Programmes are destined to succeed for the many but sadly cannot reach levels of perfection
To have found ourselves so far behind the NHS and 30 years behind the Nordic countries was a health policy failure. Headlines reporting six to nine months’ waiting times for a smear test were not uncommon in Ireland at the time. We had reached a critical juncture for cervical cancer screening. The position was quite simply untenable and unacceptable to the then board of the National Cancer Screening Service and its executive management team.
Opinions were expressed that a greater-than-expected number of errors would occur as a result of the contract award to a non-Irish laboratory. In a democratic society, opinions, debate and discussion should be welcomed but, ultimately, there can be only one fact-based truth. We now have the benefit of real data.
It is an indisputable fact that irrespective of where the laboratory is – be it Ireland, the United States or elsewhere – screening will always fail some individuals for the simple reason that screening is not a diagnostic test and can only prevent approximately 70 per cent of cervical cancers. Every single laboratory in Ireland that has ever provided cytology services has been the subject of litigation. Every single one.
The added difficulty and the many nuances of trying to attribute errors to negligence is captured succinctly in a judgment delivered by former Supreme Court Justice Frank Clarke in May 2020 when he stated “even screening processes which operate at the very highest standards can give rise to different results by competent screeners.
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