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By Elaine Loughlin, Daniel McConnell, Fiachra Ó Cionnaith and Noel Baker
A brutal culture of misogyny and paternalism left 221 women in the dark during their smear audits, Dr. Gabriel Scally discovered.
Dr. Scally discovered pervasive disregard for patients, which was "damaging, hurtful and insulting," with doctors not having "no compelling obligation" to provide information to women.
The 170-page document reveals a "total system failure", with no one responsible for the cervical cancer screening service.
Health Minister Simon Harris gave Dr. Scally additional time to examine the revelation that one US laboratory had contracted smear sample testing to four other facilities without informing CervicalCheck.
Victims Vicky Phelan, Stephen Teap and Lorraine Walsh called for full implementation of the 50 recommendations contained in the Scally Review, which they believe also raises more questions about how their own cases have been handled .
Among the main recommendations of the report are:
The "urgent" review of the HSE disclosure policy to reflect "patients' fundamental right to full knowledge of their health care";
A requirement that medical personnel, as a condition of employment, must undergo open disclosure training;
That the Minister of Health take into consideration how women's issues can be "better addressed, with more expertise and attention" within the health system;
The appointment of two Patient Advocates to the new HSE Board of Directors;
A single agreed terminology for the communication of results and specific criteria to define the different degrees of anomaly;
A legal duty of candor to health professionals and the groups where they work.
Nearly 13,000 documents were viewed, all key CervicalCheck people were surveyed and all the labs used here and in the US were visited as part of the survey.
After publishing his report, Dr. Scally called the treating physicians who did not disclose the smear audits to personally apologize to every woman because a letter from the HSE is far from being forthcoming. adequate.
He recounted the experience of the family of a deceased woman who had recently been notified of the smear audit.
They said they went to their disclosure meeting and the consultant repeatedly told about the deceased's smoking habits and also told them that "the nuns do not contract cervical cancer". Now, if it's not paternalism, what is it? It's almost misogyny.
Dr. Scally added, "This episode of poorly managed public disclosure has created tremendous psychological challenges and, in some cases, mental illness for women."
Mr. Teap, whose wife Irene died last year, said: "In going through this investigation, it is horrible to read, especially for me, when I see exactly how the end of Irene's life ends. .
"She did everything right. She did her smear. She put her 100% confidence in the system. She worked for the HSE for 15 years, everything dropped him.
He is committed to ensuring that the recommendations are now implemented so that no other family is going through a situation similar to the 221 victims of this scandal.
Taoiseach Leo Varadkar said that "all the suffering" suffered by those affected by the scandal should now lead to a new "culture in our health service of open disclosure, grace, openness and compassion."
Harris said, "Further injury, additional pain, additional suffering was added to women who already had cervical cancer and, in many cases, a devastating diagnosis."
Cabinet approved all of the report's recommendations yesterday – Mr. Harris will return to the government in December with a comprehensive implementation plan.
Opposition parties have insisted that the families of women who are dead or damaged by the scandal make the final decision as to whether an investigation commission is still necessary.
Fianna Fáil's leader, Micheal Martin, said it was clearly necessary to "talk to families and victims". Labor Health Spokesman Alan Kelly agreed that affected women should give their opinion on a large-scale commission of inquiry.
Varadkar plans to set up a "leak investigation" to find out who was responsible for telling the media that the Scally report warned against an investigation before the victims were informed.
What does Scally say
On open disclosure:
The current open disclosure policy and practice is deeply contradictory and unsatisfactory. Essentially, clinicians do not have to disclose.
It is not just the non-disclosure, but the hasty nature of the disclosure that took place after the publicity surrounding Vicky Phelan's trial that affected them. [the women] unfavorable.
On governance:
The governance structures of screening services are seriously flawed.
In the specific case of CervicalCheck, there was a clear deficit in governance and reporting relationships between the national filtering service and the senior HSE management structures.
This confusion complicated the reporting of problems and increased risks.
In the laboratories:
I am satisfied with the quality management processes in the current labs. All laboratories visited by the Scoping investigation team meet the regulatory requirements in force in their own country.
Side effects, other than physical, of cervical cancer:
Some women mentioned that their relationship was broken following treatment. It has also left women and families in financial trouble.
On access to medical records:
There can be no valid reason to delay women's access to their clinical notes. Women should not need to use lawyers to get a complete copy of their medical records.
On paternalism in the health service:
It has been argued that many of the major controversies surrounding ill-treatment of patients or denial of reproductive rights in the Irish health system involved damaged women.
On the need for a contribution from public health:
The time has surely come when public health physicians are given the same recognition as their clinical colleagues and their skills are deployed at the heart of all public health programs.
Comments from some of the women affected by the cervical cancer scandal and interviewed by Dr. Scally
Why does this always happen to women?
The rights of women and women are not taken seriously.
He said that he did not know the protocol.
He said that it was lost in the file.
He said that it was inadvisable not to disclose.
He had seen that I had a hysterectomy and decided that I did not need to know.
To think that I went to him over the years and that he did not say anything.
This story first appeared in the Irish Examiner.
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