Leak of Scally Report

Conan

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Lots of media reporting outrage at the leak of some elements of the Scally report before some of the impacted women were consulted. Blame being thrown around between the Minister, the Dept of Health etc etc. As usual SF, FF etc criticizing the leak and going on RTE but not being critical of the media for publishing the sensitive information before the Report is released tomorrow and the women were consulted.
But if there is annoyance/anger at leaking some elements of the Report, do the media not bear some of the blame for publishing the information they were given. Why did the the media, including RTE, publish this information whilst at the same time being critical of the leaker (whoever this was).
The media report the outrage at the leak whilst at the same time they publish the leaked information. Hypocrisy???
 
I saw politicians wringing their hands about this... on rte!

The public interest is not served by this.

But we know rte doesnt care about the truth or decency. Just the scoop.
 
The first thing that came into my mind was the The Government putt out a feeler to see if the would get away without having a commission of Inquiry did you notice this was they only part leaked,
 
This whole issue has been badly handled by many parties but particularly the media. There has been a fundamental misrepresentation of what a smear test is and what it tells you. I can't believe that journalists reporting on this didn't know the details beforehand, or upon their own research (5 minutes on Google), after the story broke. Yet the reporting suggested that there was a binary yes/no result after the test and a) the labs misread the results and b) the details of false negatives were reported to doctors after an audit but the doctors didn't tell the women involved. "b" is probably true in most or all cases but there is no evidence yet to suggest that "a" is true.
I have heard women being very angry about this (rightly) while at the same time not getting their daughtered vaccinated against HPV, the number one cause of cervical cancer.
The Minister for Health cannot be held responsible for the failure to communicate the test results to the women concerned; that would be ridiculous, he didn't and couldn't have known about it, but he certainly can be blamed for panicking and, along with the Taoiseach (a doctor), for failing utterly to get in front of the issue and communicate in a calm and clear manner.
The opposition, and the Shinners in particular, are guilty of lying and misdirecting in order to create political capital and the consequences, and the truth, and the women involved be damned.
Funny how our expectations of the HSE are so low that they have hardly come in for criticism.

This is a case study in incompetence by all concerned.
 
This whole issue has been badly handled by many parties but particularly the media. There has been a fundamental misrepresentation of what a smear test is and what it tells you. I can't believe that journalists reporting on this didn't know the details beforehand, or upon their own research (5 minutes on Google), after the story broke.

Fully agree. This morning, Shane Colman interviewed the health correspondent of the Sunday Business Post, Susan Mitchell, and they were both critical of the way it has been reported and politicised.(Newstalk Breakfast at around 7.10 )

It seems that the labs who do the work now want the government to indemnify them for legal claims arising from false negatives. Their insurance covers negligence claims, but they can't be insured for bizarre claims of false negatives.

Brendan
 
I missed that Brendan (I think I was ironing my daughters school uniform then).
 
It seems that the labs who do the work now want the government to indemnify them for legal claims arising from false negatives. Their insurance covers negligence claims, but they can't be insured for bizarre claims of false negatives.
This indemnity that those Labs are seeking could and should be a deal breaker. With the litigious nature of Irish people, pushed by the untouchable legal industry, the costs of this could be unimaginable.

There was a Consultant on the radio over the weekend who discussed what smear's were like before the current screening programme started - it used to take up to 12 months to get the results back from the State labs, and that when there was only a fraction of the tests there are now
 
So some details of the Scally report were leaked to the Press. It is not right that this should have happened. One of the people central to the subject was "upset" and the other had to cancel spending the day with her children. I feel for both. But, are these leaks worth making a sacred cow of gigantic proportion? Positive action is what is required after the report. The leaks are just side shows which we can do without. What is vital here is that the recommendations of the report should be implemented asap. Let's not lose sight of the recommendations.

Enter the bandwagon jumpers i.e. our politicians, baying for political gain because of the leaks. The only concern they have is for themselves and survival through the next general election. These same people when they ask Parliamentary Questions in the Dáil have the written answer in front of them at least two weeks before they ask the PQ. This is the way our system works. I am not saying it is right; I'm merely pointing out a fact.

Fresh news is a commodity on which the Press can make money. These are not the first leaks and won't be the last. But, I would ask our politicians to forget side issues and maintain full concentration on carrying through the Scally Report recommendations. Is this too much to ask?
 
No test is 100% accurate but the problem here isn't the labs but the HSE process around it which seems to assume it is.
It is an indirect screening test, not a direct diagnostic test, it is checking for cell changes not cancer cells.

They need to be clearer to the people taking the test that at least 1 in 10 of tests will be a 'false negative', i.e. missed an actual cancer.
http://www.thejournal.ie/smear-tests-hse-3990242-May2018/
 
So some details of the Scally report were leaked to the Press. It is not right that this should have happened. One of the people central to the subject was "upset" and the other had to cancel spending the day with her children. I feel for both. But, are these leaks worth making a sacred cow of gigantic proportion? Positive action is what is required after the report. The leaks are just side shows which we can do without. What is vital here is that the recommendations of the report should be implemented asap. Let's not lose sight of the recommendations.

I don't have confidence that an organisation which can't even handle the release of this report correctly will be capable of acting upon its recommendations. The behaviour that is being criticised in the report is being perpetuated through the leaks.

This is what Scally wrote about the scandal:
In my view, the manner in which they were eventually told of their situation in many cases varied from unsatisfactory and inappropriate, to damaging, hurtful and offensive.

I would say the same about the leak. It's not a sideshow, it is the show.
 
No test is 100% accurate but the problem here isn't the labs but the HSE process around it which seems to assume it is.
It is an indirect screening test, not a direct diagnostic test, it is checking for cell changes not cancer cells.
They need to be clearer to the people taking the test that at least 1 in 10 of tests will be a 'false negative', i.e. missed an actual cancer.

Fair enough with the false negative results - but there are a number of people reported in the media who encountered multiple false negatives. The odds of this reduce pretty quickly, and in a number of the cases, the laboratories have paid compensation. They did not do this out of kindness - clearly there was something wrong in their procedures.

I would say the same about the leak. It's not a sideshow, it is the show
Absolutely agree with this. The big issue here is the way it was handled and the focus on the reputation of the programme over peoples health. The harsh reality is that the screening programme and the consultants/doctors etc are accessing patients data for the patient. The patient owns the data and has an absolute right to be made immediately aware if they have been told incorrect information. Otherwise why bother give the patient the results at all. No programme/consultant/doctor has the right to hide someones personal or medical information from them for any reason.
This is the crux of the issue here, along with how they were eventually told when the 'game was up'.

Fresh news is a commodity on which the Press can make money. These are not the first leaks and won't be the last.
The government could always make it illegal to publish state information which was leaked prior to formal publication, and have a legal responsibility to report any leak they are aware of to the gardai.
 
What’s amusing (hypocritical) is the media reporting of the outrage at the leak which the media published. And of course we should not be surprised that certain politicians could equally not resist the opportunity to pontificate on the leak yesterday but seemingly row back today on the need for a Tribunal .
 
No test is 100% accurate but the problem here isn't the labs but the HSE process around it which seems to assume it is.
It is an indirect screening test, not a direct diagnostic test, it is checking for cell changes not cancer cells.

They need to be clearer to the people taking the test that at least 1 in 10 of tests will be a 'false negative', i.e. missed an actual cancer.
http://www.thejournal.ie/smear-tests-hse-3990242-May2018/
My understanding is that 20 out of every 100 tests are false negatives and 5 of those 20 will be a cancer diagnosis. The reason it is 5 in 20 is that, as you pointed out, the smear tests looks for abnormal cells which can be a sign of cancer. In one in four of the incidents where abnormal cells are present it is as a result of cancer.
The HPV test reduces that level of false negatives significantly.
If women are not clear on what the test is and all of the details around it that is 100% the fault of their GP.



I still don't know what the exact sequence of events was, who was told what and when.
There was an audit but who initiated it and who carried it out?
There were results from the audit which we know about who who specifically was told and who decided how that information was handled?
In other words who didn't tell the women involved?
Was it the people who did the audit?
Was it the Management of the HSE?
Was it the individual GP's?
 
The arrogant doctor stereotype is re-inforced by some cartoon villain type behaviour reported - doctors shushing people out of rooms, giving gallic shrugs, telling them "what difference does it make". I think a 'hairdryer' appointment with the fitness to practice committee is the least that should be coming the way of these folks. I'd be on for public floggings, but that's my solution to lots of stuff......

Is basic compassion and manners beyond these people??...mind boggles.:confused:
 
They need to be clearer to the people taking the test that at least 1 in 10 of tests will be a 'false negative', i.e. missed an actual cancer.
http://www.thejournal.ie/smear-tests-hse-3990242-May2018/
As Scally himself says, we need to be very careful in interpreting these figures.
“Scally” said:
This review found that for every 1000 women screened, around 20 women
will have precancerous changes. The HPV test will correctly identify 18 of
these women (but will miss 2 women). The Pap test will identify 15 of the
women (but will miss 5 women). The women who are missed could develop
cervical cancer.

For every 1000 women screened, there will be 980 women who will not
have precancerous changes. The HPV test will correctly identify 881
women (but 99 women will be incorrectly told that they have a lesion). The
Pap test will correctly identify 885 women (but 95 will be incorrectly told that
they have a lesion). Women who are incorrectly told that they have a lesion
may have their cervix examined or may receive surgery unnecessarily.
I think the Pap test is what has been used up to now. Out of 1,000 tests 5 are a false negative, that is a 0.5% chance not 10%. Interestingly almost 10% get false positives, which presumably get mostly sorted out after further investigation.

I skip read Scally and my read is that the big scandal is that women were not told that the test was found to be incorrect after the audit. But if they had been told it would not have made a jot of difference to their treatment though of course it would be very relevant for any potential financial claim. Of course this latter is important but I sense that some in the general public believe the far more serious accusation that the non disclosure meant they did not get the correct medical treatment.
 
They need to be clearer to the people taking the test that at least 1 in 10 of tests will be a 'false negative', i.e. missed an actual cancer.
http://www.thejournal.ie/smear-tests-hse-3990242-May2018/

Fair enough with the false negative results - but there are a number of people reported in the media who encountered multiple false negatives. The odds of this reduce pretty quickly,

If the 1 in 10 false negative result is correct. The chances of 2 false negatives, (for the same woman, in an independent test) is 1 in 100 and 3 false negatives, 1 in a thousand.

So if 100,000 women were tested 3 times each, you would expect 100 to receive 3 false negatives. So "the odds of this reduce pretty quickly" is not correct a national level, though of course for the individual they do.

If women are not clear on what the test is and all of the details around it that is 100% the fault of their GP.

The average GP does not themselves understand much statistics, how could they explain to their patients.

some in the general public believe the far more serious accusation that the non disclosure meant they did not get the correct medical treatment.

Was that not the case. Certainly the media coverage I have seen gave the impression that women are dying.
 
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Was that not the case. Certainly the media coverage I have seen gave the impression that women are dying.
That is a fairly ignorant retort and not like you cremeegg.
Scally fairly tears shreds out of CC for “non-disclosure” of the results of the audit. Disclosure would have had no impact on treatment. In fact there was extensive disclosure to the affected women’s clinicians but left to them whether to pass on the information. Information which on the one hand would have been very distressing but on the other might point to a possible financial claim.
I think you should also brush up on your statistics or at least reach Scally. The audit picks up false negatives with the benefit of hindsight, i.e. knowing the disease subsequently happened. If originally the false negative had been tested again it would likely again be negative for it was due to lack of clarity, not downright ineptitude.
Unfortunately your ignorance is all to common and partly due to very careless and ill informed media coverage.
 
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That is a fairly ignorant retort and not like you cremeegg.

I think we may be at cross purposes here.

I do not understand what exactly has happened.

Were there not women whose cancer treatment was delayed because of non-disclosure. If not why did the courts make large awards.
 
I think we may be at cross purposes here.

I do not understand what exactly has happened.

Were there not women whose cancer treatment was delayed because of non-disclosure. If not why did the courts make large awards.
No! No! No! I thought that until I read Scally. I like you just heard a media thunderous outcry and felt cover ups must have been responsible for, say, Vicky Phelan’s claim. Think of it, the non disclosure arose from the audit of the screening of those women who had actually contracted the disease so it turned up no new medical evidence.
Now Scally does not go into detail on that claim but further investigation and indeed Vicky herself on Ray D’Arcy points out that the original false negative was patently gross negligence on the part of CC’s sub contractor’s subcontractor.
That was the whole basis of the claim, nothing to do with non-disclosure.
And yet non-disclosure has become almost the bigger part of this scandal. For example it has been suggested that CC felt that if disclosure was delayed the chance of a claim might literally die. Though Scally clears CC of such a cover up strategy.
 
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