This is one of the largest reviews in Irish medical history.
On Sunday 17 December, it was discovered that 46,000 scans and X-rays were under review at University Hospital Kerry, after seven people were found to have received a delayed
cancer diagnosis over the last five months. The news was distressing for the thousands of patients whose cases were being revisited, since they were only learning about this at the same time as everyone else.
So what exactly is it that has turned Christmas into a dark waiting period for countless people in the south-west and who exactly is responsible?
How did this start?
The problem was first raised in July 2017, when the hospital's management was notified that staff had missed a cancer diagnosis, resulting in its delay. Then, in August, it was discovered that two more patients had received similarly false results.
Each one was called an extremely obvious case of cancer. This in turn, prompted management and the HSE to call for a review, and initially all of the complaints pointed to one specific consultant in the radiology department.
Who is affected here?
Beginning in October, the review consists of 46,000 CAT scans, x-rays and ultrasounds supposedly carried out by this one consultant between March 2016 and July 2017. Approximately 26,700 patients from Kerry, North Cork and South Limerick are included in these files.
As of 18 December, six external radiologists managed to examine 20,923 scans for 12,923 patients. From those, 21 patients were called back into the hospital, and fortunately, no follow-up treatment has been required so far.
Still, another ten weeks are going to be required in order to complete this "look-back" and three more consultants are being brought in to see that through.
Since the issue was first raised, however, misdiagnoses have risen from three to seven, when in autumn, four patients returned to the hospital complaining about ongoing symptoms. These people were also the victims of a delayed diagnosis and are now undergoing treatment.
Sadly, in the latest developments as of 19 December, one patient developed an inoperable tumour because of a six-month delay between the original misdiagnosis and eventual discovery.
Is this really only one person's fault?
Since the investigation is only looking into this consultant's specific length of time at the hospital, then the results from these 46,000 scans could be written off as the incompetence of one person alone. UHK clinical director, Dr. Claire O'Brien has said that the department and its services are fine, while insisting that the issue stems from just one person.
This does give off the sense that this consultant, while seemingly incompetent, could equally be labelled a scapegoat.
According to a radiology consultant at St. James's Hospital, Dr. Niall Sheehy, on average the number of scans handled by a single doctor is between 7,000 and 15,000. That would mean this consultant tripled the average over 16 months alone, so either a lot more people were responsible, or the department was being dangerously overworked.
Very quickly, that has become clear to be the case.
A Siptu spokesperson has described the UHK radiology department as a "very unhappy" place to work, while a report from December 2016 highlighted insufficient staff and equipment. What's more, it has been reported that the consultant
made a number of complaints surrounding the radiology department, although the hospital insists that these were investigated.
Why didn't the hospital say anything sooner?
What has upset many is the fact that University Hospital Kerry or the HSE did not publicly announce the review back in October, while local GPs were only made aware in late November.
One of the reasons provided here was that they did not want to cause distress to their patients, given that the chances were slim that an abnormality might be spotted during the review. Still, it will be difficult to excuse the fact that many only learned once the story was picked up by media outlets on Sunday, 17 December.
It seems likely that two of the major issues that are going to be debated over the coming months are the policies and transparency in the HSE.
