Confusion reigns in the Irish health services. The Minister has been asked to resign, because of a very serious foul-up in breast cancer care in the Midlands, but has declined. The Taoiseach (prime minister if you only speak English) has promised her his full support, which is normally a prelude to walking the plank. The opposition (full disclosure – I support them) are rubbing their hands with glee. The night is hideous with the sound of chickens coming home to roost.

So, what happened?

Well, like most stories it depends when you start. If you start recently, it seems that a substantial number of women who had mammography (breast x-rays) , and a rather larger number who had ultrasound breast examinations, in Portlaoise hospital, have needed to have them re-done, and at least 6 of these women have breast cancer. At least 80 require a full re-assessment. Three consultants spent all day (Saturday 23rd) today in Portlaoise running an emergency surgical clinic to look after he first batch of these women.

Going back a bit, queries were raised about one radiologist in the hospital, and her work, both in mammography, and ultrasound, is being re-investigated. There seem to be two investigations going on, and I’m not clear how, or indeed if, they relate. I may not be alone in this, as the minister found out about the second investigation while attending an Oireachtas (parliament) committee meeting three days ago.

Going back quite a bit, the Midland Heath Board, which no longer exists, rejected a proposal to establish one cancer centre in their area about six years ago, and instead decided that it would be nice to have three. While it might have been nice, it was also completely impossible, but that didn’t stop them. With a lethal combination of chutzpah and ignorance they set up three inadequate centres.

What role this played in the later disaster is not yet clear. It may be that some poor sod is genuinely culpable, but it seems more likely that this represents another system failure.