Final CervicalCheck report to be ‘full and frank’ on reforms left undone - investigator

The final report from the Government-appointed investigator into the CervicalCheck scandal, due in the coming weeks, will be “full and frank” on reforms left undone, he said.

Public health specialist Dr Gabriel Scally said he would report to Minister for Health Stephen Donnelly in the next couple of weeks on the remaining recommendations to be implemented from his damning 2018 report stemming from the legal case taken by Vicky Phelan who died on Monday.

Ms Phelan, the cervical cancer campaigner and public advocacy champion, died on Monday at a care hospice near her home in Co Limerick at the age of 48.

It is with an immense burden of grief that earlier today we bade our final farewell to our beloved Vicky

—  Vicky Phelan's husband, Jim

The Kilkenny woman’s 2018 High Court action and refusal to be silenced with a confidentiality clause in a €2.5 million settlement around the misreading of past smear test results led to dozens of other women diagnosed with cervical cancer discovering that earlier screenings could have been interpreted differently.

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Dr Scally’s review is likely to find that while many of his original reform recommendations have been implemented, significant work needs to be done in areas such as mandatory disclosure and the handling of patient concerns.

Despite Ms Phelan’s repeated calls for greater transparency and the controversy that flowed from her landmark High Court settlement, proposals to give effect to a system of mandatory open disclosure of medical mishaps have yet to be passed by legislators.

The Patient Safety (Notifiable Patient Safety Incidents) Bill, which provides for mandatory open disclosure, passed first stage in the Dáil in 2019 but has yet to complete its passage through the Oireachtas.

In 2019, Dr Scally said the State’s “deeply flawed” policy on disclosure remained in place. Under open disclosure, medics are required to give patients and families clear information when something goes wrong in their healthcare.

Minister for Health Stephen Donnelly has warned that the new legislation must not create a “culture of fear” among staff.

Opposition parties have called on the Government to move to enact legislation that would provide for mandatory open disclosure.

Sinn Féin health spokesman David Cullinane said the delayed Bill “needs to expedited” and it was “vital” that Dr Scally’s recommendations on open disclosure were implemented and acted upon.

A spokesman for Mr Donnelly said it was intended to take the Bill to the final stage in the Dáil as soon as a final draft of amendments was completed.

Through her tireless efforts, despite the terrible personal toll she herself had to carry, so many women’s lives have been protected into the future

—  President Michael D Higgins

Ms Phelan became a household name and respected public figure in her push for health reforms.

While living with a terminal cancer diagnosis for more than four years, she campaigned for an investigation into CervicalCheck screening programme, improved healthcare for women, sanctions for non-disclosure and for access to the Pembrolizumab immunotherapy drug to treat advanced cervical cancer.

President Michael D Higgins led the tributes to Ms Phelan, saying she made “an enormous contribution to Irish society” and that through her “tireless efforts, despite the terrible personal toll she herself had to carry”, so many women’s lives have been protected into the future.

He said that anyone who had the privilege of meeting her was struck not just by her “powerful inner strength and dignity” but also “with the sense of commitment to the public good and the rights of others with which she campaigned”, he said.

Taoiseach Micheál Martin paid tribute to Ms Phelan, calling her a woman of “extraordinary courage and integrity”.

He said she “ensured the embedding of the principle of full public disclosure in the area of public health” and that she “stood up for the public interest”.

“She was an outstanding advocate for women across this country and across the globe. Vicky always gave selflessly of her time to help others, even though she was going through severe illness herself,” he said.

Tánaiste Leo Varadkar said Ireland had “lost a woman of limitless courage, compassion and strength” and described her as a “shining example of the power of the human spirit”.

Ms Phelan’s husband, Jim, paid tribute to his wife, saying her death would leave a void in their lives that “at this point seems impossible to fill”.

“It is with an immense burden of grief that earlier today we bade our final farewell to our beloved Vicky,” he said in a statement he and his children, Amelia and Darragh, released.

“She was the heart and soul of our family unit and her passing will leave a void in all our lives, that at this point seems impossible to fill.”

He said the family cherished “the memories of a loving wife, mother, daughter and sister whose ability to deal with the struggles of life has inspired not only ourselves but an entire nation. The outpouring of grief and good wishes from far and wide are truly appreciated.”

He said the funeral would be private but there would be “an opportunity for people to pay their respects in due course”.

Cervical cancer screening is in a better place because of her

—  Dr Gabriel Scally

Members of the 221+ cervical cancer support group which Ms Phelan cofounded said she “raised her voice in 2018 because she wanted those in power, those with responsibility to learn from their mistakes”.

Paying tribute to Ms Phelan, Dr Scally said in the decades to come, her contribution would be recognised “as having changed the landscape completely in healthcare in Ireland”.

“The big thing she was interested in was people being dealt with honestly and openly and having access to their own information and being told the truth, particularly when things go wrong in healthcare and that they should be treated properly,” he told The Irish Times.

Dr Scally said cervical cancer screening was “in a better place because of her”.

Tipperary-based solicitor Cian O’Carroll, who represented the Kilkenny woman in her landmark 2018 legal action, said Ms Phelan “put truth and honesty above everything else”.

“She was such a force for good and such a force for saying that truth and honesty is important and we need that reminder every so often,” he said.

The mother of two took High Court proceedings against a US laboratory after it emerged her 2011 smear test, which showed no abnormalities, was found during a 2014 audit of smear tests on a number of women to be incorrect. She learned of the audit only in 2017, three years after she received her cancer diagnosis. She was told her cancer was incurable later that year.

In her High Court case, she described her anger after learning of the 2014 audit.

“I was in shock when I was told. I am angry, extremely angry. If I was diagnosed, I probably would have had to have a procedure and at worse a hysterectomy,” she said.

“If I was told sooner, I would not be in a position of terminal cancer diagnosis.”

Dr Scally’s review identified at least 221 women diagnosed with cervical cancer who were not previously told about misreported smear tests and who could have been alerted to the early stages of cancer.

The process of reviewing the slides of women diagnosed with cervical cancer has yet to resume after auditing was stopped at the height of the 2018 controversy.

The HSE said it was working to design a new patient review process “for how we perform and disclose look-back information to patients who develop an interval cancer”.

Mr O’Carroll, who represented other women caught up in the controversy, estimated that up to 1,500 women have not had their smear tests audited due to the cancellation of further audits, including a number of women with a prior history of cervical cancer screening.

This contrasts with the pledges around open disclosure and protecting women, he said.

During her treatment for cancer in Ireland and the US, Ms Phelan used her social media channels to inform the public about her battle with the disease.

In October 2021 she announced that she had returned from treatment at Georgetown University Hospital in Washington DC to receive palliative chemotherapy at home.

She died in Milford Care Centre in Co Limerick in the early hours of Monday morning with her husband Jim and two children Amelia (16) and Darragh (10) by her side.