How can almost half a million women go missing, and nobody notice? Yet that is what we are told has happened. Jeremy Hunt, the health secretary, came to parliament on Wednesday to confess that up to 450,000 older women in England may have somehow fallen off the breast cancer screening system, thanks to a computer glitch. Unravelling the real-life consequences of that is a complicated and contested business, but Hunt said it was likely there were people who “would have been alive today if this had not happened”; and that up to 270 lives may have been shortened. The next few days will be difficult ones for already overloaded GP surgeries and screening clinics, with anxious women now calling the hotline set up by the Department of Health in their thousands. But brushing something like this under the carpet was hardly an option.

It should be said, however, that this is not another Windrush scandal. It’s down to a faulty computer algorithm, rather than to some kind of hostile medical environment; the glitch that wrongly cancelled some women’s scans crept in accidentally in 2009, during the setting up of a pilot project on whether it was worth expanding the screening programme, not in some attempt to chop it back. Nonetheless, eight years is a hell of a long time for nobody to notice. Older women – that perennially invisible group – can be forgiven for wondering whether it would have happened to anyone else.

Up to 270 women may have died after breast cancer screening IT error Read more

Those worst affected would have been in their late 60s when their scans were cancelled and perhaps in their 70s when they started getting sick, a time of life when bad news is half-expected and medicine becomes mainly about managing decline not reversing it; when routine visits to the doctor end in apologetic mumbling that unfortunately, these things are to be expected when you get older. And older women are so often not the type to make a fuss. They’re of a generation that waits to be served, doesn’t like to bother anyone, trusts the people in charge to know what they’re doing. Of late, they have not been repaid well for that trust.

Think of the Waspi (Women’s Against State Pension Inequality) women, who didn’t realise the government had moved the goalposts on their state pension age until it was too late, and whose subsequent rage at their poverty has fallen on deaf ears. Think even of the middle-aged women who suffered for years from complications from vaginal mesh, whose complaints of agonising pain and infections weren’t taken nearly seriously enough at first, because they were often post-menopausal and well, what do you expect at your age, after a few difficult childbirths? They too found it difficult to get a public hearing, because incontinence and pelvic pain are not considered glamorous stories. Given the indignities heaped upon them – their erasure from a culture still fixated on the young – it’s surprising in a way that older women are not more radicalised politically.

To be fair to the NHS, it’s possible that the inquiry Hunt has ordered will discover that this isn’t as bad as it initially looks. Most of the women who missed a scan would thankfully have been perfectly healthy; some of those who didn’t get called in will have had scans for other reasons, such as finding a lump by themselves or being part of a programme of extra checks scheduled for women who have had breast cancer in the past. It may be that there were never enough cases clustered in the same place for doctors to spot a pattern of patients presenting with tumours who inexplicably hadn’t had mammograms for years, or for clinics to wonder why women who diligently showed up for previous scans had mysteriously stopped coming.

My heart goes out to all the grieving families who will now be wondering if their mothers and wives could have lived for longer, but sadly even some of those who died after missing a scan might not necessarily have been saved by screening. Early diagnosis gives a much better chance of survival, but it is not a cast-iron guarantee of anything.

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The sad thing, however, is that the women themselves presumably weren’t asking questions. When the letters stopped coming, they must have just assumed they’d had their lot from the NHS. It’s an age when you get used to dropping off people’s radar, after all. It is partly to avoid such human blind spots, of course, that algorithms like those our public services now use to manage data exist in the first place. Machines are meant to excel at routine tasks like churning out appointments and they don’t make emotional judgments about what you can expect at your age (or at least, not unless they’re programmed by people who do).

But we have grown so used to relying on computers to do the thinking and the remembering for us that we barely realise how much has been delegated to systems we don’t particularly understand, and didn’t realise could fail until it was too late – as those TSB customers still struggling to get into their bank accounts after an almighty car crash of an IT upgrade will know. The cervical cancer scandal currently unfolding in Ireland, where early abnormalities were not picked up in the cases of over 200 women who went on to develop cancer, and who in some cases have since died, is another grim reminder that no system is infallible.

It is important not to over-romanticise the past. These scandals did not used to happen, but only because worse ones did; before screening, more women died unnecessarily. For all its flaws and the hotly debated risks of over-treatment, screening has saved thousands of lives over the years, including in my own family. The risk remains small, but if you’re putting off a smear test, prostate check or mammogram then for heaven’s sake, go. But it isn’t women’s fault that, for whatever reason, the system missed any clue that something had gone awry for eight years. And all too often, dismissiveness and casualness is what older women have been taught to expect from a society that looks right through them. They need to be reassured that the doctor will, in all possible senses of the word, see them now.

• Gaby Hinsliff is a Guardian columnist