Dr. Gabriel Scally:

The minutes of the colposcopists meeting were very helpful. My comment also applies to the medical advisory committee but that was the only meeting of the lead colposcopists in the ten years of the existence of CervicalCheck. There was an annual educational meeting for the colposcopy community but otherwise this was the only one. Colposcopists did not feel part of CervicalCheck, even though CervicalCheck funded them via the hospitals and they often worked in clinics with CervicalCheck branding on them. They were given no role or input into the development of the review or any of its seven iterations and they felt quite alienated from the whole organisation. They did not like the idea that they were expected to talk to women about their results and this did not go well. Some behaviour was terrible and this was front and centre in my report. These attitudes have no place in medicine and it would make any doctor ashamed to hear the comments. On the other hand, some disclosure was done well. As I said, open disclosure can be done well and this was the case in the Wexford incident, something the external review noted. It was not as if it could not be done well but in a lot of cases it was not.

We can change the culture by working through the colleges, some of which are very interested in making a shift. It is not, however, sufficient. The Medical Council wants to make a shift but I am clear, also, that that is not sufficient. I would look to the Oireachtas for a solution, in particular in the Patient Safety Bill 2018, and to make it clear that open disclosure is not optional. The policy has, so far, made it entirely optional and up to the doctor but it must no longer be optional. I hope there will be a legal requirement on professionals to be honest and truthful to patients.