James Reilly (Dublin North, Fine Gael)
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Question 14: To ask the Minister for Health and Children if the Hayes Report into the non-reporting of nearly 58,000 X-rays and the failure to process thousands of general practitioner referral letters at Tallaght Hospital, Dublin, has completed their work; and if she will make a statement on the matter. [34780/10]

Mary Harney (Dublin Mid West, Independent)
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The HSE has recently received the report of the independent review undertaken by Dr Maurice Hayes. The review deals with the delay in reporting radiological examinations and the management of GP referral letters at Tallaght Hospital. It is hoped that the findings of the review will be published in the coming weeks. Prior to the separate clinical review of 57,921 X-rays carried out in Tallaght Hospital, two cases of delayed diagnosis emerged. No further cases were identified during this clinical review which was completed in April 2010.

All the GP letters have been opened and examined. It was found that 2,328 related to the period 2002 to 2008, of which 1,269 no longer required appointments. The relevant GPs were informed. Of the remaining cases, 1,059 patients were allocated appropriate orthopaedic and physiotherapy appointments. Additional clinics were held at the hospital to deal with the remainder of cases identified. All outstanding appointments will be completed by the end of next month.

James Reilly (Dublin North, Fine Gael)
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I will be brief, to save time.

Brendan Howlin (Wexford, Labour)
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I am much obliged.

James Reilly (Dublin North, Fine Gael)
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The Minister promised that the review would be ready in June but it was since delayed to September. Today she informs us that it will be published at some point in the future. That is not acceptable to the people of Tallaght who want a definite date by which they will be made aware of the contents of the report. Will the Minister set out a firm date on which the report will be made available?

The Health Information and Quality Authority, HIQA, was supposed to produce a report on how letters should be dealt with in future. What is the status of that report? I have been requested by Dignity 4 Patients to inquire into the standing of the report promised to that organisation last year.

Mary Harney (Dublin Mid West, Independent)
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This is not my report and it was not in my hands. Dr. Hayes was appointed on 18 March and he has completed and submitted his report. It is being examined by Dr. White and others at the HSE because certain legal issues arise. I have not seen the report nor have I been briefed on it. I hope to see it as soon as the legal position allows. I assure the Deputy that the report will be published at the earliest opportunity.

Jan O'Sullivan (Limerick East, Labour)
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I wish to raise with the Minister policy issues pertaining to people who undergo X-rays and other investigative procedures. We want to have proper procedures in place to ensure this does not happen again to other patients. Will the Minister clarify the procedures being followed in our hospitals to ensure X-rays are appropriately read?

I also want to ask her about the 1,059 patients who needed appointments.

The Minister has said that they have since got appointments. Does she know how long some of those patients have been waiting and how much pain they might have been suffering while their letters were unopened? Will any policy lessons be learned from this and will procedures be put in place to ensure that GP referral letters are appropriately dealt with in all hospitals?

Mary Harney (Dublin Mid West, Independent)
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The college of radiology was involved in making recommendations on the reading of X-rays and we can make that information available to the Deputy. The letters related to a period between 2002 and 2008 and of course the situation is unacceptable. It is not a policy issue. I think it is a management and operational issue. When we see the report we will be able to determine the management and operational issues that led to that situation. Clearly, it is completely unacceptable that a general practitioner's letter was left lying on a desk and the appropriate procedure was not followed to make an appointment for the patient.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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Can the Minister confirm that the Hayes report addressed the unopened referrals issue and not just the X-ray situation at Tallaght Hospital? This is not clear from her response.

Aside from the processing of the individual letters concerned, what steps have been taken to ensure that there will be no recurrence? Has there been any investigation on whether a similar backlog of referrals has taken place at any other hospital across the State? Can the Minister assure the House that this is not the case? Vacancies are not being filled due to the current recruitment embargo and there is a growing strain on clerical supports at a number of hospitals? Clerical administration is suffering as a consequence.

Mary Harney (Dublin Mid West, Independent)
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The terms of reference for Dr. Hayes included the GP referral issue. The HSE carried out an audit of all hospitals following the emergence of the Tallaght issue. The college of radiology was also asked to make recommendations and the HSE intends to publish that report.

There seems to be an assumption that all management and administrative staff are in some HSE office, but the vast bulk of them are at hospital level. There are around 400 people working in administration and management at Tallaght hospital alone. There may be some isolated cases involving problems with administrative support, but our hospitals generally have a fair amount of administrative support. The health service, like the rest of the public service, is still very dependent on manual supports. While technology is being put in place, we still have some years to go before we have the technology backup to allow for the efficient processing of correspondence and more complex issues like patient safety-----

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I want to know whether we will avoid a recurrence of what we have witnessed this year.

James Reilly (Dublin North, Fine Gael)
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When will the HIQA report on how letters should be dealt with be made available to us? When can we expect the report on dignity for patients?

Mary Harney (Dublin Mid West, Independent)
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I do not have the information on the HIQA report to hand, but I will revert to the Deputies when the authority makes its report. The purpose of appointing Dr. Hayes was to see what recommendations he would make, having done a thorough job and including a GP, a patient advocate and so on. Following the Tallaght issue, the HSE made contact with every single hospital in the country and their clinical directors.

The report on dignity for patients cannot be made public at this time.

James Reilly (Dublin North, Fine Gael)
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When will we see it?

Mary Harney (Dublin Mid West, Independent)
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We will not see it for the foreseeable future. The judge has recommended that it should not be made public because there are possible criminal proceedings on the matter.