An update on our support for cancer screening programmes in Ireland

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Update to members from Professor Mary Horgan, President, Royal College of Physicians of Ireland

We are committed to supporting the life-saving screening services, including the CervicalCheck programme.

Recent events have highlighted the limitations of screening and we acknowledge the pain and suffering experienced by those affected. We know that the system is not infallible and acknowledge that, particularly within screening services, the system will not be deemed to function for all individuals who participate and we have great sympathy for all those affected in this way.

As medical professionals, our goal is to ensure the highest attainable standards of care for our patients and for our screening population - patients are entitled to this.

We are extremely concerned that if all false negative screening tests, which we know are expected in all screening programmes, are deemed as a breach of care within the legal system, that this will seriously undermine and potentially negatively impact the viability of all screening programmes. Following the Cross judgement, RCPI stated that clarification on the impact of this judgement on screening programmes and its wider impact on all diagnostic services was urgently required.

RCPI was asked by the HSE to provide any information from clinicians that might be relevant in considering the implications of the Cross Judgement for screening in Ireland in light of its appeal to the Supreme Court. Our note, which cites international evidence, outlines the basis for establishing and implementing screening programmes, the factors to be considered before determining whether a programme delivers more positive than negative outcomes and whether it should be continued. It also considers how the judgement might impact on the cervical screening programme and the potential consequences of changes in practice that might follow the adoption of this judgement.

RCPI brought these matters to the attention of the HSE to ensure that due consideration is given to the possible unforeseen consequences that might result from changes to practice as a result of the judgement.

The Royal College of Physicians of Ireland and its Faculties and Institutes have been working with various stakeholders for many months now to address issues and concerns that impact on the screening services.

The Deans of the Faculties of Pathology, Public Health Medicine Prof Louise Burke and Prof Emer Shelley and the Chair of the Institute of Obstetricians and Gynaecologists, Dr Cliona Murphy, have, together with their colleagues, been actively engaging with the Department of Health, the HSE and other agencies on aspects of screening. Representatives have joined various committees that are inputting into the screening services and bringing the concerns of our Trainees, Members and Fellows to them. I am also representing clinical issues and concerns on the CervicalCheck Steering Committee established by the Chief Medical officer, which also includes patient advocates.

I have also separately met with a delegation of patients affected by the CervicalCheck audit as part of the process proposed by Dr Gabriel Scally.

I am grateful to the many Fellows and Members from across the College, particularly the Institute of Obstetricians and Gynaecologists, the Faculty of Pathology and the Faculty of Public Health Medicine, who volunteered to help to restore confidence in the screening services by joining committees, engaging with the media and working collaboratively to implement the recommendations. The College has also shown leadership in developing new educational materials and content to improve knowledge around screening and to support healthcare professionals with open disclosure.

You will find more information about our activities in this area on our website here https://www.rcpi.ie/policy-and-advocacy/supporting-cancer-screening/ 

Professor Mary Horgan

President, Royal College of Physicians of Ireland

Tel: 01 863 9700

Professor Mary Horgan is the President of the Royal College of Physicians of Ireland. She took up office as the 142nd President in October 2017 and will serve a three-year term. She is the first woman President in our 360 year history. Originally from Kerry, Professor Horgan graduated from UCD in 1986. She was awarded her MD in 1995, MRCPI in 1988 and FRCPI in 1997. She serves on the Board of the Health Products Regulatory Authority and the Mercy University Hospital and on the Governing Body of UCC. She is formerly a Board Member of the Irish Blood Transfusion Service and was previously Chair of the Council of Deans of Medical Schools. She is a Consultant Physician in Infectious Diseases and Internal Medicine and she served as Dean of the University College Cork School of Medicine from 2013-2017. Professor Horgan also chairs our Steering Committee on Acute Medicine (training). Mary Horgan graduated from University College Dublin in 1986.  She is Consultant Physician in Cork University Hospital and Professor in the School of Medicine, University College Cork.  She served as Chair of the Consultant Medical Staff Committee and the Executive Management Board in CUH.  Professor Horgan has served as a Board member of IBTS and is currently a Board Member of the Irish Medicines Board where she chairs the National Advisory Committee on Human Medicine.  She is President of the Infectious Diseases Society of Ireland.