Mr. Jim Lawless:

Patients who have suffered a brain haemorrhage are denied access to emergency neurosurgical treatment. Subarachnoid Haemorrhage, SAH, is an immediate and life-threatening emergency. An estimated 460 to 1290 people suffer a brain haemorrhage each year. Ten to 15 per cent of casualties die before reaching hospital and about half of all patients die within the six months. Guidelines for the management of SAH patients were introduced by HIQA in 2010 to clarify the criteria for admitting patients for emergency neurosurgical or endovascular treatment but these guidelines have not improved access to treatment, nor could they. The reality is that the neurosurgical centre is grossly under-resourced. There are just ten neurosurgical intensive care beds. A report entitled "Towards Excellence in Critical Care" by an expert group on critical care services in the Republic of Ireland was presented to the HSE in 2009. That report assessed a need for 52 intensive care and eight high dependency neurosurgical beds.
I advised HIQA in 2008 that standards and measures of performance were required to address the inconsistency of decisions being made in the neurosurgical centre to admit SAH patients for treatment. No action was taken by HIQA until after the authority had been challenged in The Irish Timesin September 2009. The measures of performance or key performance indicators, KPIs which HIQA introduced were customised to satisfy the constraints of inadequate resources. Consequently, they restrict access to treatment and are unsafe. HIQA has also failed, despite several requests, to put in place a standard to measure the outcome for SAH patients admitted to an acute hospital but denied treatment in Beaumont Hospital.
HIQA is not an independent authority ---