Gearóid Ó Loingsigh
(Reading time: 6 mins.)
First published in “Socialist Democracy” December 2022, republished here with kind permission of author.
The death of Vicky Phelan on November 14th was announced by the media. They were full of praise for a woman who was a victim in the cervical smear scandal.
She was one of over 200 women whose cervical smear tests were outsourced to a private US company, which gave back erroneous results.
Women who could have received treatment went on to develop cancer and in the case of Vicky Phelan die. But she didn’t just die. She was murdered.
Engels in his famous tract The Condition of the Working Class in England stated that
When one individual inflicts bodily injury upon another such that death results, we call the deed manslaughter; when the assailant knew in advance that the injury would be fatal, we call his deed murder.
But when society places hundreds of proletarians in such a position that they inevitably meet a too early and an unnatural death, one which is quite as much a death by violence as that by the sword or bullet; when it deprives thousands of the necessaries of life, places them under conditions in which they cannot live – forces them, through the strong arm of the law, to remain in such conditions until that death ensues which is the inevitable consequence – knows that these thousands of victims must perish, and yet permits these conditions to remain, its deed is murder just as surely as the deed of the single individual; disguised, malicious murder, murder against which none can defend himself, which does not seem what it is, because no man sees the murderer, because the death of the victim seems a natural one, since the offence is more one of omission than of commission.(1)
The Irish state has for a long time deprived its population of the necessaries, as Engels put it, of life in relation to health care. One of the first politicians to wreak havoc in the health system in pursuit of her ideology and profit was Mary Harney.
She and her party the Progressive Democrats were ideological in their commitment to the privatisation of health care. Under her rule and that of successive governments, the health service was privatised.
First, they ran it down, closing hospital wards and reducing the number of beds in the health service, paying Consultant Doctors extravagant salaries, allowing them to moonlight as private consultants, whilst there are now around one million people on public waiting lists.
The system is a shambles and compares poorly in terms of speed and quality of care to even Third World countries.
At the same time a private health care sector has arisen and expanded, all the time promoted by the state through tax breaks and discounts for the companies with affiliates being able to write off part of their private health insurance against tax.
In other words, a public subsidy to the health companies paid for through the taxes of many people who cannot afford to use these services. The Irish health service does not exist to provide health care but rather to generate profit. It is important to understand what this means in practice.
If profit is the motive, then the law of supply and demand takes over and prices and the quantity of services are calculated on the same or similar basis to the sale of a car. It also means that in order for some to be treated and live, others must die.
It is an intrinsic part of the system and they know it. For health care to be profitable some must not have full access to it, some must die in order for others to make profits. If everyone can access cancer treatment without problems then there is no need for private medicine.
This is not the situation in Ireland. Public services are run down in order to encourage private medicine and profit.
It is in this context that the Health Service Executive outsourced the testing of cervical smear tests not only to a private company, but to one in another jurisdiction. Money was to be made, and to hell with the consequences.
Dr David Gibbons, a former member of the screening programme, said he expressed concerns about the outsourcing of smear tests to the US in 2008 but they were dismissed.
Gibbons, chair of the cytology/histology group within the programme’s quality assurance committee, brought up his worries with Tony O’Brien, then chief executive of the National Cancer Screening Service and director general of the HSE until 2018, but they were not listened to.
Dr Gibbons resigned as a result. O’Brien defended the decision to outsource the testing saying that tests would have otherwise been left idle for a year or been examined by doctors “on their kitchen table”.(2)
Why would they lie idle for a year? Because they had decided not to spend money on it. Why would doctors end up examining them on their kitchen table? Because the facilities weren’t there.
When it all went wrong, they dragged their heels on informing the women, and this is where Vicky Phelan comes in.
She was diagnosed with cancer in 2014, but only informed of the false negative from the unapproved labs used by the HSE in 2011 and sued the US company and the HSE, but her case against the HSE was struck out.
The cat was out of the bag, however, but they continued to drag their heels on informing women that they may in fact have cancer and they stuck by their accountancy guns and continued to outsource the tests.
As Engels stated they know these victims will perish and yet permit the conditions to continue.
When she died, the great and good in Irish society expressed their praise for her. The murderers came back to the crime scene in a perverse act to say “It wasn’t me, I didn’t do it”. The Taoiseach, Micheál Martin stated on Twitter
Very saddened at the passing of Vicky Phelan, a woman of great courage, integrity, honesty & generosity of spirit. She will be long remembered as someone who stood up for the women of Ireland, & globally.(3)
The Tánaiste Leo Varadkar, for his part, was brazen in his Janus-like abilities.
Today Ireland has lost a woman of limitless courage, compassion and strength. I want to extend my deepest sympathies to Vicky’s family, particularly to her children on the loss of their incredible mother.
Vicky was a shining example of the power of the human spirit. Her fight to uncover the truth and the courage with which she faced her illness made her an inspiration to us all. We mourn her as a nation, as a society, and as individuals.(4)
Both of these men bear responsibility for what happened. To listen to them you would swear they were talking about some social justice warrior in a far-off land who stood up to a government that the Irish state is not on good terms with.
Varadkar was a government minister in 2011 when Vicky Phelan was tested. He was Minister for Health when she was diagnosed with cancer and he was Minister for Social Protection when she was eventually informed about the mess up with her results.
Martin has been a T.D. in the Irish parliament (Dáil) since 1989 and has served as a minister on and off since 1997 and is the current Taoiseach.
They oversaw the dismantling of the health system, they made up the rules and implemented them. What happened to Vicky Phelan was on their watch. In other jurisdictions functionaries can be held liable for decisions they take, but not in Ireland.
They took decisions on the health service which affect the lives of millions, not just Vicky Phelan. Every year countless patients die in Ireland due to a lack of access to proper healthcare; Varadkar and Martin know this and yet they proceed with their actions.
In a criminal court case where a person carries out an act knowing it could result in the death of a person and decides to proceed nonetheless, they would be liable for that person’s death through recklessness.
Yet, politicians take decisions that kill people knowing that this is the likely outcome. They are guilty of what Engels termed social murder.
Vicky Phelan didn’t just die, Fine Gael and Fianna Fáil along with the Greens murdered her. No amount of praise from Vlad the Impaler a.k.a Leo Varadkar can hide the fact that he bears responsibility for death.
(1) Engels, F. (1885) The Condition of the Working Class in England https://www.marxists.org/archive/marx/works/1845/condition-working-class/index.htm
(2) Simon Carswell (01/05/2018) CervicalCheck scandal: What is it all about? Irish Times. https://www.irishtimes.com/news/health/cervicalcheck-scandal-what-is-it-all-about-1.3480699
(4) Leo Varadkar (14/11/2022) Statement by Tánaiste and Fine Gael Leader Leo Varadkar on the death of Vicky Phelan https://www.finegael.ie/statement-by-tanaiste-and-fine-gael-leader-leo-varadkar-on-the-death-of-vicky-phelan/