Senior Medics Resign from NI Cervical Screening Program Citing Service Concerns

The BBC has been informed that two high-ranking medical professionals participating in Northern Ireland’s cervical screening initiative have stepped down due to worries regarding the service. According to their resignation letter, which BBC News NI has reviewed, the two healthcare professionals stated that the Public Health Agency (PHA) disregarded their reservations, among which was the establishment of a new centralized cervical screening facility within the Belfast Health Trust (BHSCT). The physicians, who held leadership roles in Quality Assurance, expressed that the “scandal” associated with events at the Southern Trust might be “repeated” unless authorities intervened. The PHA informed BBC News NI that it “refutes” the substantial claims presented in the resignation letter. A highly critical report published last week concerning cervical screening within the Southern Trust revealed that women, including two fatalities, had experienced systemic failures spanning numerous years. Subsequent to the incidents at the Southern Trust, and with the aim of harmonizing Northern Ireland’s cervical screening program with the rest of the UK, all HPV (human papillomavirus) screening was relocated to a single facility situated at the Royal Victoria Hospital (RVH). The two medical practitioners, identified as Dr. Gary Dorman and another who chose to remain anonymous, stated their resignation from the Northern Ireland Cervical Screening Programme (NICSP) followed years of expressing concerns, such as the consolidation of Northern Ireland’s four cytology laboratories into a single one. Both individuals maintain permanent positions within the Northern Trust, which until recently contained one of the cytology laboratories. In their correspondence to the PHA, they claimed that HPV testing was conducted at the RVH lacking appropriate regulatory accreditation, a governance and accountability framework, and any records concerning screener underperformance. They indicated that they had communicated their “deep concerns that major issues have not been acted upon in a way to ensure that the women of Northern Ireland will have the best possible cervical screening programme”. The two medical professionals asserted that the PHA had disregarded their recommendations over several years, leading to the conclusion “that their positions were untenable and therefore we must tender our resignations”. They implored the PHA “to take cognisance of this and take corrective action before it is too late and another major scandal falls within the (NI) Cervical Screening Programme”. The doctors stated that permitting such a situation would result in a “continuing lack of confidence in the programme and the PHA”. In a statement provided to BBC News NI, the PHA verified that UKAS, the accreditation body, suspended the accreditation of the Belfast Trust’s cytology service in October 2023 subsequent to an unannounced inspection. Furthermore, it was noted that a contributing factor to this suspension involved screener underperformance, which had fallen below the required standard over a prolonged duration. The BHSCT appealed this determination, arguing that screener performance calculations differed from those in England and, as per the BT, could not be directly compared to England’s benchmarks. Following the resolution of various issues concerning process documentation and enhanced audit procedures, cytology accreditation was officially reinstated approximately one year later, in June 2024. Both the PHA and the Belfast Health Trust have indicated their satisfaction that there is “no persistent underperformance of screeners in the Belfast Trust.” Nuala McAllister, the Alliance Party’s health spokesperson, commented that the resignations “only prompt more questions as to the efficacy of the cervical screening process and how it has been allowed to reach such a dangerous point.” The assembly member further stated that the resignations of two senior medics, occurring “after being made to feel their concerns were being ignored,” constitute a cause for extreme apprehension that “raises even more red flags.” “I will be raising this issue at Health Committee, however in the meantime, I would implore the Health Minister to take urgent action amidst this chaos and uncertainty and call a statutory public inquiry.” Ms. McAllister concluded by emphasizing that to prevent the recurrence of previous errors, “we must heed the warnings of health professionals now… women’s health is far too important for faith to be lost in such a crucial service.” BBC News NI has also uncovered that HPV testing at the RVH center ceased suddenly in June 2023 after a Quality Assurance inspection by the PHA determined that the trust had implemented its own HPV testing procedure without official authorization. HPV testing recommenced at the Belfast Trust once the new single HPV laboratory officially began operations on November 1, 2024. The PHA has further confirmed to BBC News NI that the new HPV laboratory has not yet received accreditation for HPV screening, as the service has only recently become operational. UKAS is reportedly aware of this situation and intends to conduct a visit in January 2025 for assessment after several months of the lab’s operation. Although the PHA has issued an apology for the events at the Southern Trust, it has consistently affirmed that Northern Ireland’s screening program is a well-structured and efficacious initiative that preserves lives. Additionally, it stresses the importance of women attending screening appointments when invited. Notwithstanding the new HPV laboratory’s operation, BBC News NI has discovered that 5,000 smear tests were recently dispatched to Gateshead for HPV screening. The Belfast Health Trust explained this was a necessary measure because other laboratories had stopped screening, and the PHA aimed to prevent a backlog and delays in women receiving their results. They indicated this arrangement was provisional. Within their resignation letter, the medical professionals asserted that the procurement procedure for operating the new single laboratory was defective. In reply, the PHA declared it “strongly refutes” this claim, clarifying that it was a HSC commissioning process, distinct from a public procurement process. The PHA further stated that proposals from three of Northern Ireland’s five health trusts were evaluated by an independent panel based on several critical criteria, including service delivery, quality, staffing, business continuity, and value for money. The PHA articulated that the justification for transitioning to a single regional laboratory for cervical screening stemmed from the imperative to centralize expertise and personnel resources in one location, acknowledging that staff in other laboratories might have been dissatisfied with the outcome.