Damien English (Meath West, Fine Gael)
Link to this: Individually | In context

I thank the Ceann Comhairle for allowing me to raise this difficult situation at Navan hospital - which I believe is being replicated in many hospitals around the country - on the Adjournment.

It has been very difficult to get answers on this question. I have tabled parliamentary questions, concerning which I believe the relevant information has been gathered, but I have not got the answers yet. Many weeks have gone by, I have tried to meet the relevant HSE officials and the matter has been raised with the Minister, and still I have not received answers. I do not understand why this service should have been withdrawn from Navan hospital. I accept that difficulties have arisen in other hospitals around the country, although many of these are being addressed and their services will be retained. However, Navan hospital has been singled out for positive comment on its embalming services in the recent Willis report and retained organs audit, which dealt, inter alia, with facilities within hospitals for bereaved families and the provision of bereavement services. I am baffled as to why this service is being withdrawn, and I am very concerned.

It will cause enormous difficulty and great distress to the families of the deceased. It also indicates a total lack of dignity and respect towards loved ones who pass away. It is a shame on us, in this day and age. Many funeral directors will be affected who do not have embalming services. This is a very important issue and I am disappointed that the Government and the HSE, at a time of so many problems, apparently try to create more. This is not necessary and can be prevented. If the HSE has any difficulty with the services at Navan, which have been positively commented on, this should be discussed, so that any changes that might be needed can be implemented. As matters stand, it is wrong and will greatly affect families in three different ways. It will cause unnecessary delay, perhaps a day or two, in the release of remains for burial, and that will give rise to great distress and inconvenience for families. The Government should not add to the distress of families who have lost loved ones.

It will also increase burial costs - including embalming costs to prepare remains for burial. This is another unnecessary cost for families because funerals already cost a fortune. Then there is the lack of dignity towards the remains entailed in the removal of embalming services from the hospital. It will mean the unnecessary transportation of dead bodies around the county for embalming purposes, and basically this is not right. What happens in the case of a death due to C. diff.? Is it not better to have the post-mortem on the body of the deceased and embalming on site so that the remains are sterilised and the threat of C. diff. being passed on is eliminated?

Surely it is common sense to have these services all in the one place, where possible. It is unclear why the HSE wants to withdraw the services. I am very disappointed at the total lack of communication on this subject. Will the Minister try to ensure that this service is restored? Its removal is wrong. Why was the embalming service at Our Lady's Hospital, Navan, stopped, since such an initiative is not indicated in the report and why was it stopped without prior notification to the funeral directors?

The review of bereavement service practices in the Willis report identified many weaknesses in embalming services within hospitals around the country. However, Our Lady's Hospital, Navan, was one of only five in Ireland which complied with the Willis recommendations. As such, it was singled out for good positive comment. It was even mentioned in press statements and so on, afterwards. The service at Our Lady's Hospital was carried out by a fully qualified embalmer, with appropriate insurance cover. Stopping this service will cause significant delays in funeral arrangements and add extra distress to bereaved families as remains have to be transferred from the public morgue into a preparation facility, and then brought back to the morgue again.

I want this service restored. The people of Navan and County Meath want this service restored. There is no reason for not having it. There is no cost to the HSE. Procedures and systems might have to be changed, which can be done. That is what management is about, there is no real explanation for this and it is totally unfair and unnecessary. The Wallis report I am quoting from, incidentally, included a detailed investigation into the question of and audit of retained organs. It recommends a great many changes. I accept the Minister of State is not in a position to address that now, but I should like a guarantee from her that the changes recommended in this report will be implemented, because many parents have suffered greatly from the scandals of the retained organs. This report, if acted upon, would prevent that. I ask the Minister of State to ensure that the Navan hospital embalming service is restored and that the recommendations of this report are adhered to as well.

Áine Brady (Kildare North, Fianna Fail)
Link to this: Individually | In context

I thank the Deputy for raising this issue. I respond on behalf of the Minister for Health and Children, Deputy Harney. One of the recommendations of the Madden report on post-mortem practices and procedures was that an independent audit of retained organs in the State be undertaken. The report of this audit, which was undertaken by Michaela Willis, was published and made publicly available by the HSE in July.

The Willis audit recommended that service level agreements be put in place with external operators who use hospital premises for embalming procedures to ensure that quality, safety and performance levels are clearly defined.

On foot of this recommendation, the HSE wrote to its hospital network managers on 16 July 2009 setting out new arrangements for embalming at hospitals. It should be noted that embalming is not a service provided or funded by the HSE. It is a service provided by commercial entities, such as funeral directors, under contract with recently bereaved families who choose this service. This does not affect mortuary services provided by hospitals, such as the removal of the remains of a deceased patient. It should also be noted that embalming is a separate and distinct service, which is not part of the procedures followed by mortuaries when preparing the bodies of deceased persons following their death. Embalming is an additional option which is chosen by some families for their deceased loved ones and is therefore provided on a commercial basis.

The memorandum issued to hospital network managers advised that staff in hospitals operated or funded by the HSE are contracted to provide safe and high quality care to patients and their families and that individual staff members should not enter into contracts with commercial entities to provide additional services while in the direct employ of the HSE or in the employ of hospitals funded by the HSE.

Under the new arrangements for embalming in hospitals, the HSE now requires that standard controls are put in place in those hospitals the facilities of which are being used for embalming purposes by undertakers or funeral directors. Each hospital wishing to continue to facilitate an embalming service must develop a service level agreement with each commercial entity that wishes to use a hospital's facilities for embalming purposes. This is in line with good governance.

Damien English (Meath West, Fine Gael)
Link to this: Individually | In context

Navan hospital had such a good governance policy in place. The Minister of State has not answered my question as to the reason the service was removed from a hospital that is quite capable of performing it.

Brian O'Shea (Waterford, Labour)
Link to this: Individually | In context

The Minister of State, without interruption.

Damien English (Meath West, Fine Gael)
Link to this: Individually | In context

A total of 80% of hospitals will retain this service.

Brian O'Shea (Waterford, Labour)
Link to this: Individually | In context

The Minister of State, without interruption.

Áine Brady (Kildare North, Fianna Fail)
Link to this: Individually | In context

Having regard to the new requirements, it is a matter for each hospital to decide whether it will enter into a service level agreement with undertakers or other external entities for the provision of embalming services. I understand that Our Lady's Hospital, Navan, has recently decided to discontinue its present arrangements for embalming services. However, it will of course continue to provide all appropriate mortuary services for deceased patients in the normal way.