Experts warn of ‘growing crisis’ in autopsy services across the country 

In Waterford, coroner-directed autopsies have had to be carried out by locum pathologists from Britain since early January after the hospital’s consultant pathologists confirmed they would withdraw from conducting the autopsies from January 1. File picture

A crisis in autopsy services has spread nationwide with staffing issues leaving families waiting years for closure on their loved ones’ deaths.

University College Dublin professor of forensic and legal medicine Denis Cusack, said the problem first highlighted in Waterford is now evident in Cork, Kerry, Limerick, Clare, and Kildare.

He also warned the Government that importing pathologists from Britain to try to solve the crisis can only serve as a temporary solution.

In Waterford, coroner-directed autopsies have had to be carried out by locum pathologists from Britain since early January after the hospital’s consultant pathologists confirmed they would withdraw from conducting the autopsies from January 1.

It was feared the move would result in lengthy funeral delays, with up to 700 coroner-directed autopsies held yearly at the hospital.

Prof Cusack said the impact of staff shortages has now spread beyond the South East.

“There is also a growing crisis in Cork, Kerry, Limerick, Clare, and Kildare,” he told the Oireachtas transport committee in recent days.

“We will be meeting with the department and the minister for justice on that in a few weeks’ time. I have spoken with my colleagues on the coroners’ council, so I am authorised to comment on these matters on behalf of the Coroner Service and the Coroners Society of Ireland. Yes, it is a big crisis. We need reforms.

“If we do not have a proper, timely post-mortem service, bringing in colleagues from the UK, some of whom I know, is costly and they come from a different jurisdiction. It is a temporary solution...The difficulty is that this is all tied up with the other reforms.”

Coroners Society of Ireland incoming president Denis McCauley, said post-mortem consultants are being treated like “second class citizens” and pay (which he claims has not increased in 20 years) and conditions are forcing consultants to leave en masse.

Recruitment issues

University Hospital Waterford CEO Ben O’Sullivan previously disclosed that expectations of working with the coroner’s post-mortem exams, coupled with an “extremely busy” diagnostic service, have hampered the hospital’s efforts to recruit consultants.

Dr McAuley said if a pathology service with two consultants sees one exit, the whole service is likely to fold as the HSE will be unable to fill the vacancy.

He also pointed out that the cost to bring in pathologists from Britain is, on average, €2,000 per autopsy.

Deputy coroner for Cork City Dr Mary McCaffrey said that while Cork enjoys relatively strong pathologist staffing levels, consultants are now being forced to deal with overflow from other counties.

According to Dr McCaffrey, Cork is still dealing with backlogs due to a lack of auxiliary services. Samples of muscle tissue taken in an autopsy still need to be sent abroad, while results from toxicology reports face significant delays.

Dr McCaffery said dead people with certain medical conditions cannot be stored in Cork morgues due to a lack of appropriate facilities.

She said that all delays have a knock-on effect on the speed at which a coroner can order an inquest.

“That inquest can be maybe a year, two years after the event, so families are left waiting on closure, which can be very distressing for them,” she said.

The Department of Justice is yet to outline a long-term vision in how autopsy services will operate in the coming years and did not respond to requests for comment at the time of writing.

Under current operations, consultant pathologists are employed by the HSE but provide coroner services as independent contractors for the Department of Justice. The division is designed to protect the independence of the service from the HSE.

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