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Dáil
‹ Leaders’ Questions.

Cancer diagnostic reviews and report publication

Summary

Gilmore sought accountability over cancer-diagnosis cases, including how a Cork pathologist was appointed, and asked when reviews concerning Portlaoise, Rebecca O’Malley and University College Hospital Galway would be published. The Taoiseach said the Portlaoise reviews were complete, with nine women identified as having cancer offered treatment and no cancers found in the ultrasound review; he expected the O’Doherty report by the end of February and said he would check the other matters.

The Irish Cancer Society told us yesterday that up to 30,000 cancer cases are being diagnosed in the State each year. This is a significant number in a country of just over 4 million. The society tells us that the numbers are increasing and that, in the next 12 years, we may face a cancer epidemic. On several occasions before Christmas we had exchanges in this House about cancer treatment and things that went wrong in cancer treatment. There was the sad and tragic case of Susie Long, known to radio listeners as Rosie, as well as the case of the women in Portlaoise who were given the all-clear for breast cancer and then were called back for re-examination. There were several other cases of misdiagnosis.

On each occasion that we raised these issues with the Taoiseach and the absent Minister for Health and Children, the answer we were given was that investigations were under way, reports would be presented and that we could not get answers to what went wrong in these cases until we had the reports. Five such investigations are still under way. These are the Dr. Ann O'Doherty report into the cases of suspected breast cancer misdiagnosis in Portlaoise, which was to have been completed by the end of November but is still not published; the review by John Fitzgerald into the circumstances surrounding the release of information on the misdiagnosis of breast cancer in Portlaoise, which is still not completed; the report by the Health Information and Quality Authority, HIQA, on the circumstances surrounding the misdiagnosis in the case of Rebecca O'Malley, which was due to be published in December but has not yet been produced; the report by HIQA of a review of pathology services at University College Hospital, Galway, in the wake of another breast cancer misdiagnosis where a woman was twice wrongly given the all-clear, which is still not completed; and the internal report by Cork University Hospital regarding the appointment of a pathologist despite the fact that his work was subject to two reviews in Finland.

These five reports are still ongoing and have not been produced. There have been no answers for the patients concerned, their families and the wider public. When will these reports be produced and published and answers provided to the questions we first raised last October and November?

Comment on this

To the best of my knowledge, the report by Cork University Hospital was acted upon. The individual involved is now out of the jurisdiction and there has been contact between consultants in Cork and the international medical organisations. I am not sure whether there was to be a written report in that case.

Comment on this

The individual concerned left of his own initiative. There should be a report on his appointment.

Comment on this

Following concerns raised by staff in the breast service, the HSE set up a clinical review last autumn of all breast radiology diagnoses in the Midland Regional Hospital from November 2003 to August 2007. That review was led by Dr. Ann O'Doherty, a consultant radiologist at St. Vincent's University Hospital and with BreastCheck. The HSE has advised that this review is complete. Nine women were identified as having a diagnosis of cancer and all nine have been offered appropriate treatment. A clinical review of ultrasounds at Portlaoise is also complete and no cancers were detected in this review.

The HSE has advised the Department of Health and Children that a report on the reviews will be published by the HSE when the necessary legal requirements have been completed. A target date of the end of this month has been set for publication. The legal issues relate to the necessity to give an opportunity to those who are mentioned in the report to make their defence or their statements. The suspension of mammography services at Portlaoise continues pending publication of these reports.

The Minister for Health and Children has asked the chief executive officer of the HSE for a report on the circumstances that led to the decisions of the executive to suspend the breast radiology services at the hospital, place a consultant radiologist on administrative leave and initiate a clinical review of the services. That report, which was led by Dr. Ann O'Doherty, has been completed and will be submitted to the chief executive officer of the HSE. The Minister also asked for a report from the board of the HSE on the management of all events starting from and subsequent to these decisions. That report is being undertaken by Mr. John Fitzgerald. It is not finished but is being drafted.

Comment on this

As I understand it, the pathologist in Cork had left before the investigation began. What we want to establish is how he was engaged in the first place given that his work had been subject to review in Finland. I ask again for an answer in this regard. There is an issue of public accountability, it is not enough just to say he is gone and let us forget about it. We must find out what happened.

I am somewhat confused by the Taoiseach's reply on the O'Doherty report. On the one hand, he tells me it will be published in the next month——

Comment on this

It will be published by the end of February.

Comment on this

He also said it will be submitted to the chief executive officer of the HSE. Have I the Taoiseach's assurance that the report will be published?

Comment on this

As I understand it, it will be published.

Comment on this

The other reports to which I referred are the two HIQA reports, one in the case of Rebecca O'Malley and the other in the case of University College Hospital, Galway. The Taoiseach did not refer to those in his response. When does he expect them to be published?

Comment on this

I will check the position on the Cork case. As I understand, the report on that was prepared. The clinician involved was only in Cork for a short period before he was suspended and then left the jurisdiction. I understand Deputy Gilmore's question relates to how this person was appointed in the first place. I will raise that point.

The HSE has informed me that there are two aspects to the Dr. Ann O'Doherty report. First, there are the nine women who were identified as having a diagnosis of cancer and, second, there is the clinical review of the ultrasounds, which is also complete and no cancers were detected in that review. The HSE has informed the Department of Health and Children that the report on the reviews will be published by the executive as soon as the necessary legal requirements have been completed. Its target date, as I said, is the end of the month.

The third part of the review is that the Minister for Health and Children asked the chief executive officer of the HSE for a report on the circumstances that led to the decision of the HSE to suspend the breast radiology services in the hospital. That report, which was done by a review group led by Dr. O'Doherty, has been completed and submitted to the chief executive officer of the HSE. It does not say in my information that this report will be published. The fourth element is the Minister's request for a report from the board of the HSE on the management of all events starting from and subsequent to these decisions. This report, which is being undertaken by John Fitzgerald, is not complete.

I will ask the Department about the Deputy's query regarding Galway. I have received no information on that.

Comment on this