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'Overly cautious' reading of smear tests would be damaging and bring an end to screening programmes

The comments come following a Supreme Court hearing into Ruth Morrissey’s High Court ruling earlier this year.

DOCTORS ARE FEELING “very nervous” after a Supreme Court hearing this week into a judgment passed during the High Court case brought by terminally-ill cancer patient Ruth Morrissey over inaccuracies in the CervicalCheck programme, a leading obstetrician has said.

The Court was hearing an appeal into a High Court decision requiring clinicians to be “absolutely certain” there are no abnormalities in a cervical smear test before clearing it.

Dr Rhona Mahony, former Master of the National Maternity Hospital, said the requirement could end up putting women in danger by forcing doctors to “practice defensively” to avoid negligence claims.

“The cost of the liability and the cost of settling the claims may well make the cost of running the programme prohibitive, and that is not good for society,” Dr Mahony told the Irish Medical Organisation (IMO) conference in Dublin on Saturday.

“Ultimately, more women will develop a cancer that could have been diagnosed at a pre-cancer stage or much earlier,” she said.

A representative of the State Claims Agency said that an “overly cautious” reading of smear tests can even lead to cervical damage, premature births and ultimately the shut down of the government’s free CervicalCheck cancer screening programme.

Excessive numbers of colposcopies and biopsies, or invasive procedures, which follow an abnormal smear test, “can leave a woman’s cervix compromised for future pregnancy” said Catherine Tarrant, head of clinical claims at the State’s Claims Agency.

“The risk of interruption to a very worthwhile and valiant service is unavoidable,” she said of CervicalCheck.

The Supreme Court heard an appeal this week by the HSE, and two labs, into last May’s High Court decision awarding €2.1 million in damages to Limerick woman Ruth Morrissey and her husband, Paul.

While the award is not in question – the state has guaranteed to pay out regardless of the outcome – doctors and legal professionals are concerned about the “absolute certainty” requirement.

It is seen as a test case following revelations last year that the labs – Quest Diagnostics Ireland Limited and US-based Medlab Pathology Limited – had misread smear tests, leading to several women developing cervical cancer – some terminally – after being told their tests were normal.

Dr Mahony said politicians and the media spread “serious misinformation” in the wake of the CervicalCheck revelations that did “real damage” to the screening programme.

She said a blanket offer of repeat smear tests caused chaos, and that widespread misunderstanding of the purpose of cancer screening undermined confidence in the CervicalCheck programme.

“What we hadn’t seen before was the political involvement and that ability to do real damage, when people come out on the airwaves and make wrong statements,” Dr Mahony said. “When we give information it has to be the correct information.”

“We had politicians, and we had all kinds of people, coming out with really serious misinformation that did nothing but make things worse,” she added.

She said the way information was communicated to patients after the story broke in the media was “deeply insensitive”.

“It was a mess, an absolute mess,” she told the conference on medical negligence, which was organised by the IMO.

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