The husband of Savita Halappanavar is considering lodging a complaint to the Ombudsman to assert his ownership of his wife’s medical notes, his solicitor has said.
Gerard O’Donnell said he had taken instructions from Praveen Halappanavar to seek direction from the Ombudsman on whether he or Galway University Hospital owns her medical records.
Mr O’Donnell had asked that the hospital, where Ms Halappanavar died last month, hand over the original medical notes. However, the HSE has said it owns them.
A spokesman for the Ombudsman said last night it was unlikely her office would have a role in this dispute.
Ms Halappanavar died on October 28th, having presented a week earlier at the hospital with back pain. She had been 17 weeks pregnant and had been found to be miscarrying. Mr Halappanavar says she asked repeatedly for a termination and this was refused as the foetal heartbeat was present.
The Health Information and Quality Authority will publish the terms of reference of its inquiry into her death next week.
The investigation, for which no time span is indicated, will make use of outside expertise, a spokesman indicated.
In a statement, the authority said it would investigate the safety, quality and standards of services provided by the HSE at Galway University Hospital to “critically ill patients, including critically ill pregnant women, as reflected in the care and treatment provided to Savita Halappanavar”.
Mr Halappanavar said after yesterday’s meeting with Mr Reilly that he was pleased to finally meet a Government representative four weeks after his wife’s death. He said he stressed to the Minister that he did not believe the HSE or Hiqa investigations would be far-reaching enough. “I’m just glad that we met and he just passed on his condolences to the family,” said Mr Halappanavar.
Mr O’Donnell said his client was prepared to go to the European Court of Human Rights if an independent public inquiry was not set up. Galway University Hospital last night confirmed it would co-operate fully with the Hiqa inquiry.
The board of the Health Information and Quality Authority is expected to confirm today that it will undertake a statutory investigation into Ms Halappanavar’s death, following a request from the Health Service Executive.
It was unclear last night whether her husband Praveen, who says he will have nothing to do with the HSE inquiry, will co-operate with the investigation to be conducted by the authority, which is the State’s health watchdog.
His solicitor Gerard O’Donnell last night said he was “not ruling out” participation in the Hiqa inquiry. However, it was key for his client that it “sits in public, is open and witnesses are called”.
The authority, which has run well-received investigations into Tallaght hospital and misdiagnoses in the health system, conducts its investigations in private and does not take statements under oath but is free to draw up its own terms of reference.
Dr Reilly welcomed the involvement of Hiqa, saying it would provide “even greater ventilation” of the issues at stake in Ms Halappanavar’s death at Galway University Hospital, his spokesman said.
Asked why the Minister had not used his powers under the 2007 Health Act to order Hiqa to investigate the matter in the first place, he said the HSE was following a protocol, which requires it to get clarity about the facts involved and ensure that a safe service was being provided for patients.
“I wouldn’t see it as a U-turn. At all stages, the first thing the Minister wanted was absolute clarity about this death,” he said. Dr Reilly is due to meet staff from Galway University Hospital today, when he attends a meeting in nearby Merlin Park Hospital.
A special board meeting of Hiqa was held yesterday and is due to reconvene today. A spokesman would only say the board was considering the request received from the HSE.
Ms Halappanavar died at the hospital on October 28th, having presented with severe back pain a week earlier. She had been 17 weeks pregnant and was found to be miscarrying. Mr Halappanavar says she asked repeatedly that the pregnancy be terminated. This was refused, he says, as a foetal heartbeat was present.
HSE director designate Tony O’Brien confirmed it was pursuing its own inquiry – now termed a “clinical review” – despite Mr Halappanavar’s refusal to participate.
Mr O’Brien said even if Ms Halappanavar’s family did not co-operate, the review “must be brought to a conclusion”. There was “no way” the inquiry could be stopped as it would be “criminally negligent” not to proceed.
He accepted the HSE had not been “as aware as it should have been” of the wider context and focused on the “clinical aspects” in its inquiry.
Mr Halappanavar alleged that repeated requests by him and his wife for her pregnancy to be terminated are not documented in her medical records. In contrast, requests for tea, toast and an extra blanket are documented.
They coincide with mounting concern among policymakers over the future needs for residential care caused by an ageing population. Earlier this week, a report found that every day for the next decade an additional seven people would need long-term residential care. The number of over-85s in the population will more than double over the next decade.
There has also been a slowdown in the provision of private nursing home beds due to uncertainty about funding and difficulties in raising bank finance.
Sinn Féin health spokesman Caoimhghín Ó Caoláin, who obtained the figures from the HSE, said the situation was even worse than he had anticipated.
“With over 1,200 public nursing home beds taken out of the system over a 20-month period, and with further bed closures signalled, we are certainly facing a crisis in services for older people,” Mr Ó Caoláin said.
He accused Dr Reilly of “burning the candle at both ends” by imposing savage cuts on home help hours and homecare packages while at the same time closing down public nursing home beds and diminishing the capacity of long-stay public residential facilities.
“This Minister has no strategy or plan to protect our public health services and even less regard for the needs of older people,” he said.
Siptu spokesman Paul Bell accused the Government of abandoning public nursing care and said a situation where 75 per cent of beds were provided by the private sector was “unbalanced”. He called on the Dáil Public Accounts Committee to investigate the costs of the Government’s strategy of “divesting itself of responsibility for care of older people”.
According to the HSE, 443 public nursing home beds were closed this year up to August, while 758 were closed last year. A further 112 beds have been identified for closure later this year.
Bed closures include 230 in HSE South region, 199 in Dublin/North-East, 322 in West and 450 in Dublin/Mid-Leinster.
The HSE attributed the closures to service plan commitments, staffing reductions and the inability of some homes to meet compliance requirements of the Health Information and Quality Authority. It said a number of new public long-stay beds have come on stream in new units in Cork, Navan, Dublin, Tralee and Mullingar.