A protest march in Newbridge recently against the cervical screening scandal
I do not envy the role of Dr Gabriel Scally, the Belfast-born, former NHS doctor who is to carry out a scoping inquiry into CervicalCheck.
We are told that he has already arrived and apparently “hit the ground running,” to use a favourite phrase of some of our public figures.
One must be aware of hitting the ground running. Tried it myself a couple of times and nearly fell on my face. You can overshoot the runway.
The other problem with it is that you can go so fast that you may miss something or even see nothing important.
I have tried to figure out what Dr Scally will be looking for and have asked myself, how would you start?
A favourite yardstick of mine came from my only meeting with the late great journalist, Claud Cockburn, in Youghal in the early 1980s.
Basically, his motto was: follow the money.
He advised that if you wanted to understand the politics of the world, you needed to read the ‘pink pages’, as the Financial Times was called.
What happens in the world of money greatly influences the world of politics and power.
That is why Dr Scally may need as much expertise in insurance and the law surrounding it. The real answer may lie in the office of a legal team perfectly entitled to defend a claim against an insurance policy.
Dr Scally is getting some specialist help on the medical front.
This is good because at end of the day, the problems with many of these types of crises, can revolve around something small and obscure, which to many are on the fringe of the issue.
The inquiry will look at what have been called “key” elements of the scandal including why so many of the women who developed cancer after getting an incorrect smear test result were not informed an internal review was carried out on their case.
It will also look at the quality of testing, the outsourcing of analysing smear tests to a laboratory in the United States as well as the role of the HSE and Department of Children.
I have some sympathy for medical mistakes. The increasing complexity of medicine and the procedures around it maybe too much for any one individual to bear. That is why medical people are insured. This maybe the rub here. It may be more costly to insured them in Ireland than other countries.
An entire legal and financial industry revolves around insurance and reinsurance.
The problem could well be what is known as “the bottom line.”
If you are insuring Dr X and Mr Y’s company, you want to get in the biggest premium possible from them. You also want to pay out less.
It won’t be Dr X/company who will have to pay for the mistake or what is deemed to be a mistake by some court or legal body.
It will be their insurance company.
An insurance company will try to keep the lid on it.
It might be wrong, but think of the money.
I would also suggest, at this point that insurance companies pay out too much for too little — sore toes, falls on floors etc. We know that whiplash claims in Ireland cost three times what it costs abroad.
Pay outs cost us all and the cost of insurance is built into our medical costs.
In the Cervical Cancer case, it may be much easier to fix or stop poor testing, for personal or technical reasons, or force doctors to give patients their own medical notes than change the role of the person or body who ultimately pays for the mistake.