Tallaght Hospital scandal: No need for accountability

Public Inquiry · Examining corruption in Ireland

I wrote recently about the missing link that marks the difference between how things are done in Ireland and how they’re done in functional democracies.

When suspicions of corruption are raised in functional jurisdictions there usually follows an investigation by an independent authority.

If the suspicions are confirmed consequences follow such as sackings, heavy fines or perhaps a trial followed by appropriate punishment.

All this is done under the principle of justice being seen to be done and the whole matter is usually followed up with new rules/regulations to prevent such events from happening again.

All these stages of accountability are also carried out in Ireland with the notable exception of holding anybody to account.

The recent scandal at Tallaght Hospital, as reported in the Irish Examiner, is a great example.

Background:

The hospital is unable to explain why five senior officials received almost €700,000 in non-salary ‘top-up’ fees between 2005 and 2010.

Ernst and Young carried out a financial investigation last year as a result of concerns raised by the Health Information Quality Authority (HIQA).

The investigation found:

The hospital was unable to provide any documents showing why the large payments were made.

The hospital was unable to explain why the supplementary payroll, under which the payments were made, was set up or what approval procedures were followed.

Board members at the time provided inconsistent recollections as to the existence and approval of the fund.

One individual received €225,833 in extra pay. Four other staff members received €104.667, €61,250, €24,000 and 259.000 respectively.

This was all taxpayer’s money at a time when Tallaght Hospital was making severe cutbacks to its budget.

We have now reached the critical point where, in a functional democracy, stronger action would ensue – police investigation, courts etc.

In Ireland this stage is skipped completely and replaced by an excuse stage.

Significant management structure changes have been carried out at the hospital – we’re told.

The new management has ‘noted’ the findings of the investigation.

The external payroll system responsible for the payouts has been abolished.

The new board has appointed a new remuneration and terms of services committee.

The new board said they were disturbed and upset by what happened.

So, no further action, no police, no investigation, no courts.

And, we can ask, is the new board a genuine improvement on its predecessor. Will this ‘new broom’ sweep all the old habits away and act in a professional and responsible manner when it comes to accountability?

No, is the emphatic answer.

When asked if the five members at the centre of the scandal were still working at the hospital and whether any of the paid out money can be retrieved they declined to comment.

Or, in plain English – Take a hike, we’re saying nothing.

The only reason, I suspect, the board of Tallaght Hospital can feel confident in refusing to answer this most basic of questions is because of the missing link in Irish accountability.

It there’s no system of accountability – there’s no need to be accountable.

via Public Inquiry · Examining corruption in Ireland.

via Public Inquiry · Examining corruption in Ireland.

Husband may lodge complaint with Ombudsman

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 Halappanavar has objected to the use of his wife’s notes in a HSE inquiry into her death. He has said he has no faith in a HSE-run inquiry and does not want her notes used in it.

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.

Mr Halappanavar met Minister for Health James Reilly for 25 minutes yesterday in Galway.

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.

via Husband may lodge complaint with Ombudsman – The Irish Times – Sat, Nov 24, 2012.

via Husband may lodge complaint with Ombudsman – The Irish Times – Sat, Nov 24, 2012.

Prime Time Special on the Death of Savita Halappanavar

The husband of Indian dentist Savita Halappanavar, who died of blood poisoning in an Ireland hospital after being denied abortion, has demanded a public inquiry into the death.

In an interview to Ireland’s RTE TV channel, Praveen Halappanavar said he would not meet the chairman of the Health Service Executive (HSE) inquiry into his wife’s death. The family, he said, wants a public inquiry funded by the government.

“I had to answer the family back home… They couldn’t believe it. It was such a simple case,” Mr Halappanavar said on the channel’s Prime Time programme.

Click on the link below to view

Prime Time – RTÉ Player.

via Prime Time – RTÉ Player.

Hopefully this programme will get to be seen worldwide

Husband objects to inquiry members -Savita Halappanavar

The husband of the late Savita Halappanavar wants employees of Galway University Hospital removed from the inquiry established by the Health Service Executive into her death.

Praveen Halappanavar said last night he would request through his solicitor that Prof John J Morrison, a consultant in obstetrics and gynaecology; Dr Catherine Fleming, consultant in infectious diseases; and Dr Brian Harte, consultant in anaesthesia and intensive care at the hospital, be removed from the inquiry.

The HSE announced details of the membership of the inquiry team at a press conference in Dublin yesterday.

Ms Halappanavar died at the Galway hospital on October 28th of septicaemia seven days after she presented with back pain. She had been 17 weeks pregnant and her husband says she asked repeatedly for a termination over a three-day period but was refused as there was a foetal heartbeat present.

Mr Halappanavar arrived back in Ireland from India on Sunday and met his solicitor in Galway yesterday to discuss the draft terms of reference for the independent inquiry.

Asked what he wanted from the inquiry, he said: “The truth to come out. As long as it is a fully independent inquiry so that the truth will come out. It does bother me that there are people from Galway hospital on the inquiry. I would prefer no Galway people on the inquiry. I will basically request that there be no-one from Galway on it.”

The inquiry team has seven members. Its chairman, Prof Sir Sabaratnam Arulkumaran, head of obstetrics and gynaecology at St George’s Hospital, University of London, said it was important to have representatives from Galway University Hospital on it to allow the panel to compare the guidelines in use there with the national and international guidelines.

He said the three consultants from Galway on the inquiry team had not been involved in the care of Ms Halappanavar.

“The main reason to have internal people involved is not for them to give specific directions but to find out about their standard practice,” he said.

Hospital co-operation

The HSE said the inquiry would seek to establish the facts surrounding the death of Ms Halappanavar, to identify any contributory factors, draw conclusions and make recommendations. It said Galway University Hospital had committed to co-operating fully.

Mr Halappanavar also said there were five members of medical staff, as well as a family friend, present in the room with him and Savita when they were told on Tuesday, October 23rd that she could not have a termination of the pregnancy she was miscarrying because “this is a Catholic country”.

Mr Halappanavar also said he believed no inquiry would have been established if his wife’s death had not been brought to public attention.

“I was in India for nearly two weeks and I never heard from the hospital . . . So I had to see people became aware . . . I don’t think there would be any inquiry if there was not the public pressure. I think there would have been an inquest and no one would have known this happened. It is a pity because I thought Ireland would care more for someone so young who died. That let me down. I was not happy about that.”

Asked whether Ms Halappanavar’s parents would come to Ireland for the inquiry or inquest, he said if her father was not “convinced with the investigation” he was “very keen to come over”.

“The law has to change. Maybe Savita was born to change the laws here.”

via Husband objects to inquiry members – The Irish Times – Tue, Nov 20, 2012.

via Husband objects to inquiry members – The Irish Times – Tue, Nov 20, 2012.