News stories about the Irish hospital system

Pressure growing on Harney and Tallaght

Pressure is growing on Health Minister Mary Harney and on the Chairman of Tallaght Hospital today as the revelations continue about the unreported x-rays scandal.

Local GP and Professor of General Practice at TCD Dr Tom O'Dowd, who has been querying why the hospital did not act on previous warnings by him about x-rays, has called on the Chairman of Tallaght, Lyndon MacCann, to consider his position.

In addition to the issue of 58,000 unreported x-rays over a four-year period, a separate serious issue has now emerged, also raised by Prof O'Dowd, over thousands of GP referral letters to the hospital remaining unopened and unprocessed.

Prof O'Dowd revealed on RTE this morning that he wrote to the acting CEO as far back as January of last year on the unprocessed referral letters issue and "cc'd" the letter to the Chairman, Mr MacCann.

Prof O'Dowd said the response he received from the acting CEO indicated that the nature of the problem was not understood by the hospital. Dr O'Dowd then wrote directly to the Chairman in April of last year raising the unprocessed referral letters and unread x-rays issue but says he received no response.

Mr MacCann has since said he did not receive the correspondence and only learned of it this week.

The independent health safety watchdog, HIQA, revealed yesterday that it had met with Tallaght hospital management on the x-ray issue on three separate occasions since last June. It was only at a meeting in mid-January, according to HIQA, that the hospital first told it that the x-ray backlog was as high as 58,000.

Previously, the hospital had told HIQA that there was only a backlog of 4,000 x-rays and these were being cleared - it had last given this assurance to HIQA at a meeting in August. Tallaght Hospital, when the scandal broke earlier this week, said it first became aware of the true extent of the problem in December but it did not mention that HIQA had already been trying to investigate the issue since last Spring.

It has also been relealed that Tallaght did not provide update reports to HIQA on the x-ray situation when requested on a number of occasions last year. HIQA has also claimed that the current CEO, Kevin Conlon, is "incorrect" in stating that the first time he informed HIQA of the extent of the x-ray crisis - 58,000 unreported x-rays - was mid-December.

The Irish Hospital Consultants Association (IHCA) has already stated that over 40 letters were written to Tallaght management about the x-ray issue over a number of years and has pointed to a shortage of radiologists at the hospital.

Nearly 60,000 x-rays at Talalght were not reported on or examined by radiologists from 2005 to September 2009, and there were two delayed diagnoses, in one case the patient has since died.

In its latest statement on the crisis, Tallaght Hospital has said a report on the x-ray backlog was first presented to its clinical governance committee on November 26 last, when it was indicated that there were only 700 issues of concern regarding the x-ray backlog. This report was presented by former CEO Michael Lyons, who has since retired on health grounds.

The hospital says the new CEO, Kevin Conlon, was not satisfied with this report and asked for more details. The day he took up his appointment on December 14, he received a report indicating that thre were around 58,000 unreported x-rays and this has since proved to be the correct number, according to the hospital.

The HSE has said it is satisfied with the current response of the hospital in clearing the unreported x-ray backlog. It expects the review of the remaining 23,000 films to be completed within 10 weeks.

It said Tallaght has assured it that every patient's x-ray has since December been reported in a timely manner by a radiologist.

It reiterated that the backlog of of 58,000 x-rays was totally unacceptable.

"While resource pressures and surges in demand can lead to short-term delays, the level of backlog at the hospital was not acceptable," the HSE said.

While the HSE says it is commissioning an investigation into the Tallaght scandal under an independent chairperson, the appropriateness of the HSE organising such a review has been questioned.

As concerns grow about similar x-ray issues occurring at other hospitals around the country, the HSE says it is examining radiology reporting in all hospitals.

This process is being carried out by the HSE's Serious Untoward Incident Unit (SUI) and a report is to be issued on the matter.

It has already been indicated that x-ray reporting by radiologists may not happen with all x-rays in some hospitals. The HSE said there is evidence to suggest that this may be reasonable in certain circumstances such as in orthopaedics.

Meanwhile, opposition parties are calling on Health Minister Mary Harney, who is currently in New Zealand, to resign on the Tallaght issue. Taoiseach Brian Cowen has defended the Minister's record.

It is speculated that the Tallaght scandal may militate against Ms Harney retaining her post in the forthcoming Cabinet reshuffle.