Health Minister Declines Public Inquiry into Cervical Screening Failures
Health Minister Mike Nesbitt has confirmed that a public inquiry into the failings of Northern Ireland's cervical screening service will not proceed.
Campaigners have persistently demanded a statutory inquiry into the issues at the Southern Health Trust, which resulted in approximately 17,500 women being contacted to have their smear test results re-examined.
An initial review identified that eight women developed cancer due to misread smear tests. A further independent review was published on Thursday.
Mike Nesbitt stated that the recent review, along with previous reports, had already addressed the issues a public inquiry would investigate.
"I recognise that this decision will be disappointing for many," he said.
"I want to reassure them that lessons have been learnt and we will continue to make developments to improve our cervical screening programme in Northern Ireland," he added.
In November of the previous year, three reports highlighted weaknesses in screening and management at the Southern Health Trust, aiming to provide learning for the wider healthcare system.
Although many details were already known, the reports confirmed that individual screeners underperformed and that leadership and oversight were insufficient when problems arose.
The reports also revealed that some women previously diagnosed and treated for cancer experienced retraumatisation after being re-contacted by the Southern Trust regarding abnormalities discovered during an audit of their cases.
Following these findings, Nesbitt commissioned a review of all reports concerning the cervical screening service at the Southern Trust instead of initiating a public inquiry.
Findings of the Independent Review by Professor Sir Frank Atherton
The review, conducted by former Chief Medical Officer for Wales, Professor Sir Frank Atherton, concluded that while there were "clear management and governance failings within" the Southern Trust and the Public Health Agency (PHA), pursuing further sanctions against individual screeners would be inappropriate.
Sir Frank noted that any cervical cancer screening programme in the UK or globally is subject to "false negative" results.
"It is an inherent feature of screening programmes that false negative results will occur and some of these will be attributable to human error," he explained.
However, he observed that the Southern Trust implemented several "variations" in its screening programme that led to "unintended consequences."
This resulted in inadequate monitoring of screener performance and "undermined the performance management process."
Sir Frank stated that while data from last November's reports could not definitively determine whether harm occurred to some women, it was "unlikely large numbers of women [had] been adversely affected and come to harm."
He emphasized that "no individual or organisation set out to deliberately cause harm or to provide a poor service," but acknowledged that any underperformance should have been identified and rectified.
He further noted that the centralisation of the new HPV (human papillomavirus) screening service within the Belfast Trust reduces future risk, but stressed the necessity for close monitoring to promptly identify and address any issues.
Speaking to NI, Sir Frank expressed confidence in the new HPV service.
"This new HPV service means there is a great degree of confidence that the system is safe," he said.
Sir Frank also shared that he heard from affected women and their partners who believed a public inquiry was necessary to "assign accountability," while healthcare officials cautioned that such an inquiry would be "time consuming, risk re-traumatisation, further delay resolution, involve significant expense..."
"I believe that it is highly unlikely that a statutory inquiry would be able to make further progress on unravelling the technical aspects of the programme failure," he stated.
Mike Nesbitt reflected on his decision to rule out a public inquiry.
"I acknowledge that this has been a particularly difficult and challenging time for the women and their families who have been impacted by cervical cancer. I want to pay tribute to their determination and acknowledge the profound effect these events have had on their lives," Nesbitt said.
Whistleblowers' Role in the Cervical Screening Service
Whistleblowers continue to play a crucial role within the health service, a fact reinforced by Atherton's findings.
In 2022, a whistleblower from the Southern Health Trust contacted expressing concerns that women's smear tests had been misread by screeners, with some women subsequently developing cancer.
Despite raising governance concerns with management, the whistleblower's warnings were not heeded.
At the core of this issue are the women affected—two of whom died, while others underwent surgery due to misread smear tests spanning more than a decade.
More than four years ago, the whistleblower had identified flaws in the programme, supported by detailed spreadsheets and extensive record examinations.
While the current focus is on listening to the women impacted, this situation also underscores the importance of heeding whistleblowers' concerns.
