If hospital is a centre of excellence, then let us have the full case history

What Mr Kelly described in his email seemed more like torture than treatment.

He wrote that he had complained about similar incidents in the past, but there were no obvious results. Whoever leaked the email should certainly be commended

WHEN I was a teenager an aunt and uncle returned from Canada. Houses were in short supply, so they stayed with us for some time.

He was a doctor and he got a job at the County Hospital as a surgical registrar at the princely salary of £18 a week. He was a conscientious doctor and I got an insight into the pressures on the medical profession. After a full day’s work, he could be called at any time of the night to treat some accident victims.

One day he told me of a woman patient who was dying of throat cancer. She was being fed by tube and had a tracheotomy to insert a tube so she could breathe.

When he looked in on her on one occasion she had gone blue and was obviously suffocating. He pulled out the tube and cleared the obstruction and she began breathing regularly again. In another minute the unfortunate woman would have been unconscious and would have been out of her agony.

His training was to save lives, not to let people die, so what he did was purely instinctive. But in the following hours he asked himself some serious questions about whether he would have been kinder to the woman if he had done nothing in view of her quality of life and her life expectancy.

Next day as he was doing his rounds, the woman pushed a note into his hand. It contained a £1 note with the message: “You saved my life. Thank you.”

Whatever doubts he had about his actions were blown away. He said it would be a lesson for him for the rest of his life — his job was to save lives, not to play God with the lives of patients.

Fifty years ago a doctor’s pay in this country was pathetic and nurses were paid even less. Those who opted for medicine had to have a vocation for it. There were no great bonuses in those days. Every so often an appreciative patient might send over a salmon or a bottle of something, and there was that £1 note.

He thought it was probably a lot of money to her, but from the way he told the story and my memory of it a half a century later, I think the gesture was worth even more to him. That was back when our health service was being operated on a figurative shoestring. Now, in Celtic Tiger Ireland, we have a highly funded health service.

But are we better off? Sick people are now being advised not to go into hospital, unless they cannot be treated at home, because patients are in danger of contracting much worse in our hospitals than the actual ailment for which they are being treated. This week there was a controversy at Cork University Hospital (CUH) about the leaked email in which Jason Kelly, a consultant plastic surgeon there, highlighted the events of one shift in which he alleged that a middle-aged woman, who suffered an horrific injury which necessitated the removal of one of her breasts, was left overnight on a trolley without morphine outside a plaster room.

The other case involved a 70-year-old woman who had suffered a serious injury to an arm that necessitated its amputation.

The consultant stated that he requested surgery for the woman at 4.30pm, but she was not operated on until 9.30 that night.

During the wait, the surgeon complained, the patient’s arm continued to swell. This made the procedure “much more difficult” and also caused unnecessary loss of blood.

What Mr Kelly described seemed more like torture than treatment. He wrote that he had complained about similar incidents in the past, but there were no obvious results. Whoever leaked the email should certainly be commended. It was sent in late May and it would seem that very little attention was paid to either of the incidents mentioned until the story broke almost a month later.

This is not a question of medical confidentiality; it is about hospital procedures. The office of Tony McNamara, the general manager of CUH, issued an extraordinary statement denouncing the “inappropriately leaked correspondence” on the grounds that it “has been the subject of interpretation out of context within the public domain”.

Nevertheless it accepted that “Mr Kelly acted and continues to act in the best interest of patients at all times”.

The hospital management has clearly acknowledged that Mr Kelly acted appropriately in sending the email, but Mr McNamara went on RTÉ to say “we absolutely refute the allegations made in the email”. It seemed he would like us to believe the people who are fault are whoever leaked the complaint and the media for reporting it.

According to the general manager’s office, “some interpretations of the misrepresented content of the email are incorrect and, as with all leaked documents, many conclusions that may be inferred without detailed discussion can be erroneous.”

What is the correct interpretation?

Whatever about the treatment of patients at CUH, when it comes to empty platitudes, they sure can torture the English language. If any of the salient facts were wrong, the statement issued on June 25 should have clarified those. Then other hospital consultants issued a statement supporting Mr Kelly. A spokesman on their behalf really compounded matters by stating that the other consultants have had similar problems. Thus, it was not just one bad day at the office. Mr McNamara told RTÉ that the operating theatre was requested at 5.40pm, not 4.30pm, for the woman who had her arm amputated. But he then danced around the question about the time the operation was actually performed.

He stated that the woman who had her breast removed did receive morphine after the operation, though it seems she was left on the trolley for the night following the operation.

IF THERE was overcrowding that night, it might be grossly unfair to blame anyone at the hospital itself. After all, it would have been so much worse if they had refused to admit either woman in the circumstances.

But this then goes back to the email, as one of the apparent reasons for sending it in the first place was to highlight the fact that there are plans for CUH to take on between 300 and 400 extra breast cancer patients annually under the national cancer control programme.

If the hospital is not capable of treating current patients properly, surely there are grounds for questioning how it could hope to cope effectively with the extra workload?

Is CUH really a “centre of excellence”?

Mr McNamara contends that it is “one of the top-performing hospitals in this country”. The first reaction to that claim should be what Mandy Rice Davies once famously said in a totally different context: “He would say that, wouldn’t he!”

If CUH is one of the top-performing hospitals, there is all the more reason that this whole mess should be clarified.

Public confidence requires a comprehensive explanation. Moreover the conscientious doctors, nurses and other staff deserve it. If the treatment of those two women at CUH was appropriate, we should know it. If it wasn’t, somebody should be held accountable, or the same things will continue to happen.