Campaign 'far from over' as minister rules out cervical screening inquiry

Health Minister Mike Nesbitt has ruled out a public inquiry into failings in Northern Ireland's cervical screening service.

That review found eight women developed cancer due to misread tests.

A further independent review was published on Thursday.

Mike Nesbitt said the latest review and previous reports had already answered the questions a public inquiry would cover.

"I recognise that this decision will be disappointing for many," he said.

I want to reassure them that lessons have been learnt and we will continue to make developments to improve our cervical screening programme in Northern Ireland," he said.

Last November, three reports detailed weaknesses in screening and management at the trust and were intended to provide future learning across the entire healthcare system.

While many of the details were already known, the reports reaffirmed that individual screeners underperformed and that leadership and oversight were lacking when things were going wrong.

The reports found that some women who had been diagnosed and treated for cancer had been retraumatised after they were again contacted by the Southern Trust about abnormalities discovered during an audit of their cases.

At that time, Nesbitt decided to commission a review into the findings of all reports into the cervical screening service at the Southern Trust rather than opt for a public inquiry.

That review - undertaken by the former chief medical officer for Wales, Professor Sir Frank Atherton - has found that while there was "clear management and governance failings within" the Southern Trust and the Public Health Agency (PHA), it would be inappropriate to seek further sanction against individual screeners.

Sir Frank said any cervical cancer programme in the UK or globally would be subject to "false negative" results.

"It is an inherent feature of screening programmes that false negative results will occur and some of these will be attributable to human error," he said.

However, he said the fact that the Southern Trust made a number of "variations" in its screening programme had led to "unintended consequences".

It meant the performance of screeners was not properly monitored and "undermined the performance management process".

Sir Frank said while available data from last November's reports could not point to harm having occurred either to some women or none at all, it was "unlikely large numbers of women [had] been adversely affected and come to harm".

While he said "no individual or organisation set out to deliberately cause harm or to provide a poor service", any underperformance should have been identified and corrected.

He added that while future risk was lessened by the centralisation of the new HPV (human papillomavirus) screening service within the Belfast Trust, there needed to be close monitoring of that programme to ensure any issues were identified and dealt with at an early stage.

He told BBC News NI that this new HPV service meant there was "a great degree of confidence that the system is safe".

Sir Frank said he heard from impacted women and their partners that a public inquiry was necessary to "assign accountability", and from healthcare officials that an inquiry would be "time consuming, risk re-traumatisation, further delay resolution, involve significant expense...".

"I believe that it is highly unlikely that a statutory inquiry would be able to make further progress on unravelling the technical aspects of the programme failure," he said.

Mike Nesbitt said he had thought long and hard about ruling out a public inquiry.

"I acknowledge that this has been a particularly difficult and challenging time for the women and their families who have been impacted by cervical cancer. I want to pay tribute to their determination and acknowledge the profound effect these events have had on their lives," Nesbitt said.

'Whistleblowers need to be heard'

Whistleblowers continue to have a powerful role within the health service and Atherton's findings confirm that.

In 2022 a whistleblower from the Southern Health Trust contacted BBC News about fears that women's smear tests had been misread by screeners with some going on to develop cancer.

He had raised concerns about governance to management, but no one listened.

At the heart of this story are women – two died while others went on to have surgery as their smear tests had been misread for more than a decade.

More than four years ago, the whistleblower told me the programme was flawed and his spreadsheets and copious amount of digging into records proved that.

While today is about listening to the women affected, it also highlights that whistleblowers need to be heard as well.