Call it a tactical apology. Call it formalistic, offered only when someone’s hand is forced. Call it face-saving. Call it expensive. But on no account call it sincere.
The Health Service Executive’s (HSE) expression of regret to the parents of Alex Butler on April 23, 2013, was about as heartfelt as praise from Simon Cowell.
It was on that date that the HSE finally apologised to Sonya and John Butler of Kilmacleague, Dunmore East, Co Waterford, for the catastrophic injures their daughter Alex suffered at birth in April 2005, leaving her quadraplegic and with cerebral palsy, confined to a wheelchair, and dependent on the goodwill of others to make it through each day.
The apology was part of a settlement involving an interim payment of €1.4m to Alex and it read: “Waterford Regional Hospital sincerely regrets the tragic consequences their failings have caused to both Alex and her parents John and Sonya Butler.”
It took eight years to extract this 22-word expression of remorse, which, while hardly grovelling, was some small comfort to the Butlers — but in hindsight hollow as a drum.
Hollow, because, in order to get a final payment that would see their daughter through the rest of her days, the Butler family spent another fortnight in court this year where they were subjected to the gross insensitivity of State-backed experts arguing how long their daughter may or may not live and how extensive her needs may be.
Having spent a day with the Butlers in 2013, following the interim payment, I witnessed first-hand just how much care Alex needs. She had to be lifted from bed, dressed, sat on the toilet, fed with soft foods, lifted and strapped into her wheelchair, carried to and from the car, assisted in school, assisted with homework, transferred to a walker at breaktime to allow her spend part of the time outdoors, strapped to a special seat in the cinema, lifted upstairs to the playroom and strapped to a special seat where she can play.
In short, she needs almost everything done, with no let-up. Even when Alex is in bed, Sonya said she sleeps “with an eye and an ear open”.
The first tragedy in this case is that if Alex had been born 10 minutes earlier, she may never have seen the inside of a court.
The second tragedy is the inability of those who caused it to own up. The alleged HSE/State Claims policy in cases such as Alex’s is Open Disclosure, but in reality the State goes to ground.
On paper, they say “we want our services to support an open, timely and consistent approach to communicating with service users and their families when things go wrong in healthcare”, but in reality everything is denied.
The case of Alex Butler was just one of three to make headlines this week featuring three separate families all put through the wringer by the State in an attempt to extract both an apology and justice.
In the case of five-day-old baby Faith Lanphier, who died at Cork University Hospital after a catheter to give her nutrition was incorrectly placed, the HSE’s eventual apology more than three years after the event was described by senior counsel as the single most important aspect of the case.
In Drogheda, the family of Milagros Martin, who has cerebral palsy following deficits of care at birth, finally received a HSE apology three-and-a-half years after the event.
Open Disclosure is a long way off doing exactly what it says on the tin.
‘Experts rowed about how long she’d live’
A mother and father who waited eight years for an apology from the State for the injuries caused to their daughter at birth were forced to listen to experts argue about how long she might live in an effort to secure a final settlement.
Sonya Butler described as “horrendous” and “absolutely disgusting” their two weeks in the High Court earlier this year where she said the State lined up “mathematicians from overseas using their statistics to prove why children like Alex die young”.
Alex Butler is quadraplegic and has cerebral palsy after injuries she suffered at birth in Waterford Regional Hospital on April 12, 2005.
Alex, through her mother, had sued consultant obstetrician John Bermingham, locum consultant obstetrician Mahmud Khbuli, and the HSE as a result of the management of her daughter’s the birth. The action against the two consultants was struck out as part of an interim €1.4m settlement with the HSE in April 2013.
Dr Bermingham, Sonya’s private consultant, had been on leave at the time of Alex’s delivery. Ironically, it was he who delivered Jordan, the latest addition to the Butler family, born just eight weeks ago. Sonya said she no longer had a difficulty with Dr Bermingham, but that his presence at the birth of their new baby showed just how wrong things had gone at the birth of Alex.
“He used a suction cap to deliver Jordan and he was out in 20 seconds. With Alex, it took 28 minutes,” she said.
While the initial court battle for a settlement had been exhausting, Sonya said their time in the High Court in April and May of this year was “10 times harder”.
“The HSE fought it tooth and nail. They brought in loads of experts who knew diddly squat about Alex.” Sonya said one expert witness gave evidence of how Alex only needed one carer to effect a transfer from sitting to standing. Sonya said the expert had spent no more than an hour-and-a-half in their home and that their daughter needed two carers.
Sonya said the HSE apology of 2013 meant nothing. “It was a two-line feeble apology read out in court, nobody was held accountable.”
She said during the latest hearing, which culminated in a final €9m settlement for Alex this week, had not been about what was best for her daughter.
Her legal representatives — foremost among them Margaret Fortune who Sonya said “amazing” — told her that at that stage, from the State’s perspective, it was “just about the money”.
She said the HSE was trying to cut costs on her daughter’s care while at the same time running up astronomical court bills.
She was also critical of the freeze put on the building of a new family home while the latest legal wrangling took place. She said they had been given High Court permission to start the building work but that the State Claims Agency had “spat the dummy” arguing that the interim payment was for personal injuries to Alex.
The Butlers are building a 5,000sq ft tailor-made home for their daughter in Waterford, complete with therapy room, hydrotherapy pool, and a garage that will allow easy access to the car for Alex. They hope to move in by Christmas.
Sonya said the HSE expected her daughter to exist rather than live. “The settlement can’t fix her, but it will ensure she is looked after,”she said.