Jersey's breast cancer screening service

2024.06.25

2.1   Deputy L.K.F. Stephenson of St. Mary , St. Ouen and St. Peter of the Minister for Health and Social Services regarding the report by the Royal College of radiologists on the breast screening service.

Will the Minister advise what actions, if any, his department is taking to rectify issues identified by the Royal College of Radiologists in their report on Jersey's breast cancer screening service and the timescales for any such actions to ensure that Islanders are receiving appropriate and effective care?

Deputy T. Binet (The Minister for Health and Social Services):

In April of this year I met with the Deputy Medical Director who gave me a full update on the situation and provided me with a thorough explanation of the breast radiology action plan. The plan included a well-considered range of recommendations, many of which have since been implemented or are in the process of being implemented. Some actions were easily addressed, but some will require further investment and support over a period of time. All the actions have been R.A.G. (red, amber, green) rated to ensure that those were the highest priority in relation to patient safety have been and continue to be addressed first. A sustained programme of support has been put in place and will be monitored on an ongoing basis. Full details of the recommendations will be made available at the next public board meeting in July. Members will be aware that there are numerous problems to be overcome at the Health Department and there is no doubt that other issues will emerge before things settle down. But at this point in time, what I can assure Members is that I have been extremely impressed with the speed and efficiency of the work that has been undertaken since the report was received.

1. Deputy L.K.F. Stephenson :

I understand again from media coverage yesterday that the radiologist referred to in the J.E.P.'s (Jersey Evening Post) coverage of the contents of that report and subsequent fallout from it is still employed by his department. Can the Minister confirm on what terms that individual is working, in what role and what steps have been taken to ensure they are up to the job and not putting further patients at risk?

Deputy T. Binet :

I cannot provide a precise detail of what that radiologist is doing at the moment, but I can assure the Assembly that nobody else is being at risk. If we look at the actual facts behind this, the level of false negatives that were detected is within the tolerances that are generally accepted in most western countries.

2. Deputy H.L. Jeune of St. John , St. Lawrence and Trinity :

I asked the Minister 2 weeks ago - in the last States sitting in fact - what are the clinical areas in the H.C.S. (Health and Community Services) that the Minister is most concerned about at the moment? His response was: "I have to say there is nothing of massive concern at this point in time." Is the Minister still content with his answer?

Deputy T. Binet :

Yes, I am. This latest affair is historical. It happened a good while ago. It was first initially dealt with a year ago. I think there are Members present who were aware of the situation. It is my job to ensure that patients are not put in a state of panic. I think this has been handled sensitively and we will carry on handling further issues of the sort in the same manner.

3. Deputy H.L. Jeune :

Could the Minister advise when he knew about the concerns outlined in the Royal Court Radiologists' Report and, when he did so, did he prioritise them as something that was an important part of his oversight?

Deputy T. Binet :

The Deputy referred to the Radiology Report. Sorry, could the Deputy repeat the question? Sorry.

Deputy H.L. Jeune :

Sorry, maybe I have the name of the report wrong, but could the Minister advise when he knew of the concerns outlined in the report that I think the J.E.P. said was published in in January, but when did the Minister know of these concerns and did he prioritise any of them from January and, if not, why not?

Deputy T. Binet :

Yes, I was informed of the situation shortly after taking office, which is end of January, early February, I believe. I have been updated ever since and, as I said earlier, I have been extremely impressed by the way this has been handled. It has been under the control of the Deputy Medical Director, and I have to say I have had full confidence in the actions that he has taken. It was very, very clear that he prioritised everything and made very good arrangements to deal with things in a timely and sensitive manner. I did not have to prioritise anything, I could see that matters were being well-prioritised by the team.

[09:45]

4. Deputy J. Renouf of St. Brelade :

The Minister says he knew in January. He says he met with the Medical Director in April. The Ministerial Code, point 28, says: "Executive Members should adopt a no-surprises approach regarding announcements, ensuring that Ministerial colleagues and then the States Members are notified in advance of the media." Why did the Minister not follow this?

Deputy T. Binet :

Simply because I deemed it in the best interests of patients not to do so. I think in all of these matters I know that we all feel that we are entitled to information here, and that is absolutely as it should be, but in Health I am afraid the patients come first and I took the view that it was in the best interest of the patients that every one of those patients that was concerned should have been contacted in the first instance. That is the way that we chose to deal with it.

5. Deputy J. Renouf :

We are dealing with this issue now because of the report in the newspaper. Can the Minister say when all those people had been contacted, given that this was first brought to his attention in January, and why it has taken so long to make those contacts?

Deputy T. Binet :

I do not know if I heard the question correctly. Did I hear correctly that we have dealt with this because of a report in the newspaper?

The Bailiff :

Well, the specific question is when did the people affected by this receive notification? That is the point to it.

Deputy T. Binet :

As soon as we had sufficient information to know what we were contacting them about. It has been a complex process. I am happy to reveal what that process is. It is not something that I could stand here and repeat in full detail, but there has been a very complicated, well-organised process that has been implemented, and I am very happy to share that with the Deputy should he so wish.

6. Connétable D.W. Mezbourian of St. Lawrence :

In the best interests of patients, how is the accountability for this being managed? Deputy T. Binet :

Once again, I cannot lay that out in precise detail, but I can assure the Constable that they are being managed appropriately. I have no reason to suspect why they would not be handled in accordance with all of the protocols that are in place.

7. The Connétable of St. Lawrence :

Has the Minister not asked that question of his officers because he should be able to answer it? Deputy T. Binet :

To be honest with you, I cannot recall having had that discussion. I may well have done. I have dozens and dozens of conversations with a lot of people on a lot of issues. But I am very comfortable with the people that are dealing with this and I am absolutely certain it has been dealt with properly. I can certainly report back to the Constable at some point after the Assembly.

8. Deputy M. Tadier of St. Brelade :

In one of his supplementary answers the Minister talked about not wanting to, I think, induce panic or something to that effect. Could he clarify what he meant by that?

Deputy T. Binet :

Well, it would have been easy enough for the former Minister for Health and Social Services or the former Chief Minister to report to this last year, because this was all known about at an earlier stage. Why would anybody want to put something out in public where people are going to be uncertain as to what their status is? We wanted to make sure that all of those things have been dealt with in an orderly manner before the public knew. I think it is the patient's right to be dealt with before the public get notice.

9. Deputy M. Tadier :

I am just wondering if this is an example of opinion management from a Ministerial department. Surely the correct way to proceed is just to present the facts at the correct time and then let people decide whether they want to panic or whether they want to be quite relaxed about the news that is going on. Would the Minister agree that is the usual way forward?

Deputy T. Binet :

No, I would not. I think it is quite preposterous, to be honest with you.

10. Deputy I. Gardiner of St. Helier North :

The Minister has mentioned that there are outstanding actions required to be implemented. Would he inform the Assembly what the outstanding actions are from that report?

Deputy T. Binet :

There is a whole series of ongoing actions that relate to this, too many and varied for me to actually commit to memory. As I say, those parties that are interested in the further details, I am quite happy to share them with Members at a later stage.

11. Deputy I. Gardiner :

I understand there are too many actions but would the Minister be able to provide at least 3 actions that he considers are important and urgent to implement?

Deputy T. Binet :

Off the top of my head, under this sort of pressure, no, but I am very happy there is a comprehensive programme of works that is being undertaken.

12. Deputy L.M.C. Doublet of St. Saviour :

Has the Minister reflected that the patient groups mostly impacted by the 2 major issues identified recently are groups that may be particularly vulnerable in medical settings, namely older people and women? In making these reflections, what actions can the Minister take to make sure that these groups are receiving appropriate medical care?

Deputy T. Binet :

Given that I take these 2 groups particularly seriously, I think it is safe to say that I have done all that I can up to this point in time.

13. Deputy L.M.C. Doublet :

I have reflected on the Minister's answers to the previous question, where he declined to give any action points off the top of his head. Did the Minister not prepare for this Question Time with his officers and does he not have that action plan in front of him today? [Approbation]

Deputy T. Binet :

Yes, I did spend a considerable amount of time preparing for this but I have also got a considerable amount of other work. We have a Health Service that is not in disarray but requires a great deal of attention. I also spend some of my time looking at redesigning the entire Health Service, a major body of work where I am going to come back to the Assembly for a large sum of money to do ill-health prevention. These are major things that are going to give rise, with the Assembly's approval, to a lot of these things not happening anymore. So I spent a little bit of time dealing with the symptoms of what is going wrong and I spend an awful lot of time dealing with the causes. I am very comfortable about that.

Deputy L.M.C. Doublet :

Sir, if I may, I think the second part of my question was not heard because of the foot stamping. I asked the Minister if he had the action plan in front of him today.

Deputy T. Binet :

No, I do not have the action plan in front of me today here, because I do not see what purpose that would serve. There is a team of very competent people dealing with this issue and I am very comfortable about that. I do not think having that report here would serve any purpose particularly.

14. Deputy L.K.F. Stephenson :

Can the Minister confirm if the R.C.R. (Royal College of Radiologists) report - which I believe there are 2 reports and this is the initial one, which focused on radiology - raises any further questions about any other aspects of radiology care which warrant further investigation or action beyond those which relate to the breast cancer screening service? Or is he satisfied that all other aspects of radiology are working appropriately and effectively and delivering the best possible care for Islanders?

Deputy T. Binet :

There are other issues of radiology under scrutiny at the moment and we will be making those findings clear probably towards the end of next month.

Deputy K.L. Moore of St. Mary , St. Ouen and St. Peter :

Sir, there was not an opportunity to ask a further question to put the record straight, but I do think that the Minister for Health and Social Services inaccurately suggested that the former Chief Minister was aware of this report. She was not.

Deputy T. Binet :

Sir, I have to say, if I may, that I checked that yesterday and I was informed that that was the case.

The Bailiff :

Well, I think this is a matter that certainly cannot be resolved. There is no mechanism for resolving any kind of dispute on this before the Assembly. I certainly cannot resolve it and so I think we have to leave it as it is there.