Denis Naughten (Roscommon-South Leitrim, Independent) | Oireachtas source

I thank Deputy Mathews for sharing his time with me. I wish to speak on a report published last month, Health Care Quality Indicators in the Irish Health System, examining the potential of hospital discharge data. I believe the report has implications for the operation of this legislation and the interaction or lack of interaction between the HSE and the Department of Health.

On 23 February, Mr. Ian Carter, national director of acute hospitals, in an interview with Ms Susan Mitchell of TheSunday Business Post, was asked if the HSE had examined the reasons behind the high mortality rates in some units. He responded by saying "not yet". He said the HSE was only now validating the figures and examining whether there was a real variance or whether the differentials could be attributed to "poor coding" of data. He went on to say: "Have we had a systematic approach? No, we haven't in terms of drilling on down to individual hospitals. It has been slow, but the exercise is now happening on a hospital by hospital basis."

His defence was that the report had only "just been published". This is an outrageous admission by a senior official within the Health Service Executive because this report was available to the Department of Health, the Minister for Health and the HSE some 30 months prior to that when the Minister came into the House and read part of the report into the record and on foot of that used it as a validation for his decision to close the emergency department at Roscommon County Hospital.

Following the publication of the report last month, the Chief Medical Officer described it as a burglar alarm. He said that while he was not saying the house was ransacked, it clearly needed to be checked out. While the Department of Health informed the HSE to check the alarm, both organisations continued to let that alarm ring for 30 months before opening the door of the house to see what was happening inside. Mr. Ian Carter said that the review was only now happening, 30 months after the information was compiled.

What is even more bizarre is that in March 2012, the Minister, Deputy Reilly, told this House the reason the report had not been published two years ago. He stated:

...the CMO, in conjunction with the HSE, is now in the process of further augmenting the analysis of the indicators to date with data from 2011 and 2012. Every public hospital in the country has been written to in order that they can ensure that the information they record and report for 2011 and 2012 is actually accurate.

These figures were setting off alarm bells in the Department of Health in July 2011 as per the comments of the Minister, Deputy Reilly, in the House during the debate on Roscommon hospital. Even after the follow-up with the hospitals, which clarified the figure in regard to Roscommon, in respect of those hospitals that were outside the norm where stroke death rates were four times higher than some of the others and the heart attack death rates were seven times higher than the best performers, amazingly, nothing was done to determine the basis of those mortality rates for 30 months. The Minister was happy to see that report lying on a shelf because he had fulfilled his short-term agenda. Rather than delving into the figures, which could have exposed weaknesses both within the Health Service Executive, HSE, and within the Department of Health that may have raised difficult questions to be answered by him politically and for his Department, the report was quietly set aside. We are told further analysis was carried out but the fact remains that the HSE is only now looking at those figures, and the Department of Health failed singularly to act upon that and ensure that the HSE had followed through on it. One of two things have happened. Either the report does not give rise to the patient concerns, which means the report is a work of fiction, or it is reflecting a problem at hospital level that has been sat on for 30 months. One way or the other, both the Department of Health and the HSE need to come into this House and explain exactly which is the case.

This revelation again raises serious concerns about the Minister, Deputy Reilly, the Department of Health and the HSE. Their failure to act on the original data and on the revised data is putting the interests of patients behind the institutional interests of the HSE and the Department of Health. That sounds very familiar in regard to what we heard in recent weeks about Portlaoise hospital where local management failed to act. As a result, the Minister has brought in the Coombe hospital in Dublin to supervise what is going on in Portlaoise but in this instance the senior management within the HSE, the Chief Medical Officer within the Department of Health and the Minister had that report for 30 months and failed to act on it and failed to ask questions as to why those stroke and heart attack death rates were so high. The people of this country and the patients admitted to those hospitals need and deserve an explanation, and we need an explanation as to the reason those senior people with responsibility for the health service failed to follow though on damning data they got 30 months ago.

See this speech in context