James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Question 45: To ask the Minister for Health and Children the action she took to address the concerns raised in a letter she personally received from a consultant in Portlaoise in 2005 expressing their concerns regarding the quality and reliability of services in the radiology department in Portlaoise General Hospital; if she will assure Dáil Éireann that no further such letters lie languishing in her Department from concerned health professionals regarding specific issues of concern in hospitals and care homes; the procedures and action her Department takes to address such concerns; the systems in place to ensure early warnings from such staff are acted upon in order that they are followed up by her Department in a timely manner in order to avoid situations like that of mammogram misdiagnosis in Portlaoise General Hospital; and if she will make a statement on the matter. [30307/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

The Department of Health and Children acted on my behalf in this matter and I am totally satisfied in every respect that the Department acted in a thorough, timely and appropriate manner on foot of the information received. It is entirely without foundation for the Deputy to claim the letter "lay languishing" in the Department.

The facts are as follows. On 5 July 2005, a consultant at the Midland Regional Hospital, Portlaoise wrote to me outlining his concerns relating to the breast services at the hospital. In accordance with normal practice, the letter was passed to relevant officials in the cancer policy unit for examination. They rightly formed the view that the letter required to be brought to the attention of the HSE and management at the hospital. It was duly referred to the HSE national hospitals office for urgent examination and appropriate attention. The Department subsequently wrote to the consultant concerned advising him of this and also brought the letter to the attention of the regional director of cancer services in the midland region. I understand he then had discussions on the issue with hospital management and with the consultant concerned.

There are robust policies and procedures in place in the Department, including in the Minister's office, for dealing with letters, e-mails and telephone calls relating to matters of patient safety and quality of care. If a senior clinician raises an immediate risk to patient safety with me in any respect, I treat that matter very seriously.

In handling communications, administrative and professional staff, the office of the Chief Medical Officer in particular works with executive agencies such as the HSE and the Health Information and Quality Authority, regulatory agencies such as the Irish Medicines Board and professional regulatory bodies, where appropriate, to identify, describe and ameliorate any potential risks to patients or the general public in areas such as systems of care, professional practice or difficulties with medical devices or therapeutic agents. Theses procedures are subject to constant review and refinement in the light of circumstances and evolving best practice.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

The Minister's answer ignores the issue raised in the letter, namely, that the radiology service was a shambles. If she can honestly describe the manner in which that letter and the issues it raised were dealt with as the best way to do so, it is not terribly reassuring to this House and the people who must use the health service.

Can the Minister confirm that this letter was brought to her personal attention? Did she read it? Based on information from the HSE, I understand that the letter was passed to the network manager and on to the hospital manager who interviewed the consultant concerned and ascertained that no unnecessary operations had taken place, which was the end of the matter. An offer to have mammograms double read in hospitals elsewhere from December 2006 was then made.

During statements to the House on 7 November 2007, the Minister said the current review covers concerns raised by medical and nursing staff within the Midland Regional Hospital in Portlaoise and that action was taken on foot of this in August 2007. When the Taoiseach was asked when the Government first became aware of this problem, he answered that it was in August 2007. The Minister did not see fit to correct him and tell him that the letter had come to her in 2005.

It seems that action was taken only 18 months after Mr. Peter Naughton wrote to the Minister. It does not even address the concerns that he raised. I want to ask the Minister a number of questions.

Brendan Howlin (Wexford, Labour)
Link to this: Individually | In context

Please do.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Does she expect all medics who are concerned about the quality and reliability of machinery to walk away from the job and their patients, as she suggested in her response in the Dáil where she said that if the machine was so faulty, why did the radiologists continue to use it? The reality is that faced with the machine with which they must deliver the service, people deliver the service they can.

This unacceptable attitude is indicative of a Minister who is unable to cope with the responsibility of managing the health service. She has relinquished responsibility to the HSE and many would say that she has lost control of it. In a radio interview, the chief executive officer of the HSE cast aspersions on the public for protesting to try to hold on to their services.

The Minister told the House that nine women have been diagnosed and are undergoing treatment. I welcome that news because in the newspapers, it was suggested that six women were still waiting for a diagnosis and treatment, which would be totally unacceptable.

I wish to ask the Minister directly, because she has not answered the question, whether there are any other letters in her Department regarding the quality and reliability of services in the Midland Regional Hospital in Portlaoise addressed to her, her predecessor or other senior officials of which we should be aware. Could she confirm whether the doctor carrying out the current review of the mammograms was one of the doctors on the interview board that appointed the locum consultant in the first instance because if this is the case, it creates a conflict of interest?

Mary Harney (Dublin Mid West, Progressive Democrats)
Link to this: Individually | In context

In response to the last question, I understand that Dr. Ann O'Doherty was a member of the interview panel. It was a Public Appointments Service interview process that appointed the radiologist who is currently on administrative leave. I believe we answered a parliamentary question here recently. We get about 6,000 letters, excluding telephone calls, e-mails, representations from parliamentarians and parliamentary questions, in a four-month period. I believe the Minister for Health and Children sees letters that are addressed "addressee only". I believe the first time I became aware of this was 29 August when I was about to do an interview on the Barringtons Hospital issue. The HSE informed me that it had suspended the service in the Midland Regional Hospital, Portlaoise. That was the first time I became aware of this.

I hasten to add and emphasise that Department officials in the cancer unit who handled this correspondence did so in a very robust, thorough and fair fashion. The outcome would not have been any different or better if I had personally seen the letter at that stage. It was discussed with Dr. Hollywood, who was the medical director.

I wish to set the record straight by saying that when the O'Higgins report was produced in 2000, there was a recommendation that, marginally speaking because it was doubtful in terms of numbers, the midlands could have had a centre. The health board decided that each of three hospitals would have a little bit of the action. Some of it would be provided in Mullingar, some of it would be provided in Portlaoise and some of it would be provided in Tullamore. Even though over €7 million was allocated to develop the O'Higgins guidelines and multidisciplinary care, it was divided between three places, which was totally unsatisfactory.

Following that letter, a radiologist was appointed. Subsequent to her appointment, the hospital advertised for another radiologist. I understand that someone initially accepted the job and subsequently did not take up the appointment. I want to put on record that it is increasingly difficult to get leading specialists with a sub-speciality in something like breast cancer to take up positions in smaller hospitals. That is a fact. It is not just increasingly difficult to do so in Ireland. Based on what Professor Keane and others have told me, I understand it is a problem all over the world. Specialists with a sub-speciality in these areas want to work in big centres where there is a high volume of activity and where the environment for their work is conducive to excellence and good outcomes for their patients because of the sheer volume of activity.

I do not know if there are any other letters. We have in recent times involved the Chief Medical Officer and his team. There is a team of medics in the Department and I want to see them involved in patient safety issues. Regardless of whether the patient safety issue is raised by a doctor or patient — many such issues are raised with me by patients — I want to see the medical team in the Department involved in the follow-up to correspondence that comes to our attention, if that is possible.