Dr Tony Holohan speaking to Joe Duffy on The Meaning of Life The Meaning of Life/RTÉ
The Meaning of Life

Holohan says there is a 'very poor understanding' of what happened in CervicalCheck scandal

The former Chief Medical Officer said the “adversarial model of medical negligence” in Ireland played a major role in the controversy.

DR TONY HOLOHAN has said there is a “very poor understanding” of what happened during the CervicalCheck scandal.

The former Chief Medical Officer also said the “adversarial model of medical negligence” which exists in Ireland played a major role in the controversy.

Ireland’s cervical smear screening programme has been the centre of much controversy since 2018, when it was revealed that some women diagnosed with invasive cervical cancer were not told that their previous smear tests had been reviewed.

More crucially, the women affected were not informed that the review concluded a different action could have been taken, either for another smear test, a smear at an earlier stage, or a cytology examination.

In an interview due to air on RTÉ One tonight, Holohan said that a misunderstanding of what happened still persists to this day.

“The reality is there’s a very poor understanding of what happened in the course of CervicalCheck, even now,” Holohan said.

He noted that some social media criticism directed at him and others “suggests that there were failures to act on opportunities to prevent people’s cancers, but the reality is the CervicalCheck audit that was in question here was an audit done on people whose cancers had already been diagnosed”.

Holohan continued: “But it’s a very complex situation because you’re talking about somebody after the fact – who knows that a woman has been diagnosed – looking at a slide saying, ‘Well, I have a slight difference of view to what was reported at the time’.

“And those discordances were what was at issue, the CervicalCheck programme was to feed those back to the individual women concerned, and didn’t do that.”

Speaking to Joe Duffy on The Meaning of Life, Holohan said the women in question should have been informed of what happened, but this didn’t take place.

He said that CervicalCheck informed doctors, but the clinicians “didn’t feed that information back to the women”.

Fears over medical negligence

Holohan said the “adversarial model of medical negligence” in Ireland “creates fear on the part of clinicians” and “is at the root of a lot of failure to really apply the lessons”.

“If you’re a patient in a healthcare setting, and you’re unlucky enough to experience some kind of an adverse event, if you’re in that unfortunate situation, what you need from the doctors and nurses at that point is truth and openness.

You need people to step forward, as it were, metaphorically put their arms around you, ensure that you now get the right kinds of services, that you get truth.

“The evidence is very clear when that happens. The patients who are spoken to truthfully and openly, even when mistakes are made, significant mistakes, will work with medical teams to try to find what the best solution is for them.

“[They] don’t have recourse very often to legal solutions. And once that trust is gone, there’s no restoring it, it’s not going to be restored by any legal process.”

Holohan told Duffy he believes the CervicalCheck audit was “an honest effort to add an extra layer of quality assurance to our programme” but that it “wasn’t implemented effectively”.

Duffy asked Holohan why so many medical scandals in Ireland over the years have involved women – such as controversies related to symphysiotomy and the anti-D blood transfusion scandal.

Holohan said there is “no single explanation” but there’s “no question” that the medical profession was “perhaps too paternalistic”.

He said the healthcare system has “evolved and modernised” but at times “reflected old values, inappropriate values” that are no longer acceptable.

Holohan noted that such outdated views were not confined to the medical profession, but were also evident across other sectors of Irish society.

Citing the mistreatment of women in Magdalene laundries and mother and baby institutions, he said “you have to ask questions about the position of women in society more generally”.

In the wide-ranging interview, which will air on RTÉ One at 10.30pm, Holohan also discusses the loss of his wife Eimear to cancer, the Covid-19 pandemic, his role in drafting abortion legislation, and why he withdrew from a secondment to Trinity College after a public outcry.

Clarification: An earlier version of this article included quotes about the CervicalCheck controversy which were initially included in this episode of The Meaning of Life but were removed from the final version of the programme before it aired on RTÉ One on Sunday night. This article was updated on Monday 16 October to only include quotes which were broadcast in the episode.