Thursday, 15 December 2005
Coroners (Amendment) Bill 2005: Committee and Remaining Stages.
I move amendment No. 2:
In page 3, between lines 8 and 9, to insert the following:
"(b) by the insertion of the following new section after section 32:
32A—There shall be a duty on a coroner to include any notifiable diseases, as provided for under the Infectious Diseases (Amendment) (No. 3) Regulations 2003, on the verdict of any inquest he shall sign under section 32 of this Act."
This point has arisen on a regular basis. There seems to be a lack of sharing of data, whether on the part of the Revenue Commissioners or other parties. Patients are dying from MRSA and the message in this regard is not necessarily relayed to the necessary State agencies. There is no pooling of information and it is difficult to ascertain the true figure as regards deaths arising from MRSA. I hope that if the amendment is not accepted, a follow-up Bill might be introduced by the next Government.
I thought the Minister was about to give us the election date.
Different agencies should pool information. We have seen examples of where the Department of Social and Family Affairs does not inform the Revenue Commissioners of information it holds and, as a result, people get caught out. People need to be given the full picture about MRSA, which is a serious problem in our hospitals.
Under the Bill, I am putting forward, for consideration by Government in the near future, all the policy and legal issues, including best practice for coroners, involved. Under the Infectious Diseases (Amendment) (No. 3) Regulations 2003, as soon as a medical practitioner becomes aware of or suspects that a person on whom he or she is in professional attendance is suffering from or is the carrier of a notifiable infectious disease or a clinical director of a diagnostic laboratory becomes aware that an infectious disease has been identified in that laboratory, he or she is required to transmit an electronic notification to a medical officer of health. Therefore, a provision of this kind exists. I do not think a notifiable disease will come to light in the course of a coroner's inquest if it had escaped the attention of everybody who had dealt with the death during the inquest.
I accept the Senator's point that MRSA is very serious and that we should have proper statistics in respect of it. Where deaths occur as a result of it, they should be properly recorded. I am not sure whether MRSA is a notifiable disease.
That is interesting, because notifiable infectious diseases are much broader in their spread. Tuberculosis and other diseases are also involved.
On a practical point, if I accepted this amendment I would have to bring the Bill back to the Dáil and it would then have to wait until late January, so that its whole purpose would be frustrated. For that practical reason, regardless of the merits of the Senator's technical amendment, it would frustrate the purpose of expediting the Bill if I were to accept the amendment.
In light of the Dáil rising today, I did not expect these amendments to be accepted, but felt there was an opportunity to put them on the record. We had a very good meeting recently with the Minister's colleague, the Tánaiste, along with Deputies Breen and McGuinness, on the MRSA issue. It is shocking to think that people are swabbed when they go into hospital and are proven to have MRSA. It might not necessarily be contracted in the hospital but the hospital authorities would know people have MRSA, and people are not being informed. One might be told officially that they are, but they are not.
I mentioned a case previously, involving a lady in a ward with four people. She discovered she had MRSA when the contract cleaner roared across to a colleague to ask what mop he was using and told him not to use one particular mop because the lady had MRSA. Another lady found out by being told by a junior nurse, months after her husband had gone into hospital and was not making a recovery, and whose condition could not be diagnosed by those in charge.
It is a very piecemeal approach. The Tánaiste was shocked when she heard about it. I am not a medical expert but it makes common sense that a patient who has some disease should be told straightaway. A person who gives blood to the blood transfusion service in the morning has his or her blood screened. If anything shows up, such as hepatitis A, or even AIDS, God forbid, the person is notified straightaway by the Irish Blood Transfusion Service and counselling is provided.
That does not happen in hospitals. The amendment which I had hoped to insert today involves an issue at which the Minister should look when bringing forward the full coroners Bill in the new year. There should be an onus on a hospital authority to inform families or relatives of those who have passed away in hospitals while suffering from MRSA that they have the option of a coroner's inquest. If a person dies a so-called natural death there is no need for a coroner's inquest, but if one dies a so-called unnatural death, the right to a coroner's inquest is there. MRSA was listed as a notifiable and an infectious disease in 1994 and 2003, or so I understand — those were the key dates involved.
I recently sympathised with a person in Carlow whose father had been in St. Luke's Hospital in Kilkenny and had been transferred back to St. Dympna's Hospital. When the man died, it was discovered that he had contracted MRSA in St. Luke's Hospital, a fact to which the staff in St. Dympna's were never alerted, so that the man was put into a ward with other patients. There was a clear lack of information relay. I do not know if that is because of snobbery in the medical profession, that it feels patients would not understand the long words involved.
There is an onus on hospitals in this area. People should be given information, and what they do with it afterwards is up to themselves. Many families are horrified when they discover, after a person has been buried, that they had the option of a coroner's inquest. Many people might not want an inquest, and that is fine, which is why I inserted the word "option" in the amendment. The amendment has not been accepted today but the Minister might consider drafting another such amendment to the Bill in the new year.
I support much of what Senator Browne has said on this section. During the recent tragedy we had in Wexford, when people were lost off the south coast, members of one of the families, as they waited each day in Kilmore for news of their lost brother, told me that their father had taken ill because of the trauma and ended up in Waterford Regional Hospital, where he was suffering from MRSA. There is a need to address the issues. In that regard, the audit recently undertaken by the Tánaiste is a step in the right direction but we must get to the stage where people are held accountable. That is the thrust of a coroner's inquest in situations where people should perhaps have taken action, or where their inaction has led to serious outcomes.
I do not know how this issue can be related to or brought into the impending revised coroners Bill but it should be considered and beefed up so that everyone treats it as the priority it is. The situation is not good enough. I mentioned one circumstance but there are many similar ones to which people could allude. The circumstances in which the family members I spoke of found themselves compounded their trauma and tragedy.
I concur with the sentiments expressed by Senator Cummins. I pay tribute to Deputy Rabbitte for his initiative and to the Minister and his staff for accommodating and facilitating the passage of the Bill so quickly. Hopefully it will be of some small comfort to the Nowlan family. There will also be other beneficiaries of the changes in legislation and we look forward to the more comprehensive Bill which will be before us in the next session.
I concur with the previous speakers and again extend my congratulations to everyone associated, including the Labour Party and the speakers and those who have contributed to the debate in both Houses and brought along the legislation to where it now is. I hope that legislation such as this will have an immediate impact and will help bring about a certain justice to the Nowlan family.
I join in the genuine thanks to the proposers of this Bill. What a pleasure it has been to participate among Deputies in the other House and Members of this House in a process whereby the legislation was passed so speedily.
It is my intention to bring the new Bill into law in the lifetime of this Government. I will take heed of what the Leader has said and will propose to my colleagues in Government that the new Bill be initiated in this House because I know it would get the kind of debate it needs. There will be plenty of pressure on the other House in the next 14 months so it is a good idea to have a good deal of legislation first considered in this House, where it can get the time it deserves.
One of the points I discussed with the Nowlan family when they came to visit me in my Department was the interpretation of that section because, as I pointed out, if one fell down the stairs at a medical convention, is the mere fact all the witnesses were doctors a reason for limiting the number of witnesses at the inquest or is it purely related on a narrow point to the actual medical cause of death and debate on that issue?
Members might be interested to know that the case of the Eastern Health Board v. Farrell was one in which the health board and the coroner tested in court whether the three-in-one vaccine could be a proximate cause of death. The reason I know the case is that I participated in the coroner's inquest, although not in the court proceedings. To go back to what Senator Jim Walsh said, we must be fair in mind. Do we want corners' inquests to turn into huge debates on whether the three-in-one vaccine does or does not have adverse medical consequences or whatever? That is the type of issue which must be dealt with. When one says one wants to widen the scope of a coroner's inquest, it cannot turn into a vast tribunal of inquiry to which witnesses are flown in from around the world to state what surveys have proved internationally.
On what the Leader said, I have to admit this is not a case where I had to persuade my officials to adopt this point.
It was quite the reverse. They tried to persuade me that instead of going ahead with the big project, I might be wiser to go ahead with the smaller one. This was a case where I said "No", that I wanted to go ahead with the big project. In effect, Deputy Rabbitte and the Nowlan family came to my aid by creating a situation in which we could do both. In case it is thought that hard-hearted officials were prevailed on by a mean-minded Minister, that was not so — in fact, it was the reverse.
When the Nowlan family visited me to explain their particular position that unless the law was changed soon their inquest would effectively be aborted, the situation was one in which, in effect, one could not make a decision other than the one I chose to make. I do not claim to have any special powers of generosity. Pierce's parents explained to me all the circumstances surrounding his death and the fact he ran away from them down the corridor to have this operation done and that was the last they saw of him alive. We must bear in mind that we could not deny them justice. It has been said hard cases make bad law but I do not believe that on this occasion. I believe hard cases are making good law.
I thank Members for their ongoing kindness and I wish them a happy and holy Christmas.