221+ Statement in response to Dr. Scally’s Nov 22 Implementation Review Report

Statement from 221+ in response to Dr. Gabriel Scally’s Review of the Implementation of Recommendations of the Scoping Inquiry into the CervicalCheck Screening Programme – Implementation Review Report – November 2022

23rd November 2022

The context for today’s report is very different to that which faced us all four years ago. We had barely connected the dots, or the people then. We didn’t know what to expect and despite our individual experiences, we were shocked.

We now know a lot more. From the stories of hundreds of women we know that our individual lived experiences were not about us, but about a system that that has been, and in many case still is, fundamentally flawed and in desperate need of regeneration.

This report is not looking at the system through our eyes, or in language that we would be comfortable with. We respect that Dr. Scally was confined to operating within the frame of reference established by the previously published Scoping Inquiry into the CervicalCheck Screening Programme.

That notwithstanding it still highlights a range of continuing shortcomings, and actions that have not been addressed.  We thus have mixed feelings about today’s report. It commends fair progress made that is important because protecting and strengthening the future of screening is critically important. It also reflects our long-expressed concerns that there remains an active determination within the Irish healthcare system to avoid dealing up front with things that go wrong and with respecting those who point out those missteps.

We welcome that the report acknowledges that “what was revealed in the aftermath of Vicky Phelan’s court case was that Ireland had a cervical screening programme that was deeply flawed“ to which he adds that in his view it was “entirely reprehensible to claim that, in the past, CervicalCheck was as good as any other cervical screening programme in the world”

While it may seem regressive to bring these points up again, this was a position taken up by the senior executives of the screening service on a recurring basis up to very recently.

While we acknowledge the recent commitment of the HSE’s senior management to a reset in this regard, change takes commitment over time and the starting point as Dr Scally sets out is that “If you can’t bring yourself to acknowledge past failings, why would anyone trust you today?

There are a number of further points highlighted in today’s report that reflect our continuing concerns;

  • The experience of being treated as ’second-class citizens’ where clinicians have questioned women about any association with 221+ before considering treating them.
  • The absence of respect for the role of patient advocates and treating them as equal partners in the system.
  • The limited effort to put resolution, to whatever degree possible, of the damage done to individual patient/doctor relationships by the inadequacy of much of the communication that has taken place.
  • The lack of progress on developing effective sustainable alternative mechanisms to avoid lengthy and traumatic legal proceedings and court appearances. We fully agree that litigation is a sad indictment of any system for dealing with possible clinical errors.
  • Patients should be told the truth when things go wrong and doctors ‘must’ rather than ‘should’ be open and honest with patients
  • The necessity for future oversight and leadership of the cervical screening programme should not be neglected

We also call for the urgent enactment of the legislation in respect of Patient Safety and open disclosure as recently promised by the Taoiseach

In everything that we say and do, we exclusively and unapologetically take a patient perspective rooted in real life experiences.

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Comments or requests, please contact Communications Coordinator Lily Fox at communications@221plus.ie .