The state versus women

The last few weeks have seen the southern state rocked by the cervical smear scandal and a shameful lack of individual and institutional accountability for this. It’s a story that only emerged as a result of the determination of terminally ill Vicky Phelan to stand up for truth and transparency. In April Vicky refused to collude in the cover up by rejecting a demand that she sign a confidentiality agreement as part of the settlement between her and a US Laboratory, Clinical Pathology Laboratories Inc. The laboratory was responsible for giving her the all clear from a 2011 smear test.

Three years after her test and the all clear she was diagnosed with cervical cancer. It was another three years before Vicky Phelan learned that her original smear result had been wrong.

Her refusal to acquiesce to the demand that she remain silent was key to lifting the lid on this scandal. In the weeks since almost every day has brought new information and new victims to light.

Several hundred women were wrongly given the all clear. Despite an audit of cervical smear tests which brought this information to light most the women affected – 162 – were not told that their results were incorrect. 18 of these women are dead and 15 died without ever knowing that their original all-clear smear results were wrong.

Stephen Teap’s wife Irene was diagnosed with cervical cancer in 2015, and died two years later. Last week Stephen was told by the Health Service Executive (HSE) that she had been given two inaccurate smear test results. The first in 2010. The second in 2013.

Emma Mhic Mhathúna’s desperately sad and emotional interview on RTE’s Morning Ireland programme last Thursday morning shocked everyone who heard it. A mother of five from Kerry Emma told how she had been given the all clear in 2013 after a smear test. Three years later she was diagnosed with cervical cancer and last week she was told that she is going to die. She said: “If my smear test was right in 2013 I wouldn’t be where I am today. That’s what makes it so heartbreaking. I’m dying while I don’t need to die. My children are going to be without me and I’m going to be without them… I don’t even know if my little baby is going to remember me.”

At the weekend Paul Reck revealed that his wife Catherine was one of the 209 women who had not been told that their all-clear results were wrong. Catherine had had a smear test done in November 2010 and was subsequently told that it showed low grade cell abnormalities. A year later she was diagnosed with cervical cancer and died in April 2012. Last Thursday Paul was told by Tallaght hospital that the smear test result was wrong.

On its own the cervical cancer smear test scandal is bad. It reveals much about the poor state of the health system in the south and the desire of those in senior positions to cover-up mistakes, incompetence and bad decisions. It reveals a government failing its citizens and especially our most vulnerable patients.

But it also says much about the very nature of the southern state. Over recent years and decades there have been a succession of scandals that have for a time captured the headlines and shocked society. The revelations about the ill-treatment of children in the industrial schools, the horrifying extent of clerical child abuse, the disgraceful mistreatment of women in the Magdalene Laundries, the butchery of symphysiotomy, the death of Savita Halappanavar, the mother and baby homes, the arrogance of a state that forced Louise O’Keefe to go through the trauma of an endless court battle and many more.

Cover-up, the deliberate use of misinformation and concealment, incompetence and lies have been the norm in the Irish state’s response to scandals that have emerged.

In the 1990’s over a thousand people, mainly women, were infected with contaminated blood products. The Blood Transfusion Service Board were told this but failed to tell those who had received the products. A report published three years ago revealed that at least 260 people who were infected with Hepatitis C from these blood products, had died in the 20 years since the facts first emerged.

One of those to die was Brigid McCole. As well as fighting for her life Brigid was forced to contest a long legal battle, which only ended several days before she died when the state finally agreed compensation. Over one billion euro has since been paid in compensation to the victims of Hepatitis C.

Another victim of the state’s strategy of forcing victims into lengthy legal ordeals is Louise O’Keefe. She was the victim of child abuse at a school in West Cork. In January 2014, after a fifteen year legal battle with the Department of Education the European Court of Justice ordered the Irish government to pay Louise compensation for the abuse she had endured as a pupil.

Shortly after I was elected as a TD for Louth and East Meath I met with several elderly women who came to see me to explain about symphysiotomy and about what had been done to them. I had never heard of symphysiotomy, but from them I learned that it involves severing the cartilage that connects the symphysis pubis with a scalpel under local anaesthesia, followed by unhinging of the pelvic bones to the extent needed for the delivery of a baby.

I was deeply moved by their stories of pain and abuse and overwhelmed by their courage and resilience. Many of them were never asked if they wanted the procedure and endured decades of distress afterward. Almost all are now in the eighties. Once again the government had to be dragged into agreeing a redress scheme which has so far paid out almost €34 million in compensation. Some women refused to participate in the government sponsored scheme and continue to seek redress through the courts.

In all of these and other instances there are two common threads. In almost every case the victims were women. And in almost every case the Irish state refused to treat the victims humanely and compassionately, forced them into court and spent millions fighting court cases despite knowing that they were in the wrong. One media report in recent days quotes Caoimhe Haughey, a solicitor who represents victims of medical negligence saying: “My experience of dealing with these cases is that is it a nightmare. Everything is fought tooth and nail”.

This has to change. So too must the denial of information to victims and families. As Health Minister, Leo Varadkar promised to introduce mandatory disclosure for health professionals but, following advice from the Chief Medical Officer, he decided not to proceed. Sinn Féin brought forward a Dáil motion this week calling on the government to legislate for mandatory disclosure before the summer recess. The onus is now very much on the government to right these past wrongs.