Thursday, 2 June 2005
I am grateful for the opportunity to raise the matter of the termination of the employment of Mr. K. Maha Lingam, orthopaedic surgeon, by the management of Cork University Hospital from a position he held for 11 years. His employment was terminated on the grounds that the Department of Health and Children failed to sanction an additional post which would have allowed him to continue in his position as orthopaedic surgeon in the hospital.
It is utterly unacceptable that elderly people with orthopaedic problems are told that they cannot be put on the outpatient waiting list and, when they are eventually put on the list, that they can expect to wait for up to two years for an examination. I know elderly people who have come to my clinic in tears because of pain and have been told that they may have to wait years for an examination. They have also been told that if they have €4,000 or, sometimes, €6,000, they can receive treatment within weeks from the same surgeons in the same hospital. This is scandalous and, despite the Tánaiste being aware of it, it has been allowed to continue. That medical apartheid must be dealt with sooner rather than later if social justice is to exist.
The public waiting lists at that hospital are unacceptable and cannot be allowed to continue at their present level. No matter how unacceptable they are, I find it incredible that Mr. Maha Lingam's position as trauma surgeon has been terminated with effect from 31 May 2005. Records available to me for St. Mary's Orthopaedic Hospital, the associated hospital of Cork University Hospital, for the years 1994-2001 show that Mr. Lingam carried out 30% of all hip replacements and over 30% of knee replacements in that orthopaedic unit, which had six orthopaedic surgeons. The figures are only available up to 2001 because I am informed that in that year, theatre space in the hospital was no longer made available to Mr. Lingam, despite the fact that theatre sessions were free for three years from 2002.
My attempt, as a member of the former Southern Health Board, to get a breakdown of the level of public and private practice on a consultant-by-consultant basis in that hospital was refused by the management at the behest of some people who had a vested interest in what I would term a very lucrative business. I submitted a freedom of information request, which was turned down. My appeal was refused and I made a detailed appeal to the Information Commissioner, which was not dealt with for over three years. Subsequently, I withdrew the request because the case was not being dealt with.
I find it incredible that, as a member of the former Southern Health Board, I could not get information from that health board about what was happening in hospitals funded by taxpayers. If the Minister is serious about dealing with some of the issues in the health services, that issue should be dealt with quickly and effectively.
Very little spinal surgery and cruciate ligament work and little, if any, shoulder replacements have been carried out at Cork University Hospital since 2001. I have been told that there have been ongoing difficulties with orthopaedic services in Cork for quite some time, which have resulted in this unacceptable situation regarding waiting lists. I call on the Tánaiste and Minister for Health and Children to carry out an independent inquiry into the activities at Cork University Hospital and to immediately sanction the surgical position so that Mr. Maha Lingam can continue his work within the greater Cork area. His reputation in Cork is top class and he enjoys the confidence and support of his patients, past and present.
This is not a party political issue. I regret the Tánaiste is not here. In the interests of justice for people who cannot help themselves and are at the mercy of those who make decisions about their future, this matter should be looked into and there should be a full and independent inquiry into what is happening.
I am pleased to have been given the opportunity by Deputy Allen to clarify, on behalf of the Tánaiste, who is unavoidably absent, the position of the Department of Health and Children. The Health Act 2004 provided for the Health Service Executive, which was established on 1 January 2005. Under the Act, the executive has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes responsibility for the provision of acute hospital services and the appointment of new or replacement consultant posts.
With regard to the specific case mentioned by the Deputy, the former Southern Health Board made application for financial clearance to the Department of Health and Children for the appointment of a seventh consultant orthopaedic surgeon post. In view of the financial implications of the proposed post, the Department of Health and Children was not in a position to allocate funding for this post in 2004 nor in the letter of determination for 2005 which issued to the Southern Health Board in early December 2004.
Since the establishment of the Health Service Executive, the Department of Health and Children no longer has a role in the approval or funding arrangements for individual consultant posts. The Department has been informed that this case is the subject of ongoing litigation, including an appeal to the Supreme Court. Therefore, it is not appropriate to comment on the case.