Mary Harney (Dublin Mid West, Progressive Democrats)

Yesterday evening, the HSE issued letters to almost 4,600 patients in the north east advising them that chest X-rays and CAT scans from 2006 and 2007 were to be reviewed. Individual patients will be notified of their result as soon as their X-ray-CAT scan has been reviewed, namely, they will be informed whether they are clear or are to be referred for further assessment.

The HSE has emphasised in its letters to patients and others that the review is for precautionary reasons. The review arises from concerns raised relating to the practice of a locum radiologist. In late 2007, it came to the attention of the HSE that a small number of patients in Our Lady of Lourdes Hospital Drogheda and Our Lady's Hospital Navan during 2006 and 2007 had their diagnosis delayed due to an abnormality on their chest X-ray not being noted on initial examination by the radiologist. These patients, through follow-up X-rays, were subsequently diagnosed with lung cancer and have all passed away.

The HSE has established a review by external experts into these four cases. The review led by Professor Muiris Fitzgerald, respiratory consultant, will allow the HSE to establish if there was a clinical significance to the delayed diagnoses. The HSE has made contact with the families concerned and remains in regular contact with them to update them on progress and to offer any appropriate supports.

I was informed in March of this year that the HSE, following further examination of the issue, was considering a separate look-back review in regard to the work of the radiologist. The HSE issued a press release on 31 March following media reports concerning radiology services in the north east. That press release was based on the information available at the time. In its subsequent assessment of the situation, and taking into account the advice of external experts, the HSE agreed the look-back review would include a small number of CAT scans.

The HSE decided that a look back exercise was required to review approximately 6,000 chest X-rays and approximately 70 CAT scans reported by the locum consultant radiologist in Drogheda and Navan from August 2006 to August 2007 to ascertain if other significant clinical findings had been missed. These X-rays-CAT scans relate to approximately 4,590 patients.

Chest radiographs are performed for many reasons. Most are done for respiratory tract infections, bronchitis, asthma, pneumonia, accidents, injuries, chest pain and heart failure. A small number would have been done for possible lung tumours, but the majority of patients who are being checked are extremely low risk and included as a measure of prudence.

The planning for this review commenced in March. A steering group was formed by the HSE on 9 April to oversee the radiology review. Between April and 14 May the steering group undertook preparatory work which included defining the methodology for the look-back exercise, sourcing radiologists to undertake the look-back, arranging indemnity for participants and working to provide assurance that any and all claims arising from this review would be covered, developing the process and resources for the look-back exercise across two X-ray departments in Navan and Drogheda, establishing the communication needs around the review and putting plans in place to meet these.

This review will be undertaken by an internal and external mixed panel of radiologists from Louth, Meath and Northern Ireland. The HSE issued letters to patients, general practitioners and public representatives by post informing them of the arrangements for the review and giving details of the HSE information line. It is expected that the review will take approximately eight weeks. In patients' interests and in keeping with the lessons learned from previous reviews, neither the HSE nor the Department will report further on specific details of the reviews until they have concluded.

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