Latest CervicalCheck controversy a communications failure

A doctor writes: Contact GP if you’re worried about a recent test, says Muris Houston

‘Concern with the latest CervicalCheck problem is what it says about open disclosure. Photograph: Getty

‘Concern with the latest CervicalCheck problem is what it says about open disclosure. Photograph: Getty


What’s the latest problem with CervicalCheck?

It’s primarily a problem (yet again) of failed communication. A computer glitch at a Quest Diagnostics laboratory in the US meant that some 800 cervical cancer screening results were not communicated electronically.

It appears it was agreed in February with the HSE that the results would be sent out manually by the laboratory. But they were only to be sent to the women’s GPs. The women were not to be notified, as would normally be the case. And then, it appears, the letters to the GPs were not sent. The HSE only became aware of this at the beginning of the month.

While technical problems may beset any computerised system, the concern with the latest CervicalCheck problem is what it says about open disclosure. In his report into the debacle, Dr Gabriel Scally described existing policy and practice in relation to open disclosure as “deeply contradictory and unsatisfactory”.

We were told by HSE officials, Department of Health mandarins and senior Government figures that the withholding of results from patients was wrong and that a bulletproof system of open disclosure would be put in place. So the really worrying aspect of the latest development is not a computer failure in an outside screening laboratory; it is the failure to contact the 800 women directly to tell them a problem had arisen and what was being done about it. And ultimately it suggests that the import of the original scandal has not permeated through the HSE to the extent that not communicating promptly with patients should now be reflexively seen as a red flag issue.

If I’m worried about a recent test what should I do?

Contact your GP in the first instance. While smear results used to be available some six weeks after the test, the ongoing backlog from the retesting of women means that 14- to 18-week waits are not uncommon.

If your result does not emerge in that extended time frame then it is important that you follow the issue up directly with CervicalCheck. Crucially, never, ever assume that “no news is good news”. There is a huge learning point from the commendable actions of Sharon, the women who exposed the latest problem, for any of us having any kind of medical test performed: always chase up and ask for a detailed result.

My GP says the test did not show up an abnormality but couldn’t say with 100% certainty I was clear. Why is this?

First, no test in medicine is 100 per cent accurate. There will always be falsely positive and falsely negative results. Also cervical screening is not a diagnostic test for cancer; it is a screening test to determine whether you need to be referred for a diagnostic test. Your GP’s response may also reflect their doubt as to whether all of CervicalCheck’s problems have been fully addressed.

Can women have confidence in CervicalCheck now?

In his latest report Dr Scally once again said he is not concerned about the quality of the clinical aspects of the national screening programme. Women should continue to attend for screening and have faith in this aspect of CervicalCheck. Whether it is possible to have full confidence in the HSE -controlled administrative aspects of the programme remains an open question.