Ireland's health service


#462

Sure it’s just natural progression from here on in Art, the game is rigged, we have it made, we are mugging off all the plebs who are paying for our grossly inflated pensions.


#463

I think my grossly inflated private sector pension is still worth more than my civil service pension. god only knows how much @Funtime s pension is worth now after all those years.


#464

It’s almost like some lads here want us to believe their work performance is evaluated. They’re a bit defensive.


#465

good chap, the only work evaluation you’ve ever had is when they finally gave you the ticket for the forks


#466

Meow.

As I said - very, very defensive.


#467

The standard procedure is that when a woman tests positive, an audit is done of her prior tests to see if anything was missed. In the case of Vicky Phelan for example as it’s been reported, her (by then) cancer was discovered in her 2014 test. The audit on her 2011 test showed that there were abnormalities and it was missed. Apparently this is the case with roughly 200 women in Ireland who have tested positive and audits revealed false negatives in prior tests.

The context here is the pap smear is a very successful screen test against cancer, rates of cervical cancer have reduced 70% since its introduction. In Ireland alone since the program was introduced in 2008, 50,000 women have had abnormal cell growth detected and treated, so arguably the lives of 50,000 women have been saved, or put another way without the testing 50,000 women would likely be dead or dying of cancer.

I have no idea why the women impacted were not informed of their prior false negatives, it sounds like an issue between CervicalCheck and individual doctors. I also have no idea what doctors and gynecologists in Ireland are telling their patients, other than hopefully recommending they have regular pap smears, and if they have daughters have them vaccinated.


#468

As you said the scandal here is the cover up.

The other scandal is that the HSE and Mary Harney took the cheap option against clinical advice to outsource testing to the US.

The HSE knew that the risk of misread smears was high. In Ireland previously the smears had therefore been checked by two people. In the US, the smears were done annually to lessen the risk of misread screens as they were only examined by one person. Despite these practices the HSE decided to go with a policy of taking the smears every three years and have them examined by just on person.

This was unacceptable risk management, which should a central pillar of any healthcare organization.


#469

Agreed on cover-up. The handling of that has been shocking from start to finish and is correctly a scandal. It’s a scandal we’ve seen before in terms of handling of other medical cases in Ireland though and nothing seems to change.

In terms of your other argument - it’s based upon the assumption that there would have been sufficient resources (in terms of trained personnel and money) to implement the screening program in Ireland. CervicalCheck was set up in 2008 - I’m not sure we were launching into a “recruit loads of extra people on the current pay and benefits structure” at that point in time. Even in that scenario we would still have gotten false negatives (and presumably the same cover-up) which in an alternative scenario would have had politicians arguing that we couldn’t do anything properly in Ireland and that we should have out-sourced it!

Bottom line - no matter how poorly handled this has been the screening has most likely still saved more women than it has let down.


#470

Sure what could go wrong appointing school teachers (or journalists like the current incumbent), as ministers of Health.


#471

This.

Tony O’Brien deserves to go now if only for his role in how the contract to the US lab was awarded in 2008 when he was CEO of National Cancer Screening Services.

Olivia O’Leary’s monologue on this is a must listen, explains it all calmly and concisely.

1 hour and 53 minutes into the link here, lasts around five minutes.


#472

We should try doctors as ministers for health, they’d know what to do. Oh wait.


#473

But surely a bit of context is in order here…

Prior to 2008, there was no fucking screening at all offered to the roughly 1 million Irish women who should have been checked at least once every three years. I wonder how many Irish women have died of cervical cancer since the 1940s when the pap test was in use in most of the civilized world? 6 decades later and Ireland offered nothing?

At the time in 2008 there had to have been minimal or almost no lab or trained personnel in Ireland, so to get that scope of program up and running probably required outsourcing. I agree it shouldn’t have been outsourced but how long would it have taken to get labs established and the necessary personnel trained. By normal Irish standards I would guess it wouldn’t be functional now. It would appear though that there has been good progress since then as CervicalCheck now use two Irish based Labs and Quest Diagnostics in the US, who are one of the two largest and highest quality labs around.

There’s plenty of blame to go around here, starting with the utter wankers in government up to 2008 who denied essential treatment to the women of Ireland. Considering the progress since 2008 and the number of women who have had cervical cancer detected early and treated (50,000), O’Brien sounds like he made a valuable contribution, while operating within a government of utter morons.


#474

The bottom line is Mary Harney and Tony O’Brien had a chance to bring in something better than they did, and didn’t.

Cost was pretty obviously the major factor.

Yes, you will always get false negatives, but ultimately lives were lost by going with the cheap option.


#475

Do you have any evidence that the labs used by CervicalCheck have a worse record of false negatives than other labs? I just saw an article in the Irish Examiner that appears to support your claim that cost was the major factor in choosing labs, the problem is the lab mentioned and chosen in 2012 is Quest Diagnostics which is extremely highly rated and would (along with LabCorp) be the first choice of most medical practitioners in the US. Cost shouldn’t be the only factor of course, but lower cost doesn’t necessarily equate to lower quality, Quest for example would have advantages over smaller labs in terms of scale and are highly efficient.


#476

Think I heard it mentioned on the radio that they made more mistakes alright.


#477

Possibly although that hasn’t been substantiated yet. What is inarguable is that lives were saved with going with an option, even imperfect. Apart from cost it’s unclear if the Irish system even had the capacity.


#478

The young fella’s eye went cross-eyed overnight* a while back, in April. Apparently it’s common enough. We’d to see a doctor, who obviously knows fuck all about eyes but has to write the referral letter. She gave us the name and number of a specialist in Temple St.
I rang the secretary for the specialist to be told we could get an appointment for October. I offered to go private for a quicker appointment, she said ‘that is private’. Public appointments are available for a year and a half away. After haggling a bit she offered me an appointment for someone else in August.
Watching little boggle eyes made me start googling the private hospitals. I got an appointment for someone pretty quickly in the MAter Private. A couple of appointments and a failed trial of corrective glasses later, the young fella is booked in for corrective surgery in August. Apparently speed is of the essence with this condition as the Brain stops taking signals from the turned eye after a while. Mrs J wants a second opinion but I was fairly happy with the consultant.

My point is… if you’re completely public reliant, your kid’s sight goes to shit while you wait for appointments. This goes for plenty of other illnesses and conditions in this country. You’d be mad not to have private health insurance.


#479

If you were on the electoral register in North Tipp you’d ring Lowry and he’d bunk you up the public appointment list pretty sharpish. Ivor Callaly used to be great for this craic as well


#480

+1. Whatever about taking a chance with yourself, it’s a different ball game with dependents. PEOPLE I KNOW didn’t bother with private health insurance when their children were born and are now faced with these waiting lists as one of the kids needs treatment for something. It’s not a risk I’d be willing to take.

Hope the young man gets on well. Just look to me and @Fitzy for inspiration when it comes to people who’ve overcome eye issues to excel at general administrative duties.


#481

Is that what you call driving your life partner around?