Scoping Inquiry established into the CervicalCheck Screening Programme and Dr Gabriel Scally appointed to lead it
The Cabinet has agreed today (Tuesday) to establish a Scoping Inquiry into the issues which have recently come to light in relation to the CervicalCheck Screening Programme. Dr Gabriel Scally has been appointed to carry out the Scoping Inquiry. Dr Scally will report back to the Minister for Health by the end of next month setting out his findings.
Dr Scally has also asked an international expert in women’s health, Dr Karin Denton, Consultant in Cellular Pathology North Bristol NHS Trust and previously Regional Head of Screening Quality Assurance Public Health England, to provide assistance in undertaking this review.
Minister for Health Simon Harris said “I gave a commitment that some good would come from this situation and today Cabinet has agreed to establish a Scoping Inquiry into the issues which have recently come to light in relation to the CervicalCheck Screening Programme. We need to examine the facts and get answers quickly for Irish women, while also identifying issues that may merit a further full statutory investigation.
Dr Gabriel Scally, who has been appointed to carry out the Scoping Inquiry, has widespread experience in undertaking reviews of this type. He had a distinguished career as a senior public health doctor and advisor with the UK Department of Health as well as the NHS and is currently President of the Epidemiology and Public Health section of the Royal Society of Medicine, and a Professor of Public Health at both the University of the West of England and the University of Bristol.
Dr Scally arrived in Ireland today and will immediately begin his work. He will report back by the end of next month setting out his findings.
I would like to acknowledge again the tireless efforts of Vicky Phelan. I have briefed her on these developments and I understand that Dr Scally has already spoken with her and will meet with her shortly.
I have engaged on a cross-party basis about this Inquiry and reflecting the issues raised by all parties, the Terms of Reference are very comprehensive. These inputs from across the political spectrum will be shared with Dr Scally, to inform his work.
The inquiry will independently examine the facts including details of the non-disclosure to patients relating to CervicalCheck clinical audits and the management and level of knowledge of various parties including, the HSE and the Department of Health. It will also examine the tendering, contracting, operation etc. of the labs contracted by CervicalCheck.
Separately, there will be an international expert panel review led by the Royal College of Obstetricians and Gynaecologists, and the British Society for Colposcopy and Cervical Pathology. This will review the results of screening tests of all women who have developed cervical cancer who participated in the screening programme since it was established. This will provide independent clinical assurance to women about the timing of their diagnosis and any issues relating to their treatment and outcome.
These two strands of investigation are crucial to firstly establish the facts, secondly determine what action is needed to address the issues, and thirdly help to restore trust and confidence of women in CervicalCheck.
I have also informed Cabinet today of my intention to appoint a new HSE board and introduce legislation to allow this and I have brought to Cabinet my plans on mandatory open disclosure.”
Notes for Editors
Terms of Reference of Scoping Inquiry
a. examine the facts including details of:
i. The non-disclosure of information to Ms. Phelan relating to a CervicalCheck standard case clinical audit carried out following her diagnosis of cervical cancer in July 2014;
ii. The apparent widespread practice of non-disclosure to patients relating to CervicalCheck standard case clinical audits;
iii. The management and level of knowledge of various parties including, but not limited to the HSE, the Department of Health or other public authorities and any relevant service provider of:
1. the Vicky Phelan case
2. any other cases concerning CervicalCheck
3. issues related to the non-disclosure of the clinical audit results
iv. The manner and means through which the relevant facts were shared, escalated, reported and communicated;
b. engage directly with Ms. Phelan and any other woman affected or her next of kin, who may wish to have an input;
c. examine all aspects of CervicalCheck;
d. examine the information provided by CervicalCheck to those receiving a service;
e. examine why the policy of open disclosure was not implemented by CervicalCheck;
f. examine the tendering, contracting, operation, conflict of interest arrangements, performance information and performance management, accreditation and quality assurance of contracted cytology laboratory services by CervicalCheck from initiation of the programme;
g. examine the other screening programmes operated by the National Screening Service particularly in relation to quality assurance and clinical audit, open disclosure and governance;
h. incorporate further elements if identified, including through engagement with stakeholders;
i. have flexibility to issue discrete reports or findings on particular matters if it is in a position to do so and provide a progress update in the first week of June;
j. report to the Minister for Health by the end of June 2018 setting out issues and recommendations to be addressed by means of a Commission of Investigation, which can take a modular approach, together with recommendations to address other issues by such other means as is considered appropriate.
Biographical details for Dr Gabriel Scally
- Gabriel Scally was born and brought up in Belfast. He is currently President of the Epidemiology and Public Health section of the Royal Society of Medicine, and is Chair of the Soil Association.
- Gabriel studied medicine at The Queen’s University of Belfast. He specialised in general practice and subsequently public health. From 1989-93 he was Chief Administrative Medical Officer and Director of Public Health for the Eastern Health and Social Services Board in Northern Ireland. Among his achievements in Northern Ireland was the establishment of the Brook Advisory young people’s sexual health service in the teeth of substantial opposition.
- From 1993 until 2012 he was a Regional Director of Public Health in England. For most of this time he worked in the NHS and Department of Health covering the South West of England. During that time Dr Scally dealt with several high profile clinical service failures including breast screening in Exeter, pathology in Swindon, and led the NHS review of the commissioning of care and treatment for patients at Winterbourne View where patients were seriously abused. Dr Scally has assisted the Northern Ireland Inquiry into Hyponatraemia Related Death as both an expert witness and as an advisor to the Chair, Justice O’Hara, in the preparation of his report which was published in January 2018.
- Dr Scally is currently visiting Professor of Public Health at both the University of the West of England (UWE) and the University of Bristol. His most recent academic role was as Director the World Health Organization Collaborating Centre on Healthy Urban Environments at the UWE. He currently jointly leads a Wellcome Trust funded research project into the current importance attached to health considerations in the planning of urban settlements.