Wednesday 20 February 2019

HSE boss quits as memos show plan to handle fallout

HSE chief Tony O’Brien will leave his post today
HSE chief Tony O’Brien will leave his post today

HSE chief Tony O'Brien has bowed to public pressure and will resign from his position today.

The Director General was facing the prospect of being sacked in the wake of a devastating day of developments in the CervicalCheck controversy.

In a statement, the HSE said he made his decision "in order to avoid any further impact to the delivery of health and social care services".

It emerged yesterday that health chiefs knew more than two years ago that information on faulty smear tests was being withheld from women with cervical cancer.

Mr O'Brien admitted briefing notes circulated in 2016 highlighted the potential for bad publicity if significant numbers of patients were told about the errors.

One memo, compiled when Leo Varadkar was the Minister for Health, warned of the need for a plan to deal with headlines such as 'screening did not diagnose my cancer'.


Despite this Mr O'Brien claimed there was nothing in the note "that rang alarm bells".

His position became untenable when Children's Minister Katherine Zappone broke Cabinet protocol to publicly state he should be sacked.

Separately, Fianna Fail indicated they will support a Sinn Fein motion in the Dail next week calling for his resignation.

As the Taoiseach was pulled directly into the controversy, the agenda for a special Cabinet meeting in Monaghan to celebrate two years of this Government was ripped up.

Instead, ministers were to hold an emergency session in Dublin to discuss Mr O'Brien's future. But shortly after 9pm last night, the HSE confirmed he would leave his post at the close of business today.

Mr O'Brien said he looks forward to engaging with the scoping inquiry set up by the Government into the case of Vicky Phelan and other women who were not told that opportunities to spot cancer cells were missed. He described himself as proud to have led the health services and the many staff who have "worked tirelessly and with great dedication to provide health and social care services in a very challenging environment".

Health Minister Simon Harris thanked Mr O'Brien for almost seven years of service at the top of the HSE.

"I know that he is standing down from his role today because he believes it is in the best interest of rebuilding public confidence in the wake of the issues which have arisen in CervicalCheck."

The Cabinet will now focus on delivering a package of measures aimed at helping the women directly affected by the scandal.

The Herald understands the Department of Health is to issue medical cards to the women and provide some practical supports, like transport for hospital appointments.

In cases where the women have passed away, medical cards will be provided for their next of kin. An instruction will also be given to the HSE to treat the families as special cases in all their dealings.


Finance Minister Paschal Donohoe will brief colleagues on the possibility of creating a fast-track redress scheme in order to avoid a flurry of cases coming before the courts.

But a source said: "Whatever redress is put in place could become a template for settling cases in the future, but we have to make sure the State is not accepting liability for the laboratories."

A email trawl in the Department of Health last night led officials to issue a statement claiming neither Leo Varadkar or Simon Harris were alerted to a series of explosive memos in 2016.

The first document compiled by the HSE just a week after the 2016 general election states that CervicalCheck was "approaching the stage" where individual clinicians would be told that an opportunity was missed to diagnose a patient with cancer.

"There is always the risk that in communicating individual case reports to clinicians of an individual patient reacting by contacting the media if they feel that 'screening did not diagnose my cancer'," the memo said.

It also noted that one of the laboratories involved in analysing smear tests had sought legal advice about the right of CervicalCheck to issue reports back to patients.

Under "Next Steps", the memo advised the HSE to:

  • Pause all letters
  • Await advice of solicitors
  • Decide on the order and volume of dispatch to mitigate any potential risks
  • Continue to prepare reactive communications response for a media headline that 'screening did not diagnose my cancer'.

At the Dail's PAC, Mr O'Brien was asked if he gad heard the RTE Morning Ireland radio interview with Emma Mhic Mhathna, who has been diagnosed with terminal cancer.

The HSE boss said he did not hear the piece but would listen to it later. Fianna Fail's Marc MacSharry relayed how Ms Mhic Mhathuna feared her baby won't remember her.

"In light of statements like that. In light of the principle of accountability. Do you not feel that it is totally untenable for you not to resign your positon now?," he asked.

Mr O'Brien said it's "clearly always very tragic when any young person receives a diagnosis of terminal cancer."

He said the question was based on the presumption that there is some action that has been taken that has led to that diagnosis, adding: "That is far from established".

Labour TD Alan Kelly said the memo had nothing to do with communication to patients.

"That is the most devastating part of this", he said. "The women were not being thought of."

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