Ireland's health service


yeah that’s fair enough
Kev isnt very analytical and is unable to articulate what his problem statement actually is but you have summarised it there i think,


There was a young mother interviewed on Morning Ireland who had been in the media a lot last week over the cervical cancer scandal. She was told this week her cancer is back and it’s terminal. The interview was one of the heart wrenching things I’ve heard in my life.

She called on Tony O’Brien to quit too, and she called out Simon Harris & Leo. I can’t see O’Brien lasting beyond the weekend after it.


Talk about handling it wrong.

Government are so weak. If they just said look he is gone in a few weeks and it gives us the time to find someone else anyway.

If he goes you have more rushed decisions.

They need to start appointing from outside the organisations. This will reduce the in-house politics and climbing somewhat. People will know you cannot just climb the ladder, you have to be good too.


Was there any clinical error in her case?

It’s very hard in this whole story to separate

  • shite communication that had a negative health impact from
  • shite communication that was just shite but didn’t affect anyone and
  • poor test results that are unfortunately a known outcome from the type of tests carried out


Ya, she was given the all clear in 2013, when in fact her smear was abnormal, she developed cancer after that went through treatment got the all clear, but then in recent months the cancer returned and now she’s been told it’s terminal.

From RTE:

Ms Mhic Mhathúna, who was originally given a clear smear test in 2013, said her gynaecologist told her that if her abnormal test had been picked up in 2013 she would not be in this position now.


It puts into perspective all those dopey parents refusing to give their daughters the cervical cancer vaccine. What these women would give to have had that vaccine


Is it not the case though that there is an expected error rate in these tests and that a percentage of abnormal results are expected to be missed?

It’s more about the audit of the process which indicated there may have been abnormalities and how the results of that audit were communicated.

Speaking on RTÉ’s Drivetime, Ms Phelan’s solicitor Cian O’Carroll said he believes a large proportion of the 15 women who have had issues in relation to their cervical smears, were informed of it by their clinician.

He said: "That’s not to say, there was negligence involved in the misdiagnosis of those women’s cancer.

“What is clear, however, is that there was a gross breach of trust in not informing them promptly at the time the misdiagnosis was discovered by CervicalCheck”.


Yes, and I believe in this instance she was never told about her original abnormal smear until recently.

The issue around the error rate is also contentious because they sent the smears to the US. The system applied by the lab was the US System which was based on yearly tests, so if an abnormality was missed in year 1, it would be picked up in year 2 when it was more obvious and there was still plenty of time for treatment. Irish smears were subjected to the same system but were only retested on a 3 year basis, so if abnormalities were missed in the initial smear it could be 3 years later before they would be detected.

Then there was all the communication issues which arose after that.


O’Brien is or was (at least) from outside. UK Family Planning Association → Irish Family Planning Association → HSE.


Still state run though ya???

And the irony


To be honest I find it quite difficult to follow this whole issue and pardon me for my ignorance.

The lady that was on Morning Ireland this morning - is it a case that nothing could be done for her given the large error rate in these tests and that an incorrect diagnosis is ‘normal’?

Or was this case selected for audit, the error was found but the woman was not contacted hence impacting the success of any potential treatment for her cancer which is now, as you said, terminal? If this is the case then that is outrageous.


Ultimately the whole thing comes down to failed free market ideology.

Divide the process into two sections - frequency of tests and quality of analysis.

Ireland went for the least frequent tests, with the poorest quality analysis, under a PD Heath Minister.

Because it was the most “competitive” contract.

You get what you pay for.


Bitter irony to it alright. I certainly believe there’s a weakness for being told the same shite but in a foreign accent for a lot of these appointments.


You are truly one of the most naive people I have ever encountered

Take a walk into a few hospitals and chat to pretty much anyone over 55. They will all have some story of ignore nice from anyone doctor or misdiagnosis or plain mix ups. Many terminal or causing extended hospital stays.

Many extended hospital stays mean a person comes out very weak and a totally fucked immune system so they often get sick and/or die reasonable quickly after.

There is no real health system in ireland. Just a very large minority milking the shit out of it and a moderate number trying hard but playing against the wind and another large minority having given up.

There is no health system. That would infer they were trying to help people


Whether you could ever trust an Irish state body to be competent is a moot point but outsourcing something as important as cancer testing/screening is extremely risky. Post crash costs had to be cut but salaries was one area that couldn’t be touched so it was services and end-users that were going to suffer. This is the result of these policies. I’m sure these people will take solace in the fact that their deaths are not in vain and it was done so that people got to keep their inflated salaries/pensions.


That’s nice but I wasn’t addressing you so go away.


Absolutely. Especially in a small country like ireland.

Some of the “best” surgeons/consultants around around re the ones who around reread quite disliked because they are straight and abrupt. You would even hear of people avoiding them fir this reason. Willing to take their chance with someone known to be lesser but will massage their ego or sensibilities


You need to be told shit.

You would be fucking useless in a crisis


You would be grand though. You’d know loads of people.


I find it hard to follow myself but I believe this to be a similar instance to the Vicky Phelan case, where the case selected for audit, abnormalities found, but the results of the audit never passed on. I could be wrong on that though.