TALLAGHT Hospital may like to describe its actions this week as open and transparent, but in reality another word is far more apt: irony.
Since Tuesday, the facility has been inundated with calls following the shocking revelation that 57,921 X-rays were not examined by consultant radiologists over a five-year period.
The scans, which highlight otherwise hidden information, are at the centre of the scandal. But despite this fact, the hospital is keeping vital details surrounding what happened away from the public view. Irony, not transparency, is the label that fits.
Since the true extent of Tallaght’s failure was revealed on Tuesday evening, the hospital has repeatedly failed to answer specific questions on the crisis.
It has:
Declined to outline the public-private patient breakdown of the 57,921 x-rays involved.
Failed to clarify whether protocols were in place to ensure the most senior doctor available examined the scans, or whether giving this responsibility to any one of consultants, junior doctors, senior house officers or registrars would do.
Refused to respond to questions over when — or if — it sought the appointment of more consultant radiologists, and if new radiologist posts will be at the expense of other staff positions.
Declined to confirm the geographical and annual breakdown of when the 57,921 X-rays were taken.
Failed to explain what response management made to more than 40 letters sent by its own staff warning of the looming crisis.
These questions are not trivial matters. They are at the heart of a crisis that has led almost 58,000 patients to fear for their health, and has played a role in one death and another cancer diagnosis.
Yet despite the genuine concern involved, none of these questions — which highlight exactly what went wrong at the hospital, when it went wrong and, importantly, whether publicpatients suffered while private patients were treated — have been answered.
While management at Tallaght’s Hospital has been at pains to provide an image of a hospital keen to make all information public, in reality only the top-line information in the X-ray scandal is being released.
Anything else — whether it involves 3,500 unopened GP referral letters, a 2009 independent report warning of how the hospital is being run, and formal concerns raised by staff and patient groups as far back as 2007 — is either leaking out slowly or being kept hidden in the dark altogether.
Ironic.
In hindsight, the fact Tallaght is withholding information at worst, unable to find the information at least, is hardly surprising.
Delays in making the details of the X-ray crisis public have played a central role throughout the scandal.
From April to mid-summer last year the Health Information Quality Authority (HIQA) met with Michael Lyons, then chief executive of Tallaght Hospital, and his successor, Prof Kevin Conlon, due to unread X-ray concerns.
The number of cases involved was a fraction of what is now known, but no information was made public. When Prof Conlon became chief executive in December, he learned the full extent of the damage caused, including a fatality and a cancer diagnosis.
But, while he says he contacted Health Minister Mary Harney, no information was made public for another three months.
The only comment Tallaght Hospital has made is that there is no record of the issue being raised at its medical board at any stage before December.
But considering the fact that both its current and former chief executives had met to discuss concerns with HIQA last April, the apparent contradiction in what was known raises yet more questions still to be answered.
Outside Tallaght Hospital, the X-ray scandal underlines further questions about the way the health service is managed. However, it is unclear who has responsibility for answering them.
Mary Harney has overall control of the health service, but instead of addressing the issue is enjoying a 15-day junket to New Zealand.
Her department, who are behind a staff embargo which has left Tallaght Hospital without its necessary number of consultant radiologists, insists the frontline services issue is a matter for the HSE.
However, the HSE’s chief executive Prof Brendan Drumm was one of the last people to be informed of the crisis. While the HSE insisted any queries must be sent to Tallaght Hospital as it is a voluntary hospital, it is organising an "independent review" of what happened at the facility.
However, the statutory group with sole responsibility for such independent reviews — HIQA — says it is unaware of this decision.
The result is a systematic mess where vital information is almost impossible to obtain — ironically, a mirror image for the problems faced by physicians and patients in the overall health service. Tallaght Hospital’s board of management has agreed that, in light of the difficulties at the facility, change is needed.
Opposition TDs, hospital consultants and other medics believe a similar response involving how the wider public health service operates is just as badly needed.
Ensuring hidden information is made public — the sole purpose of the X-rays at the heart of the scandal — might be a good place to start.
a d v e r t i s e m e n t
This appeared in the printed version of the Irish Examiner Saturday, March 13, 2010
