James Reilly (Dublin North, Fine Gael)
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Question 266: To ask the Minister for Health and Children if the persons (details supplied) were made aware of the review of ultrasounds at Midlands Regional Hospital, Portlaoise; and if she will make a statement on the matter. [5205/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The two persons mentioned, my Special Advisers, were aware that the review of symptomatic breast radiology services at Midlands Regional Hospital, Portlaoise, covered patients who had ultrasounds as well as mammograms, since this was included in information provided to my Department by the HSE in relation to the decision to initiate the review and also because it was public information. The press release issued by the HSE on 31 August 2007 referred to 'a review of the practice of one Consultant Radiologist within the radiology breast service in the Midland Regional Hospital at Portlaoise and said that, 'Pending the outcome of the external review, all mammography and breast ultrasound work will be carried out at St Vincent's Hospital, Dublin.'

It was reported on RTE News on 4 September that

'The Health Service Executive is to review the files of more than 3,000 breast cancer patients who attended the Midlands Regional Hospital in Portlaoise over a four-year period. 3,000 mammograms and 2,500 breast ultrasounds will be re-examined.

The Irish Times reported on the same day,

'The review will involve a re- examination of all the mammograms and breast ultrasounds conducted at the hospital since November 2003.'

This review was clearly and reasonably understood by Department officials, including the medical staff, my advisers and myself as covering a group of approximately 3,000 women, some of whom had had both mammograms and ultrasounds. As a result, my focus and that of my officials was on tracking the progress of the review being led by Dr. Ann O'Doherty to ensure the women concerned received appropriate care as quickly as possible. My understanding in this regard should be readily apparent from my statement to the Dáil on 7 November.

In the course of enquiries made by Department officials and advisers, no information was provided that contradicted this understanding, up until 21 November. A note attached to an e-mail sent to one of my advisers on 28 September does not alter that position. The note stated that the scope of the review covered all mammograms and ultrasounds performed at MRHP from the period November 2003 to the end of August 2007. It said it was 'anticipated the review will be completed in a couple of weeks', which turned out not to be the case. This unsigned, undated and incomplete note was marked 'Draft for Discussion', without identifying between whom there was to be a discussion and for what purpose.

A formal briefing note provided by the HSE to my Department on 6 November 2007 confirmed that the terms of reference were "To review the symptomatic breast radiology service at Midland Hospital Portlaoise for the period November 2003 to August 2007 with particular reference to mammography and ultrasound tests taken during that period". It was only on the day before my appearance at the Joint Oireachtas Committee on Health and Children on 22 November that my Department was made aware that the case notes of an additional number of women who had received ultrasounds in the period August 2005 to August 2007 were also being reviewed. It was only the following morning that I and my officials heard further details of the numbers involved (568 women) and the progress of this review.

The Board of the HSE, with the assistance of Mr John Fitzgerald, is undertaking a review at my request of the management of all the events starting from, and subsequent to, the decisions taken by the HSE in relation to the breast radiology service at Portlaoise. In asking for this report, my main concern related to the manner in which patients were dealt with throughout this period, but the report will also cover communication arrangements within the HSE and with my Department. I await the comprehensive report about the full range of matters being considered, and I would urge everyone to do likewise.