Trolley waits cast further doubts on ‘invaluable’ A&E review

UP to 569 people forced to wait on trolleys on January 5, and 59 waiting at a single hospital on Monday raise questions about our emergency department crisis.

However, at one hospital in particular, the problems guarantee further issues must also be raised.

Last autumn, an Irish Examiner investigation forced the HSE to reluctantly admit an internal inquiry was under way into how almost half a million euro in charitable donations to Cork University Hospital (CUH) had been spent in 2008.

The finances — which involved both small and large amounts of money given by grateful patients to help specific services at departments, wards and units in the hospital and the nearby Cork University Maternity Hospital (CUMH) — were placed under the control of the CUH Foundation.

The group was tasked with ensuring funds, such as €122,596 for the paediatrics ward, €77,016 for maternity and €41,155 for dialysis, were spent how the donator specified.

However, concerns have been raised this may not have taken place, with an emergency department report chief among the issues.

Despite requests, it is still unclear whether this document, part of the two-year long health service inquiry, was commissioned with the knowledge of donators.

Between December 2007 and December 2008, at a time when the foundation’s cash-in-hand levels dwindled from €230,603 to zero, Company Registration Office (CRO) records show administrative expenses rose from €3,428 to €445,302.

This included €365,000 in “consultancy fees” for four reports, including the emergency department document by outside consultants Michael Crowley, Claire Devereux and Paul O’Leary. This report, concluded in May 2009, focused specifically on improving patient services at CUH’s emergency department.

However, the views of patients who have been to the unit this week suggest its achievements are not apparent on the ground.

Considering the cost, the nature of the document and the fact it is unclear whether donors knew how their money was being spent, it is surprising that the information has not been made available.

The Irish Examiner has repeatedly asked for clarification on when exactly the work was tendered for; who commissioned it; and whether a terms of reference had been published.

However, the HSE has failed to provide an adequate response — despite launching a still-to-be-completed formal inquiry into these issues, among others related to the foundation, almost two years ago.

Further questions over its exact cost, specific service changes related to the research and whether the document previously received taxpayer funds pre-dating the foundation have also been unanswered.

The information falls outside of Freedom of Information requests as the foundation is a separate legal entity to the HSE.

During the period the HSE investigation examined, there were just two directors of the CUH foundation— one of whom, the hospital’s chief executive Tony McNamara, was also the foundation’s secretary.

Mr McNamara has not responded to repeated interview requests on the foundation or the inquiry.

His only comment has been to describe the emergency department report as “invaluable” — a claim privately called into question by hospital staff who say they were peripheral figures to the research.

This week’s trolley wait figures only puts more scrutiny on an expensive report at the centre of the delayed inquiry’s conclusions.