Accountability and transparency needed over health crises on both sides of the border
Two major crises which have the potential to undermine public confidence in the health authorities on both sides of the border have highlighted key differences in accountability, north and south.
The controversy over errors in cervical smear tests in the Republic has developed into a scandal of enormous proportions, leading to the departure of the head of the Health Service Executive (HSE) and placing significant pressure on the Irish government.
This issue came to public attention last month when Vicky Phelan, a mother of two from Co Limerick, settled a High Court action after being incorrectly told in 2011 that her smear test had been negative. In 2014, she was diagnosed with cancer but only told about the false negative last September. She is now terminally ill.
It has subsequently emerged that 209 cancer patients had previously been told their tests were clear. Of those women, 17 have since died.
The stories behind the statistics are absolutely heartbreaking. Mother of five Emma Mhic Mhathuna (37) from Co Kerry gave a profoundly moving RTE interview in which she said: ''I don't know if my little baby will remember me.''
Stephen Teap, from Co Cork, expressed anger that his wife Irene died without knowing that her smear tests had been wrongly interpreted.
HSE director general Tony O'Brien resigned on Thursday night after it was revealed that memos dating back to 2016 were concerned about the potential for negative headlines such as 'screening did not diagnose my cancer.'
These messages have caused widespread disgust while this entire debacle may have far-reaching political implications.
Taoiseach Leo Varadkar was health minister at the time the first memo was circulated although the department said the information was not brought to the attention of any serving minister.
Even so, there is an overwhelming call for full accountability in relation to this appalling situation, which has shaken trust in the health service in the Republic.
Meanwhile, the health authorities in Northern Ireland are faced with their own difficulties, and are grappling with the recall of 2,500 patients under the care of consultant neurologist Dr Michael Watt amid concerns that some may have been misdiagnosed.
An independent inquiry panel will also assess whether any complaints prior to December 2016 should have provided grounds for earlier intervention.
Unlike the crisis in the Republic, where senior figures can be questioned and challenged, the lack of a Stormont assembly or a health minister removes a crucial layer of accountability which is essential in a democratic process.
Patients and the wider public have questions that need to be answered and are entitled to know that all relevant information will be disclosed as a matter of urgency.