Did outsourcing of cancer testing sentence a woman with cervical cancer to death?

Ardillaun

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Mandatory disclosure would be a good thing in an approriate legal and cultural environment but you simply don’t have anything like those conditions in Ireland.
 
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Ardillaun

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Yes you've said that and i've told you there is evidence from the US that mandatory disclosure reduces costs in the long term.

This makes sense as mandatory disclosure will reduce the time spent in the high court and consequently legal fees. Additionally mandatory disclosure also means the likelihood of repitition will be much lower than where the failing is covered up and concealed as currently is official policy.

The medics really are scaremongering here!!!
How long is long-term? How long is it taking Ireland to correct its compo madness on a simple matter like whiplash, for example?
 

ruman

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Mandatory dusclosure woukd be a good thing in an approriate legal and cultural environment but you simply don’t have anything like those conditions in Ireland.
"appopriate cultural environment" ?

Not sure what you mean by that is it a culture where medics dont " deliberatedly remove medical records" as Justice Harding Clarke put it ?

Well we best get on with reforming our culture so. This concealment of information from patients isnt acceptable in modern society. You'll always get the odd dinosaur objecting of course, they had a great run.
 

ruman

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How long is long-term? How long is it taking Ireland to correct its compo madness on a simple matter like whiplash, for example?
Far shorter then a mother has to battle to get an admission of negligence in the high court anyway.

I'm far more concerned about the culture of altering and removing medical records to conceal negligence. Ultimately we are moving inevitably towards a patient focused health service, the women hating dinosaurs have had their day.
 

Ardillaun

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"appopriate cultural environment" ?

Not sure what you mean by that is it a culture where medics dont " deliberatedly remove medical records" as Justice Harding Clarke put it ?

Well we best get on with reforming our culture so. This concealment of information from patients isnt acceptable in modern society. You'll always get the odd dinosaur objecting of course, they had a great run.
When doctors have their reputations trashed in court with absurdly hyperbolic language, that inevitably breeds an adversarial attitude in the medical profession. It’s the wrong way to go if you are really interested in improving systems and moving away from a blame culture.
 

Ardillaun

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Far shorter then a mother has to battle to get an admission of negligence in the high court anyway.

I'm far more concerned about the culture of altering and removing medical records to conceal negligence. Ultimately we are moving inevitably towards a patient focused health service, the women hating dinosaurs have had their day.
Nobody here supports removing or altering records.
 

ruman

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When doctors have their reputations trashed in court with absurdly hyperbolic language that inevitably breeds an adversarial attitude in the medical profession. It’s the wrong way to go if you are really interested in improving systems and moving away from a blame culture.
" blame culture" LOL ! All these awards yet i cant recall the medical council making adverse findings against a ( white irish born consultant ) doctor.

I prefer the term accountability , of which there is none ( unless you are a junior doctor from nigeria etc).

Anyway admit your mistake and you have nothing to fear. Fail to do so and well you only have yourself to blame now. Ultimately you are there to serve the patient so shouldnt be a big issue not lying to them you would think!
 

ruman

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Nobody here supports removing or altering records.
Yeah you'd think if you brought such an action to the attention of one of the most senior medics in the state it might lead to disciplinery action given this apparently endemic " blame culture"!

At the very least you would think they wouldnt try and excuse and justify it. You'd be wrong though.

Welcome to the irish health service.

As i said, criminal charges for deliberate concealment of negligence.
 

Ardillaun

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Yeah you'd think if you brought such an action to the attention of one of the most senior medics in the state it might lead to disciplinery action given this apparently endemic " blame culture"!

At the very least you would think they wouldnt try and excuse and justify it. You'd be wrong though.

Welcome to the irish health service.

As i said, criminal charges for deliberate concealment of negligence.
None of what you say there excludes the basic reality of blame culture which is obvious to any reasonable observer. Grossly inappropriate actions by individuals deserve to be sanctioned but that is not the norm in litigation. If health care is to transform the way it improves itself through a just culture model, more in line with the aviation industry, it will need to focus more on systems and processes than pinning the blame on individuals.
 

redmonite

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There appears to be a lot of jumping up and down about the level of the ex gratia payment for the non-disclosure of the audit results.

People seem to think that 20 grand for the non-nondisclosure of clinically irrelevant information is somehow an insult (despite the fact that disclosure of such QA audits hadn't previously been common practice in other similar screening programmes, but that's history).

BTW, the courts determined that 10 grand was an appropriate level of redress for this issue.

Summary
249. The first named plaintiff is entitled to:
Damages in respect of failure by first named defendant in relation to the audit €10,000

Yes its amusing to see the weasel words used by the media in the Morrisey case" an award from the labs and HSE of 2.1m euros" and the same loons saying the state should settle all cases!
 

ruman

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None of what you say there excludes the basic reality of blame culture which is obvious to any reasonable observer. Grossly inappropriate actions by individuals deserve to be sanctioned but that is not the norm in litigation. If health care is to transform the way it improves itself through a just culture model, more in line with the aviation industry, it will need to focus more on systems and processes than pinning the blame on individuals.
There's no blame or sanctions on individuals currently given the taxpayayer foots the bill and the medics carry on.

In order for your theory for non disclosure to have merit there would need to be mass incidences of doctors having their licenses removed. Not only is this not the case but in fact the President of the Irish Medical Council has spoken about the gross under reporting of medics by the HSE in comparison with international norms.

So your claim that a blame culture is stopping medics disclosing failures is entirely without foundation as accountability for medics is currently non existent in Ireland. You are ( deliberatedly?) muddling civil damage cases with professional body actions against individual medics.The later are effectively non existent ( for white Irish born consultants) and havent risen despite huge increases in claims.

If you make a mistake, own up. There is zero justication for not doing so and a medic who deliberatedly conceals negligence from a patient deserves to face criminal sanctions.

We both know medics are simply attempting to block mandatory disclosure.
 
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ruman

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Yes its amusing to see the weasel words used by the media in the Morrisey case" an award from the labs and HSE of 2.1m euros" and the same loons saying the state should settle all cases!
Ideally the state should go after the individuals who concealed the information or gave instruction to do so rather than saddle the taxpayer with the costs.

Doing so would also send a message on non disclosure. Going forward we should include a mandatory disclosure clause in the contracts of all medics. Anyone deliberatedly concealing should face both criminal and civil actions.

Once we have mandatory disclosure the state needs to robustly deal with non compliance. Certainly the taxpayer should not have to bear the cost of deviant behaviour by HSE managers and medics.
 
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Ardillaun

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There's no blame or sanctions on individuals currently given the taxpayayer foots the bill and the medics carry on.

In order for your theory for non disclosure to have merit there would need to be mass incidences of doctors having their licenses removed. Not only is this not the case but in fact the President of the Irish Medical Council has spoken about the gross under reporting of medics by the HSE in comparison with international norms.

So your claim that a blame culture is stopping medics disclosing failures is entirely without foundation as accountability for medics is currently non existent in Ireland. You are ( deliberatedly?) muddling civil damage cases with professional body actions against individual medics.The later are effectively non existent ( for white Irish born consultants) and havent risen despite huge increases in claims.

If you make a mistake, own up. There is zero justication for not doing so and a medic who deliberatedly conceals negligence from a patient deserves to face criminal sanctions.

We both know medics are simply attempting to block mandatory disclosure.
I am certainly not doing the muddling here and I have no desire to defend the licensing authorities. That is one issue and civil litigation is another. You seem not to understand the effect a civil suit has on a physician and the chill such suits exert on physicians in general. I don’t believe that Ireland, with its unusual compo culture, is ready for mandatory disclosure on the draconian scale that you envisage. My principle interest in Irish health care these days is to ensure a decent, functioning system for my relatives. I don’t see how a dramatic increase in lawsuits will assist there.

On this cervical screening issue, we have already seen many allegations about the quality of the actual screening performed that have turned out to be unfounded. The perfect ‘absolute confidence’ standard should not be the enemy of the good.
 
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redmonite

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Ideally the state should go after the individuals who concealed the information or gave instruction to do so rather than saddle the taxpayer with the costs.

Doing so would also send a message on non disclosure. Going forward we should include a mandatory disclosure clause in the contracts of all medics. Anyone deliberatedly concealing should face both criminal and civil actions.

Once we have mandatory disclosure the state needs to robustly deal with non compliance. Certainly the taxpayer should not have to bear the cost of deviant behaviour by HSE managers and medics.
Look, the Irish tax payer will be paying out over half a billion euros for missed screening tests. To date there is no evidence that the testing regime was inaccurate outside the international norms for such testing. So l am not sure mandatory disclosure will be the panacea you think it will.
 

ruman

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I am certainly not doing the muddling here and I have no desire to defend the licensing authorities. That is one issue and civil litigation is another. You seem not to understand the effect a civil suit has on a physician and the chill such suits exert on physicians in general. I don’t believe that Ireland, with its unusual compo culture, is ready for mandatory disclosure on the draconian scale that you envisage. My principle interest in Irish health care these days is to ensure a decent, functioning system for my relatives. I don’t see how a dramatic increase in lawsuits will assist there.

On this cervical screening issue, we have already seen many allegations about the quality of the actual screening performed that have turned out to be unfounded. The perfect ‘absolute confidence’ standard should not be the enemy of the good.

You're very muddled given the vast majority of negligence cases are agsinst the HSE.
You have shown ZERO concern for the victims of medical negligence and you have provided no alternatives to the current system where victims ( predominantly mothers) are dragged through the courts for years due to the moral cowardice of your colleagues. In essence you want a continuation of the status quo effectively " i'm alright jack ".

Incidentally in parts of the US mandatory disclosure reduced litigation in the long term as certain victims were content with an explanation and apology. Here currently the only way to get an explanation is in fact to take a civil action. Non disclosure encourages litigation.
.So you are wrong again sadly.

The UK has " absolute confidence'" and the world has not fallen in despite the OTT hysteria from our celebrity consultants.
 
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ruman

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Look, the Irish tax payer will be paying out over half a billion euros for missed screening tests. To date there is no evidence that the testing regime was inaccurate outside the international norms for such testing. So l am not sure mandatory disclosure will be the panacea you think it will.
I'm not sure you understand what exactly mandatory disclosure is. It is patently obvious that the medics are attempting to use the size of the awards to take down mandatory disclosure.

I've no interest in commenting on the size of the awards or the merits of payouts in specific cases. What i will say is patients are entitled to full disclosure in regard to their private medical information. It is completely unacceptable to conceal information from patients.

There is zero justification for concealing information from patients. Its astonishing that anyone would argue that point.
 

ruman

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The life of an Irish Medical Consultant

- irish taxpayer funds their education ( US grads have 6 figure loans.
- Irish taxpayer foots the bill for their mistakes
-- Irish taxpayer pays for their private consulting rooms in new hospital
- Most irish taxpayers are left dealing with junior or inadequately vetted doctors as consultant looks after his private patient.
 

Ardillaun

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You're very muddled given the vast majority of negligence cases are agsinst the HSE.
You have shown ZERO concern for the victims of medical negligence and you have provided no alternatives to the current system where victims ( predominantly mothers) are dragged through the courts for years due to the moral cowardice of your colleagues. In essence you want a continuation of the status quo effectively " i'm alright jack ".

Incidentally in parts of the US mandatory disclosure reduced litigation in the long term as certain victims were content with an explanation and apology. Here currently the only way to get an explanation is in fact to take a civil action. Non disclosure encourages litigation.
.So you are wrong again sadly.

The UK has " absolute confidence'" and the world has not fallen in despite the OTT hysteria from our celebrity consultants.
Take a look at the coverage of these lawsuits some time and how the care by doctors who are named is attacked. Do you understand the trauma that such an adversarial process can bring for the doctors and nurses involved?

Years ago, I did a locum in Ireland and the cost of insurance was over four times what it was in Canada. When it comes to litigation, Ireland is definitely an outlier. There’s no question about that.

In practice, the UK does not have a regime that demands absolute anything which is why one of the US experts took such exception to those words. Judge Cross made a fool of himself by copying and pasting that and Lord knows where it will lead in an Irish legal context.

I care about how health care functions, about outcomes. Obsessing about punishing individual doctors is not the best place to start on improving a system which is actually quite good already. And bad outcomes happen everywhere. A relative of mine had a cancer missed on a scan here but I didn’t consider suing.

We have some similar problems with our own licensing authority here where there seems to have been a reluctance to discipline local doctors, a few examples of which I think I have already catalogued in the opioid thread here.
 
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ruman

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Take a look at the coverage of these lawsuits some time and how the care by doctors who are named is attacked. Years ago, I did a locum in Ireland and the cost of insurance was over four times what it was in Canada. When it comes to litigation, Ireland is definitely an outlier. There’s no question about that.

In practice, the UK does not have a regime that demands absolute anything which is why one of the US experts took such exception to those words. Judge Cross made a fool of himself by copying and pasting that and Lord knows where it will lead in an Irish legal context.

I care about how health care functions, about outcomes. We have some similar problems with our own licensing authority here where there seems to have been a reluctance to discipline local doctors, a few examples of which I think I have already catalogued in the opioid thread here.
So high insurance costs justify medics lying to patients in your eyes?

Have you considered your insurance company might just be ripping you off?

I'm fully aware of coverage these cases thank you, far more than you i would say. Media coverage tends to focus little on care , certainly not in any great detail. Victims are harrassed on the steps of the 4 courts with sensational headlines focusing on numbers. Medic coverage is minimal in comparison. Again you fail to even mention the victim often a mother left providing 24 hour care to a disabled child whilst having to fund legal costs herself. In contrast the state funds the defense entirely.

Incidentally the care will only be examined in court where the medic/HSE has denied negligence so again said medic could avoid that by accepting responsibility and admitting the error. Where he doesnt admit the error he will only be in court as a medical expert feels there is negligence on his part. So lets not pretend spurious cases are appearing weekly in the high court now. In fact given the substanial costs of litigation ( to the victim not the medic) many victims simply cannot afford to take a case no matter how clearcut the negligence may be.

The regulatory bodies in contrast offer zero legal representation to patients and the attitude towards consultants is deferential bordering on fawning. Quite frankly the medical council are scared stiff of litigation from medics. The regulatory body enquiries are a waste of time and inreasingly appear to be PR stunts with the odd finding against a junior mostly african doctor for the benefit of optics.

Anyway denial and cover ups of failings make repitition far more likely. For that reason alone mandatory disclosure is essential.

Ultimately a patients right to data and information trumps all. The world has moved in that direction our health service has to. Given the patriarchical element at work here i'm confident scaremongering by the usual dinosaur consultants wont halt it.
 
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Massey

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He copied the term from an English case. Its still makes no sense to anybody who has ever worked in a lab. The Brits make mistakes too. You can see the special spin we can put on foreign terms here. Whiplash, for example, is a far more serious injury in Ireland than elsewhere.
That’s why it has to be appealed , the consequences are that nearly all screening will have to stop if it becomes precedent .
 


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