Fergus O'Dowd (Louth, Fine Gael) | Oireachtas source

This important legislation attempts to change the face and the modus operandiof the HSE. I am speaking personally when I say that, regretfully, it is like changing the deckchairs on the Titanicat this stage. The good ship HSE will continue to sail on without accountability or transparency, both of which were mentioned by the previous speaker. I have many examples because my constituents have come to me with them. I have been told by people from outside my constituency that the HSE is not working and is not accountable. I will give a few examples.

In November 2012, a patient died after being brought in a very serious condition from Cherry Orchard Hospital to St. James's Hospital, where he passed away. He should not have died. He was in such a disgraceful condition from a medical perspective when he arrived at the accident and emergency department at St. James's Hospital that the receiving doctor who met him there expressed serious concern to the members of his family who accompanied him to the hospital. When he asked them why they had not looked after him in his home, they informed him that he had not been in his home, but had been in a HSE hospital for a long time. He was a victim of AIDS. When the AIDS ward in Cherry Orchard Hospital was closing because people were thankfully living longer, people within the health service recommended that he be sent to the St. Doolagh's facility on the north side of Dublin city. That option was refused to him and he was kept in Cherry Orchard Hospital in a geriatric ward to which he was not suited. They had no training, no knowledge, no concern and no care for this man because he had AIDS. That is an absolute tested fact. It is known.

The facts are that the family was deeply concerned about that and they contacted management in the HSE and fought like hell to get an inquiry. The inquiry was set up. No doctor was put on the inquiry team to examine the medical issues which were of deep concern to the family. The family rejected the finding of the first inquiry. They came to me and we got a second inquiry set up. The second inquiry commenced into the death of this person and a doctor was put on the team but in the middle of the process the doctor left the inquiry and it collapsed because there was no medical person on it. We insisted on a third inquiry. The HSE tried and was unable to get a doctor anywhere in this country to sit on this board for almost a full year. It requested the medical association to nominate somebody to examine this situation, which is appalling and deeply concerning. No one stepped forward. Eventually, it had to get a private company to do it and then - this was almost four years later - the family got the truth of the death of their loved one and the reasons that person died. It had to do with a lack of management in Cherry Orchard Hospital, a lack of accountability and many other issues. The family has not left it at that because they are looking for a final relief of the burden on them because of the death of that man and the way he was treated by the HSE. I rang the family today and was told they are being challenged in the courts not by the HSE but by its legal advisers. That poor man died in 2012 and they still have no closure. There is no accountability within the HSE for this. It goes on and on. The only people who have suffered are the poor person who died and his family.

That is not the end of the story in Cherry Orchard Hospital. During the course of our inquiries, freedom of information requests and parliamentary questions, we discovered there were two other deaths at the same time in that hospital. Three people died in Cherry Orchard Hospital over a very short period of time in 2012. I do not know, I cannot get and I will not be given the details: I do not want to know their names but I want to know what the outcomes of those two other separate inquiries were. When we met the third inquiry team we were not told that it was looking into the other two deaths. I want to know what the hell was going on. What was happening in Cherry Orchard? Why did they not tell us what the outcomes of those two other inquiries were? We still do not know if anybody has been suspended. We do not know what has happened or what the outcomes were.

This goes to the heart of what this reform should be about. It should be about transparency of process and accountability. One of the issues concerns the medical profession. As a result of a discussion I had with people in the HSE, I believe we need an independent board - obviously there would have to be due process before a case would go to it - that will examine and investigate deaths and other medical issues that have arisen. We have heard of other people who have died tragically since, namely, Emma Mhic Mhathúna. Vicky Phelan is fighting very hard and she is shining light into the darkness of the HSE and its operation. We need now, and on Committee Stage, a better decision to be made other than to change the names of the people who sit around that board. Putting two people on it who have public knowledge all sounds very well and grandiose but it means nothing unless the HSE is accountable.

We need a body that will invigilate and examine what they are doing separately and that when people die tragically in hospitals or there is a significant medical misadventure that there would be an automatic referral to this body, which would have medical expertise provided by the medical professionals. They are remiss in not coming forward and doing their duty of care to people who were mistreated in our medical service. They are afraid to go forward. How in the name of God can they stand over their oath, if they, as an ethical body, will not say that they will nominate people who will investigate and examine the reason a person died or was badly mistreated by this system, which is unaccountable and rotten in many respects in this area? It is an outrage. It annoys me. When people come to me with cases like this one, I tell them I will do my best for them, but we are only voices here, we make our speeches and they waft off into the air. Nobody gives a damn, or do they care? I challenge them to do something about it now. I challenge my Government to step up to the plate and make sure there is a proper independent, scientific and medically based process in place, backed by the medical profession, that ensures that where these issues arise, they are dealt with clearly, openly, transparently and accountably and that people are fired for not doing their job. Nobody gets fired in the HSE. One cannot find out if there is even an investigation under way in some cases. It is not good enough.

The other issue that concerns me about the HSE is that of transparency and how can we improve it and accountability. I was sitting in my office one day and I got a telephone call from a person who told me that they found a medical record from a hospital somewhere in Dublin lying in a ditch on the side of the road. The medical records of patients were found on the side of the road in Baltray in County Louth, not once, not twice but on three separate occasions. I advised the person to bring them directly to the Garda station, which is the appropriate place to bring them. The person told me there was no hospital name on the documents but they did contain the names of the patients and their treatments. It is appalling those records were found on the side of the road.

The reply I got from Beaumont Hospital stated:

Dear Mr. O'Dowd,

A recent incident occurred whereby personal healthcare information on patients who attended our Emergency Department was found outside of Beaumont Hospital. [It was found on the side of the road in County Louth.]

On review ... the source of the information has been identified as an Emergency Department summary clinical hangover report used by nursing/medical staff during shift changeover. [They were changing shift and suddenly a sheet of paper fell out, landed on a car or whatever and ends up on the side of the road.]

As a result of this incident all Emergency Department staff have been directed to use the confidential bins provided for such reports prior to leaving the hospital.

As well, I have written to all of the patients personally outlining the cause and details pertaining to the information breach and apologised on behalf of the hospital.

That happened three times on three separate dates over a period of time. That is not good enough. The way they treat serious significant confidential information in a cavalier way is unacceptable. Somebody should be held accountable for this. I do not know who they are and we will never find out because they are not going to do anything about it.

I welcome the interest of the Minister of State particularly in this matter because she has visited the town of Drogheda on three separate occasions at least to deal with the issue of drug abuse and the medical issues pertaining to that. The context of drug abuse in County Louth is clear with the appalling situation we have with the drug barons, the criminals, the violence on our streets, people being shot at in houses and people being intimidated. A woman who called to my office this week told me that her son was told that if he did not pay his debt, this was the knife - which they showed him outside a supermarket - with which they were going to cut her. Would my colleagues believe that? That is the truth. That is what happened in my office last Monday morning. We have the proceeds of crime, the criminality and all of that is going on.

On the medical side of it, I have information on the number of significant drug users, the use of syringes and so on. It is a quarterly measure of the amount of heroin and other substances that are being injected in County Louth. The figure is shocking. It is 11,000, on average, over a three-month period in County Louth.

The Minister of State, other people and I have tried to get a needle exchange programme and recognition for a top-class voluntary organisation, the Red Door Project in Drogheda. It does not have a proper outreach service because it cannot afford it. When Senator Nash, who is not in this House right now, and I made representations to the Minister, the official involved wrote a letter naming me and Senator Nash as using our political position with Red Door to get it funding and asking what she should do. Nothing happened. The project got no funding and has not got it to date. Almost €500,000 of health board money has gone into another location in Drogheda to additional services, which is very welcome. One of these services is drug outreach, which is welcome too. There was no consultation with Red Door, the Garda or anybody. The HSE is not accountable and it is not helping where it is critically needed to deal seriously with the drug problem in Drogheda by engaging, participating, sharing and working together with community groups. What better thing could be done than that?

Looking at the HSE and its CHO areas, the CHO area of Louth is different to the acute hospital area. There is one administrative area for community services and a different acute hospital area. They are not joined up in their thinking but they set up a group of counties which have nothing in common. Louth and Meath have a lot in common but we have nothing in common with Laois, Offaly, Westmeath and Longford but they are all in one area. It does not make sense. Louth, Meath, Cavan and Monaghan would make sense as an area. That is how it used to be. A lot of thinking needs to be done and on Committee Stage of this Bill, I hope to table some amendments to challenge the system, not the Minister, and the HSE to be accountable and to look again at making a better health service which would work with involvement, support, and more time for the community. I acknowledge all the good work, as the acting chairman has, of the tremendous nurses, doctors and staff. They are fantastic. There are some excellent top class administrators. The inquiry relating to Cherry Orchard Hospital would not have taken place if not for two very good HSE officials when we insisted at the end in getting full transparency.

How much does it cost to change the name of a hospital? The HSE, in its wisdom, has decided that Our Lady of Lourdes Hospital in Drogheda which was built in 1950 by the people of Drogheda and elsewhere in the country, when everybody bought a brick and supported it, should have a name change. The ethos of the hospital changed some years ago, rightly so, when the health board took it over. The order of nuns, the wonderful Medical Missionaries of Mary, no longer have any role to play in it but people like the name - the Lourdes hospital - which is what they know it as. I like where I live, a place called St. Mary's Villas. One of the main streets in the town is called St. Laurence Street. I like that and St. Laurence's Gate. I do not want to change the names. We like names such as Peter Street or St. Laurence Street. They are historic and part of what we are. The Lourdes hospital's name is being changed and there has been no consultation with the people, who are angry about that. Many of them protested it. One might ask what a name change is. It is a fundamental thing for people to show respect for what is there. I am talking about the name, not the ethos, which has changed and I fully support a secular health service and complete separation of church and State. I do not think it is a good idea to change willy-nilly the names of institutions that have been there for a long time. Will the name of St. James's Hospital change? If it did change, what would it cost?

I believe there is a total lack of sensitivity and awareness on issues like this and of understanding of people who respect and like what the hospital means to them. Changing the name is rubbish. I would like to talk about many other things although I know my time is getting short. If a hospital in one's county closes, one is in trouble but one would have no say in that and there is no forum to complain about it. The only place to deal with health in this place is in the Chamber, with the Minister or in the Joint Committee on Health. I have a significant interest in health. I am not on the Joint Committee on Health and if I went in, I am sure 20 others would be ahead of me. We are talking about regional accountability. One thing the Minister should consider is that there should be a regional health forum that Members of the Oireachtas would attend. It should be quarterly, based on their acute hospital grouping or CHO. I do not mind which it is. There would be an agenda which would be made known in advance. One would ask for reports at it but not interfere with decision-making. One could ask why something was done, what is happening in a certain situation or how one could help. That debate and knowledge do not exist.

The HSE is a bit like the Kremlin. I will be visiting Russia fairly soon and it is probably the last place I would like to be. One cannot get answers, cannot find people and will be put through the hoops if one submits a freedom of information request. Moreover, one must request meetings. The problem with the HSE is that it is not interactive with the political system. The political system, in a way, is afraid of that responsibility. The Minister will face responsibility every day if anything goes wrong but he has no say in what is happening and this Oireachtas has no say. There is no real understanding or effort to get a better system to make it better for ordinary people. It is not good enough when people such as those I am dealing with lose loved ones in appalling, disgraceful, shameful and unacceptable circumstances and are still fighting for justice six years after a person died. This has to change.

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