€1,000 the price of Roisin’s life

THE surgeon who was forced to cancel life-saving surgery on Róisín Ruddle revealed last night the nursing care needed for her operation to proceed would have cost less than €1,000.

Cardiac specialist Mr Freddie Wood said the operating theatre and surgical personnel were ready for the most complex and expensive part of the procedure on two-year-old Róisín but the comparatively inexpensive post-operative care was not available.

"What was missing was a nurse to nurse the bed space for the child to go to. It would not cost €1,000 to hire a nurse one for the afternoon shift and one for the night shift would not cost anything like €1,000."

Mr Wood said Our Lady's, one of just two children's hospitals in the country with an ICU and the only one providing heart and general surgical services, had 21 intensive care spaces but only 13 or 14 were functional on any given day because of the shortage of nurses.

It is not clear why preparations for Róisín's surgery were allowed to proceed to an advanced stage at Our Lady's Hospital for Sick Children, Crumlin, before it was realised there were not enough specialist nurses in the intensive care unit to look after her in the critical post-operative phase.

A report ordered from the Eastern Region Health Authority by Health Minister Michéal Martin is expected to say if the last-minute change of plans was due to a breakdown in communications between the surgical and nursing departments, a lack of agency nurses or the funds to hire them, or whether an emergency case took priority.

Mr Martin is under intense pressure as Róisín is the second child to die in seven months as a result of health cuts. In December Bronagh Livingstone died because of curtailments in maternity services in Monaghan.

The minister yesterday warned against jumping to conclusions before the ERHA report, due tomorrow, became available.

However, he conceded something had gone badly wrong in the system. "No child, in my view, should have to wait," he said.

But while the specific circumstances of Róisín 's case were being investigated, angry medics complained it was long known there was a chronic shortage of ICU nurses and an over-reliance on agency nurses to cover vacant staff positions and that surgery cancellations were commonplace

Dr Brian Marsh, president of the Intensive Care Society of Ireland which published a report over a year ago stating one-third of children and adults needing ICU treatment were turned away because of the nursing shortage, accused the authorities of lacking urgency in addressing the issue.

Irish Nurses Organisation industrial relations director Phil O'Shea described the situation as "lunacy" and blamed it on endemic poor planning by the health authorities.

She said the tragedy of toddler Róisín could have been prevented and warned: "There is no doubt but that it will be repeated."

Mr Wood said that while it had been intended to reschedule her surgery for later this week, her sudden deterioration and death was unexpected. Mr Martin conveyed his sympathies to her parents.

"We feel for the family today. It is a very distressing time for them," he said.

Ernest Cantillon, a solicitor who specialises in medical negligence cases, warned health boards could be held legally liable in situations where a child dies because of failure to receive medical treatment.

He said if a child could not be treated because the hospital did not have the resources, the health board was obliged under treatment abroad regulations to pay for travel to another EU country where the procedure could be performed.