Hiqa report on Midland Regional Hospital ‘highly unfair’ to staff, says HSE chief

The Health Information and Quality Authority's draft report into Midland Regional Hospital, Portlaoise, contains some factual inaccuracies, lacks context and balance and fails to give reasons for, or to substantiate, certain findings, the Health Service Executive's director general, Tony O'Brien, has said.

In a letter sent to HSE staff last week he argued that the draft report, which he received on February 2nd, reflected "a subjective and selective approach to this particular investigation" by Hiqa.

Mr O’Brien said the draft was “highly unfair to the dedicated staff, who work under enormous pressure to provide the best level of care possible in the [hospital].

“This is to the detriment of providing a report on the true status of safety, quality and standards of care at the time of the investigation at Portlaoise hospital.”

He said what was of most concern to him was that many staff members (clinical and management) referred to in the draft report had not been informed of the findings or given the relevant information or documentation to allow them to respond appropriately.

Court intervention

He confirmed that as a last resort he had been prepared if necessary “to seek court intervention in order to secure fair procedures”.

"As a final measure before initiating court action I requested the intervention of the Department of Health to secure a meeting with the regulator; this meeting avoided any immediate need for legal measures to be taken."

Mr O’Brien acknowledged in the letter that the draft report contained some observations and criticisms of senior HSE management. However, he said this was not the reason for his unhappiness with the draft and his consideration of court action.

“It became clear to me that a wide range of people who have not had the opportunity to see or respond to the draft report should have been given that opportunity. This includes nurses and midwives in the hospital and some senior managers.”

Fair procedures

“The HSE does not favour pursuing court action against any public body. A number of courses of action were considered in order to ensure that Hiqa dealt with our concerns in a meaningful way. Any consideration of court action was a reasoned statement of intent in the absence of meaningful engagement and fair procedures by Hiqa. If the regulator’s procedures were fair then consideration of an application to the court would not have been necessary. ”

He added: “The HSE has no desire to delay or prevent publication of this important report. In fact, had there been a response to my first request for engagement with Hiqa, the final report might well have been published by now. Five weeks were wasted by a refusal by Hiqa to engage in order to deal with the HSE’s concerns.”

Mr O’Brien said it was important to emphasise that he fully acknowledged there had been significant failings at Portlaoise. He said he had publicly expressed his apologies on behalf of the HSE to the families concerned.

“Many of the failings have been addressed at this juncture and other changes are under way. It is important to state that the services delivered at Midland Regional Hospital Portlaoise today are safe and this is an important message for clients and patients who use its services.”