Dept withheld Portlaoise info from PQ

[Posted: Thu 01/05/2008 by Niall Hunter, Editor www.irishhealth.com]

Department of Health officials decided to withhold vital new information on a separate ultrasound review of women patients at Portlaoise General Hospital from a parliamentary question response by Health Minister Mary Harney last November, the day before it was announced that around 100 women who had had ultrasounds would have to be re-checked.

irishhealth.com has learned that Department officials decided to exclude information it had received from the HSE on November 21 last on an additional ultrasound review shortly before Health Minister Mary Harney was due to answer questions in the Dail on that day about the breast cancer testing scandal at Portlaoise.

No information about the separate ultrasound review was given in parliamentary responses by the Minister on that day. The HSE had suggested to the Department that this information be included in PQ replies on November 21.

The following day, a senior HSE official revealed the existence of the ultrasound review at an Oireachtas Health Committee meeting and stated that the ultrasounds of hundreds of women had been reviewed and around 100 women were to be recalled for surgical review.

The revelation caused a public outcry, as the details of this review had not until then been made public and because the women concerned had not at that stage been informed.

The HSE's overall handling of the mammogram and ultrasound reviews at Portlaoise and how it communicated information about them were subsequently criticised in the recent Fitzgerald report.

Health Minister Mary Harney has stated that it was only on the day before her appearance at the Oireachtas Committee on 22 November that her Department became aware that the case notes of an additional number of women who had had ultrasounds in the period August 2005 to August 2007 were being reviewed, and it was only on the morning of the Oireachtas Committee meeting that both she and her officials heard further details of the numbers involved and the progress of this review.

The Minister has said it was both she and her officials' understanding from September 2007 was that the review at Portlaoise involved around 3,000 women, some of whom had had both mammograms and ultrasounds.

She has said she only became aware on November 21 that the case notes of an additional number of women who had received ultrasounds in the period August 2005 to August 2007 were also being reviewed, and only learned of the numbers involved the next day.

The Minister, in media statements following the Oireachtas Committee meeting, said she only became aware of the separate ultrasound review and that there was a dual mammogram and ultrasound review process, on the night of November 21.

The documentation shows, however, that her officials had become aware of this information earlier that day, and did not include information on it for the Minister's PQ reponses that afternoon.

Correspondence between the Department and the HSE at the time, released under FOI, shows that Department officials were made aware of the additional ultrasound review around lunchtime on November 21, shortly before the Minister was due to answer questions in the Dail.

A note from a Department official attached to the relevant email sent to the Department from the HSE indicates that this was the first the Department had heard about a secondary ultrasound review, although not  the details of the number of cases involved, but states that it was agreed that this information should not be included in the PQ response to be given by the Minister later that day.

A note sent six days later by Department Secretary General Michael Scanlan to the same official states that the was satisfied that it would have been 'entirely inappropriate' to refer to the ultrasound aspect in the reply to the relevant PQs on November 21.

"Given this was the first we had heard about the existence of this review, in no way could it be said that the Minister was now aware of the review simply on the basis of the sentence (referring to the separate ultrasound review) which the HSE had suggested might be include in one of the replies. I have discussed this with the Minister and she is in full agreement." Mr Scanlan wrote.

Mr Scanlan added that it was because the Department was still not in possession of sufficient facts even late that evening that it was agreed he should contact HSE CEO Brendan Drumm and advise him that it was a matter for the HSE to decide how best to deal with this issue at the meeting of the Oireachtas Committee scheduled for the following morning, "including whether it would be preferable to take a proactive approach to making this aspect of the review known or to await enquiries and be in a position to respond."

A Department spokeswoman told irishhealth.com that the Department on November 21 last received
entirely new information minutes before the Minister was due to answer PQs in the Dáil.

"In view of the absence of  any specific detail, and in order  to ensure that the Dáil was only given accurate information, no reference to it was made in the Minister's answer . The records released confirm the facts as already stated by the Minister on several occasions," the spokeswoman added.

It subsequently transpired that none of the 130 women who were eventually recalled for surgical review following their ultrasounds had had a breast cancer misdiagnosis.

However, the mammogram review at Portlaoise revealed that nine women had been falsely given the all-clear for breast cancer.

CATHY  Posted: 05/05/2008 21:50

If the Honourable Health Minister was not aware of the info, why did she give out false info in front of an audience without confirming the same. If someone out there has a good memory, they will remember that the Health Minister, praised those management over and over again-- said that they were the future leader of the country. In spite of the failure of systems, all the management are still in their posts and in fact some of these are in higher positions/ promoted, IT ONLY HAPPENS IN EIRE. Then again what happened in Portlaoise is a cover up for the rest of the country's failures. So blatantly obvious now. It is time for FOI of the original reports of mammograms --for confirming or refuting the alleged misdiagnosis!!

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