Analysis: Reaction key after Wexford cancer setback

Mistakes are inevitable in any health service, but there is good reason for public concern over the size of the controversy around missed cancer diagnoses at Wexford General Hospital.

In all, 13 cases of bowel cancer went undetected for up to two years because of alleged shortcomings in the work of a single doctor at the hospital.

This is a tragedy for the families concerned, but what matters for the wider public and for the future is how the system reacts when something like this happens.

How quickly did the hospital respond when the problem was flagged initially? How well did it communicate with patients? What actions did it take to improve matters? And can it be sure the problem won’t happen again?

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Reassuring

On these points, it is reassuring to find from the review into the controversy that the doctor ceased performing BowelScreen colonoscopies in November 2014, a month after the first two problematic cases were identified.

After successive re-examination of cases pointed to further missed cancers, he stood down from all colonoscopy work in February 2015.

The review published yesterday says there was a cumulative series of “minor delays” during this period of looking back at previous work.

It says there were “critical junctures” during this process when a different approach might have worked faster but goes on to add, somewhat contradictorily, that “the cohort affected was identified in a timely manner and the recall was not unduly delayed”.

This was the first time the policy of open disclosure was applied within the health service to such a wide-ranging review. Patients were informed of the decision to review previous tests and the response planned by the hospital. The inevitable downside of this welcome transparency was the leaking of details of the investigation over the past two years.

Early pick-up

The affair highlights the need for up-to-date statistics so abnormal results can be picked up early. It also shows the need for every doctor, however experienced, to have someone looking over their shoulder as a second opinion. The fact that all colonoscopies in Wexford are now double-checked is welcome.

The two years it has taken to complete the review has been hard on the affected families, but most of this delay is due to human resources and legal issues rather than the process of sorting out what happened medically.

The doctor, known as “Clinician Y”, remains on leave while disciplinary processes are considered. He is likely to remain on full pay for some time before a resolution is found.

It would be a shame if the Wexford controversy were to cause long-term harm to the BowelScreen programme, which has led to the identification of 500 cancers since it started in 2013.