Cancer Screening again...

Fintan O'Toole has an excellent opinion piece on the the charming Ms. Harney and the current cancer screening farce in today's Irish Times.

Have a look here (subscription required).

Harney fails a basic test

'Mr Naughton is an outstanding surgeon and I have to rely on his clinical judgment in this matter." Thus Mary Harney answering a question from Áine Lawlor on Morning Ireland last Friday about the restricted scope of the review of ultrasound results at Portlaoise hospital, writes Fintan O'Toole .

She was explaining, reasonably enough, that she doesn't know about such things and that she has to trust those who do. Except, of course, when they tell her things she doesn't want to know. Like when the same consultant, Peter Naughton, told her on July 5th, 2005 that the breast cancer service at the hospital was a "shambles". His clinical judgment was that he would not want his own wife to use the services at the hospital.

Given her faith in Peter Naughton's professional judgment, we might expect Mary Harney to have been stunned by the revelation that a major hospital was incapable of providing a safe and efficient service for women threatened by a potentially deadly disease. Protecting the lives of its citizens is the most basic duty of a government.

How she responded to the information that serious and avoidable harm was being done to significant numbers of citizens was a straightforward test of Mary Harney's fitness for office. She failed it utterly.

It is almost funny that the central problem that Peter Naughton identified in his letter was "a total lack of decision-making". Ten days after Mary Harney received the letter, her officials wrote back "advising that his letter had been brought to the HSE national hospitals office for urgent examination and appropriate attention".

Nothing really changed. Naughton had complained that mammograms were being read by people who had no specialist expertise. The response was to appoint a consultant who had no specialist expertise.

The problems continued, and as far as we know, Mary Harney never made any personal inquiry about whether the threats to the lives of women attending Portlaoise were now gone.

Anyone in Mary Harney's position with any sense of shame would have resigned on August 29th this year when she learned that her inaction had contributed to the catastrophe in Portlaoise. Anyone without a sense of shame but at least a modicum of concern would have clung on to office but made this situation a personal priority.

She would have gone to Portlaoise and talked to all the senior managers involved. She would have given them her private number and told them to call her directly with any concerns. Instead, as we know, Mary Harney didn't even bother to find out what was being done by the person she should have been most anxious to hear from: Peter Naughton.

Naughton's review of ultrasound results disappeared into Donald Rumsfeld territory. It was an unknown unknown. Not only did Mary Harney not know about it, but she didn't know who else didn't know. As late as Friday morning last, she told RTÉ that "it remains to be established who knew about this parallel review". Yet she also claimed to be "very much in the loop" on the whole issue which, as she admitted, "is not something that was under the radar". Hers was not a passive failure to know some obscure fact. It was an active failure to inform herself - and therefore the public - about a key aspect of an issue that was being debated in the Dáil and dominating the media. That suggests a level, not just of political incompetence, but of moral disengagement.

And this disengagement will be re-enforced this week, when the Dáil will vote its confidence in Mary Harney. Public representatives who have no confidence in her will repeat her own failure to take personal responsibility.

Mary O'Rourke, for example, told the Dáil debate on cancer services on November 7th that on a short walk from the Dáil to Brown Thomas in Grafton Street that morning no fewer than 11 women stopped her "to describe what had happened to their relatives and neighbours [in the health service] and all had awful tales to tell".

She went on to say that "I am in despair about the health services in Ireland" and to express her utter lack of faith in Mary Harney's promises of reform: "Will Nirvana or Hy Brasil ever appear? Will we ever see the promised land in health? I do not think so."

She quite literally has no confidence in Mary Harney. But will she use her vote to speak for those women who stopped her on the way to Brown Thomas and to tell the truth as she sees it? In her own words, I don't think so.

Nobody knows anything, nobody does anything. The chain of irresponsibility passes downwards from the top to the bottom, until it reaches the general public. At that point, it's not about them anymore, it's about us.

We're left with a moral choice too. Do we ape our betters and do nothing until we or our loved ones are unfortunate enough to get sick or old or disabled? Or do we make our voices heard in the only place that's left to us - on the streets, in our tens of thousands?