling is you may be unsure how strong your case is. Would a jury agree that it was criminal negligence or forgivable human error if the doctors had character witnesses etc.

That's extremely unfair. If the health system didn't care about women there would never have been a cervical check or breast check.

My own fear was that after all these failures that the screening programmes would end up cancelled as they drew a liability on the State. To be fair though, that has not happened and screening has expanded.

If you are doing a retrospective audit its guaranteed for any screening program to then identify a number of false negatives, especially if you are auditing from a sick population .

All screening programs have a given false negative and false positive rate. Generally you want to have a balance between low number of false positives (which could jam up the system and cause huge unnecessary concern and surgical intervention) while at the same time trying to reduce the number of missed true positives . Remember yoo could be dealing with millions of people.

That is the way they are designed and there is no perfect approach to this.

To get a 100% false negative rate is impossible for any diagnostic test, there is no perfect test for any disease, and for cervical smears , like tests that depend on xrays, they depended on a lot of human judgment which can cause more variation to creep in.

I haven’t followed the procedural issues behind this so I wont comment on that part. Of course I feel terrible for those who have lost loved ones from misdiagnosis.

HSE has paid hundreds of millions, and possibly billions, out for different issues related to testing but I beleive it is largely due to issues in how the results were communicated rather than the tests themeselves having specific issues because, again, when you order a diagnostic test it comes with an inbuilt error rate assumed already. In other jurisdictions patients are not getting compensation to the same level as seen in Ireland.

@political analyst said "It was outsourced because of quality-control issues with Irish labs."

That is not true.

HSE still not fit for purpose. 20 years on after an organ retention scandal,

1. The Doctor at the centre of it back then, is working again in pathology for the HSE
2. They're holding organs too long and surprising parents with horrible, callous communications "Hi, this is the HSE, you filled out the form wrong. What do you want to do with your baby's body parts?"
3. Investigations and recommendations in 2009, kinda not implemented yet.

At least Paul Reid's gone. Maybe they'll eventually have a doctor in charge of the HSE.