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When sorry is the hardest word

In addition to failures at timeously communicating with patients and with GPs, the failure to apologise to GPs also stood out to Lloyd Mudiwa

“No support for GPs who are the first port of call for worried women. Not good enough. Should there not be a helpline­/point of contact for GP practices on how to manage patient’s concerns?”, reads a tweet sent out by the woman at the centre of the CervicalCheck screening scandal, Vicky Phelan, on May 1 at 4:31pm.

This follows revelations almost a week earlier that CervicalCheck issued a circular in July 2016 that gave doctors discretion whether or not to inform women misdiagnosed after a cervical check.

The tweet, which had received 58 retweets and 128 likes at the time of going to press, also attracted reactions and comments from GPs that were also retweeted.
Directing her query to the Minister for Health Simon Harris, single-handed Limerick GP Nicola Stapleton responded: “I can confirm I also have gotten zero communication from CervicalCheck or the Health Service Executive [HSE] regarding this. Why are GPs (who provide this service and are the first port of call for worried patients) not being contacted?”

Yet another GP, this time GP Lead for Antibiotic Resistance Irish College of General Practitioners (ICGP) Dr Nuala O’Connor, chipped in: “Over the years, my first know­ledge of major health issues has been Morning Ireland. Our practice fielding calls all day from worried patients. Zero direct communication to GPs from the Department of Health, HSE or CervicalCheck.”

It was not until the following day (May 2), that the HSE via Dr Peter McKenna, Clinical Director, National Women and Infants’ Health Programme, and Dr Jerome Coffey, Director, National Cancer Control Programme, wrote to all GPs and smeartakers contracted to the National Cervical Screening Programme, with an update on the evolving situation around the cervical screening programme and its recent audit process.

“We would also specifically like to seek the support of you and your teams in helping women to allay concerns caused by the way this issue has been communicated and how it may be resolved over the coming weeks. As we hope you are aware, the HSE and the Cervical­Check programme have reiterated their deepest apologies to women for any worry caused by this ongoing situation,” states the letter.

“The HSE is keen to provide reassurance to women who may be affected, and to those involved in their care and from who they may seek advice and support. With this in mind, we have outlined below an overview of what has happened to date and advice for both healthcare workers and women.

“I hope this update has been useful to you, and I and our wider team are extremely appreciative of any support that you can offer women affected by this very regrettable situation.”

While this letter is to be commended for expressing the HSE’s “deepest apologies” to women for any worry caused by this ongoing situation and comprehensively providing an update and outlining how GPs ought to manage patients’ concerns, this was long after the ICGP’s call for clarity on CervicalCheck services had highlighted that GPs at the frontline were immediately inundated with concerns from anxious patients on the management of their screening test results.

“We need clarity as a matter of urgency and will ensure this is communicated to the members of the College,” the College had urged.

It was aware that many GPs were concerned about the impact of the developments regarding the services of the national cervical cancer screening service.

“The ICGP wishes to acknowledge the stress to patients following the revelations of the breakdown in the management of test results by CervicalCheck,” the College also stated.

It added that it would liaise with CervicalCheck and the HSE regarding the failings on their side and how this was to be managed.

“This is yet another crisis in our healthcare system that places increased pressure on GPs who are already stretched beyond capacity.

“The ICGP supports screening for prevention of cancers, and encourages all patients who have been called for screening to attend,” the training and professional body had said.

What the HSE letter, however, failed to do was to apologise to GPs for leaving them in the unenviable position of dealing with the fallout from the scandal that they knew nothing about, and unsupported at that.

After all, expressing regret is simply good manners — not to mention a low-cost way of curtailing blame from the people we’ve upset.

lloyd.mudiwa@imt.ie

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