The cervical cancer scandals in England and Ireland, explained

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Moya Crockett
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Two parallel cervical cancer scandals are currently engulfing health services in England and Ireland. Read on for a breakdown of everything you need to know about the issue. 

First things first: what’s going on in Ireland? 

It has been confirmed that 18 women died after being given incorrect smear test results by CervicalCheck, Ireland’s national cervical cancer screening programme.

More than 200 women developed cervical cancer in Ireland after receiving ‘false negative’ smear test results, which showed – incorrectly – that they had no abnormal cervical cells.

These inaccurate results could mean they missed out on earlier and potentially life-saving medical intervention.

How was this scandal uncovered?

Vicky Phelan (right) with Stephen Teap, whose late wife Irene was also given a false negative reading after a smear test 

In April, Vicky Phelan took the Irish Health Service Executive (HSE) to the Irish High Court.

Phelan, a 43-year-old mother of two from Limerick, had a smear test in 2011 which showed no abnormalities. However, a retrospective audit in 2014 revealed that she had been given a false negative result.

This information was relayed to Phelan’s doctor in 2016, but she was not informed for 15 months. By that point, she had been diagnosed with terminal cancer.

Phelan also sued Clinical Pathology Laboratories, the US laboratory which had been responsible for analysing CervicalCheck tests. She settled her case for €2.5million (£2.2m).

“The misdiagnosis in my case has cost me my life,” Phelan said on 16 May. “I’ve got terminal cancer.” 

What has happened since this information was made public? 

Irish Taoiseach Leo Varadkar apologises to women affected by the cervical cancer scandal at a press conference on 11 May 

It emerged that almost 1,500 women in Ireland also had their smear test results audited without their knowledge in 2014. That audit revealed 209 women like Phelan, who were told that their test showed no abnormalities when they should have been given a potential cancer warning. None of these women were informed at the time that their smear test had shown a false negative result.

The HSE says it has made contact with 205 women and families known to have been affected by misread smear test results. One such person was Stephen Teap, who was phoned at the beginning of May and informed that his late wife Irene - who died in July 2017 - had been twice given false negative results. Teap said the way the HSE broke the “devastating” news to him was “insensitive” and “lacked respect”.

Four women and/or their families have yet to be told that their results were included in the audit. 

Tony O’Brien, the former head of the HSE, resigned two days after the inquiry was opened. He was replaced by John Connaghan, who described the failure to communicate with women affected as something that “has ultimately impacted on every female in Ireland, their families, their spouses and their children”. 

What will happen next?

Cervical cancer cells under a microscope 

The Irish government launched an inquiry into the scandal earlier this month, to examine the outsourcing of cervical cancer services to laboratories in the US and establish why CervicalCheck failed to tell women what the audits of their smear tests had discovered.

The inquiry also aims to discover how much the HSE and the Irish Department of Health knew about the audit. Its findings are expected to be reported in June. 

The Irish Taoiseach (Prime Minister), Leo Varadkar, has said that his government is “acting as quickly as we can to get on top of this issue”.

According to Varadkar, the Irish government has four main priorities: helping women who have been affected, getting the facts through the inquiry, holding people to account, and restoring confidence in cancer screenings.

And what’s going on in England?

Dozens of women in England were not invited to smear tests 

On 17 May, it was revealed that almost 90 women in England had been incorrectly informed that they were no longer required to have smear tests.

An investigation by the National Audit Office (NAO) found that 87 women were wrongly told they were no longer part of the cervical screening programme after certain NHS England services were outsourced to a private company in 2015.

Fortunately, no actual harm was identified as a result of these mistakes. 

Why did this happen? 

Some services at GPs surgeries were outsourced to a private company 

NHS England agreed a seven-year deal with a company called Capita three years ago, appointing it to run some services for care providers such as GPs, dentists and pharmacists.

It was hoped that this deal would cut NHS costs by 35%. However, the NAO investigation has shown that outsourcing the work led to services that were “a long way below an acceptable standard”.

Around 1,000 GPs, dentists, pharmacists and opticians had their work with patients disrupted as a result of Capita being brought on board, meaning that some patients were put at risk of “serious harm”. 

What will happen next? 

The NAO’s report recommends that NHS England consider whether it is really worth outsourcing its services to Capita, given that the company has failed to meet expected standards of service delivery.

Amyas Morse, the head of the NAO, said that the services may be better delivered in-house, observing: “Value for money is about more than just cost reduction.”

Around 3,000 cases of cervical cancer are diagnosed in the UK each year. Women over the age of 25 are invited to attend a cervical screening – otherwise known as a smear test – every three years until their 50th birthday.

Got a question about smear tests? Read our Q&A with a gynaecologist here.

Images: Getty Images / iStock