Obstetrician and gynaecologist, Dr Nóirín Russell is clinical director of CervicalCheck, made some ill-advised remarks during a video call in late 2020 with Meath TD Peadar Tóibín.

There are few events that could focus the mind more sharply on the benefits of health screening than the death of your mother at age 44, when you were just 11 years old.

I was only a teenager when I first became aware that having a primary relative with breast cancer could increase my own risk of the disease. Screening should be considered at a far earlier stage than normal. Quite the double blow — loss of a mother, plus the realisation of a higher risk of being diagnosed with the same horrible disease yourself.

It is so long ago now since my first mammogram that I do not remember how many I’ve had, just that I hate when that time of year comes around and the stress of waiting for the results. The thoughts of history repeating itself feel all too real.

In the earlier days, in my twenties and thirties, the message from the medics was always the same — this is a wise course of action to take, but mammography is not perfect, especially in younger women, who have more dense breast tissue. By the way, they would add, we’re not 100% sure how much risk you’re placing yourself at with this annual radiation exposure, but we reckon it should be OK. All very comforting. So each year a clear result is returned there is immediate relief, but also a knowledge the screening devices are not perfect. You have to learn to live with that.

At least the screening option is available. Indeed it was an annual mammogram that showed up an early breast cancer in a close relative just last year. How glad she, and all of us were then, that they do exist, and that she had been availing of them each year.

A national cervical screening programme was established in Ireland in 2008. Funnily enough, when I began having smear tests I too believed they were far superior in terms of accuracy.

 It was not until the CervicalCheck controversy of 2018 I realised that just like mammography it is not failsafe.

So for the women who got clear smear results, but in actuality had cancer, some of whom have tragically died since, it was an incredible shock. This was all compounded by the manner in which they were told how this had come to light. No one had been repeating that message I had been receiving when it came to mammography — although BreastCheck too has been subject to court cases. In hindsight, many GPs around the country were also not properly informed of the limitations of cervical screening.

As a result of all of this, we are in a place where screening for women has a dangerously bad reputation in Ireland — dangerous in that so many people feel such anger and suspicion towards these services, as opposed to something that can benefit us hugely as a female population.

It is against this rather toxic backdrop the people who run these services have been trying to keep the show on the road — despite the overhang of high court cases, a high level of aggression and a sense that they have been trying to harm women rather than save as many lives as possible.

This is the backdrop against which The Sunday Times published a lead story quoting CervicalCheck head Dr Nóirín Russell who made some ill-advised remarks during a video call in late 2020 with Meath TD Peadar Tóibín.

Dr Russell suggested some women were using the government-established tribunal for claims against CervicalCheck to “get some money” and claimed women with stage one cancer “probably know in [their] heart and soul that [they] haven’t been wronged”.

Dr Russell has since said the comments were “careless and hurtful”, made shortly after she took up the role. 

The tough thing to say is that depending on your perspective there is truth in what she said, but that is a horrible truth if you have lost a wife, partner or mother, often a young woman with a young family, from cervical cancer.

It is difficult to accept but when reading the same slide you can get two different results from two different cytologists. Imperfect, yes, but this sort of screening is still an enormous lifesaver globally. In four out of 10 cases when a slide is reviewed after cancer is discovered the slide will then be upgraded. False negative and false positive results are simply a part of any screening programme. They do not mean that the programme is not working as it should.

Of course, those women will feel enormously upset and angry and failed by screeners, but this is the reality and actuality of cervical screening. Added to that there will also be occasions when there is actual human error because humans are involved. It is heart-rending to hear dying women say they do not want this to happen to other women with children, but the awful fact is that it can and will, without anything having gone wrong with the system.

In Ireland this year CervicalCheck will diagnose around 160 women with cervical cancer. Ninety will die and it is completely possible some of those cases could involve negligence, but certainly not the majority, most cases are to do with the “grey zone” that can happen with screening.

The refusal to accept these realities does put our screening services at risk. What an incredibly harmful own goal for women that would be. In so many other countries the reality and limitations, although so sad, are accepted. It is worth adding, as always, for context, that women in Ireland have a host of good reasons to distrust the state when it comes to female health and wellbeing.

Researching this I came across a piece written by a doctor, published in this newspaper in the wake of the CervicalCheck controversy.

 She recalled, as a newly qualified doctor in Cork University Hospital in 2001, admitting to the gynaecology ward a woman who was the same age as her mother. Like her mother, she had four children.

She had been bleeding and the bleeding restarted later that night. The young doctor recalled being terrified and phoning for help. The consultant who arrived suspected the woman had cervical cancer. 

What's your view on this issue?

You can tell us here

He was afraid it was so advanced surgery would not be an option. He explained that because Ireland did not have a cervical cancer screening programme, he regularly saw women with advanced cervical cancer in his clinic.

“I was devastated,” wrote the young doctor. “This was the start of my interest in cervical cancer prevention.”

That doctor was Nóirín Russell, now the clinical director of CervicalCheck, as well as an obstetrician and gynaecologist. To my mind, there is no doubting her sincerity, then or since, in trying to save the lives of Irish women, even if she might choose her words and who she says them to a little more wisely.

Then again you don’t imagine a member of Dáil Éireann would do as underhand a thing as leak the transcript of a conversation you believed to be private.

Read MoreMichael Moynihan: Doubling the flow of traffic down a narrow street makes little sense

Some of the best bits from irishexaminer.com direct to your inbox every Monday.

Select your favourite newsletters and get the best of Irish Examiner delivered to your inbox

© Irish Examiner Ltd, Linn Dubh, Assumption Road, Blackpool, Cork. Registered in Ireland: 523712.