Pat Breen (Clare, Fine Gael)
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Question 498: To ask the Minister for Health and Children if she will ensure that an independent investigation into recent allegations of misdiagnosis at Ennis General Hospital and St. James's Hospital, Dublin takes place; her views on this matter; the plans she has to establish a patient safety authority; and if she will make a statement on the matter. [30289/08]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I have been considering how best to address the serious issues arising from the recent cases of the late Ms. Anne Moriarty and the late Ms. Edel Kelly following their treatment in Ennis General Hospital. I have met the husband of one of the deceased women and I intend to meet the family of the other woman next week. I wish to extend my sympathy to both families on their sad loss.

In relation to St. James's Hospital, I am aware that Ms Moriarty was diagnosed with breast cancer there two years previously and continued to attend for follow-up at the Hospital. Ms Moriarty's most recent follow-up in St James's was in April 2007 in which the mammogram was reported as clear. Subsequently the Hospital has not been able to locate this mammogram to have it reviewed.

The expert clinical advice available to me is that a clinical review of other patients treated in Ennis would not be warranted. I am also conscious that, in the context of future lessons for cancer services, breast cancer services have now been transferred from the Hospital to a designated specialist cancer centre.

Since we have now moved breast cancer services from Ennis General Hospital I feel it is important to have a wider examination of the operation of the Hospital, which would look at the approach there to issues relating to diagnosis and treatment of patients, including the governance arrangements for quality and safety, and to communications both within the hospital and with patients. I believe that there may be lessons to be learned both for Ennis General Hospital itself and for the wider acute hospital system.

I am very conscious that the Health Service Executive has been working for some time to reconfigure services in the Mid Western region. It has been engaging with clinicians and other health professionals in the region to agree on a practical, patient-centred plan for reorganising services between Limerick Regional, Ennis, Nenagh and St. John's Hospital. The clinicians in the region have been working very positively and have shown strong leadership towards this end. I am aware that the HSE has placed a particular emphasis on integrating A&E services, with clear roles for all four hospitals as part of a well defined emergency care network.

I am also aware that HIQA has been reviewing documentation relating to the cases of Ms. Moriarty and Ms. Kelly and that it is formulating its own views on the question of carrying out an appropriate investigation or review.

With all of these factors in mind I have requested the Health Information and Quality Authority (HIQA), under section 9(2) of the Health Act 2007, to review the arrangements for providing services at Ennis General Hospital with particular reference to the diagnosis and follow-up of patients and the communication systems in place within the Hospital for both patients and staff. The review, which I have asked HIQA to complete within three months, will include how these arrangements work in the Emergency Department. I think it would be particularly helpful if any of the conclusions or recommendations were applicable to other acute hospitals also.

Patient safety has always been high on my agenda and on the agenda of the Government. I have taken a number of initiatives in the area of patient safety including the establishment of the Health Information and Quality Authority in 2007. Among the functions of HIQA are to monitor healthcare quality and to investigate issues of patient safety.

I set up the Commission on Patient Safety and Quality Assurance which reported to me in late July of this year. The Commission's Report 'Building a Culture of Patient Safety' was published on 7th August 2008. This is the first report of its kind and it makes far reaching recommendations which, when implemented, will have a very positive impact on patients and their families. The most significant recommendation of the report is the introduction of a licensing system for all health services whether they are delivered publicly or privately. The Commission proposed that the licensing scheme will be operated by HIQA. Compliance with standards set down by HIQA will be a prerequisite to licensing. Other recommendations from the Commission include the participation of all licensed healthcare facilities in local and national clinical audit, a mandatory adverse event reporting system, enhanced education, training and research and improved governance structures. I am currently considering these recommendations in detail. It is my intention to bring the report, together with an implementation strategy, to Government as soon as possible.