Decision by Beacon Hospital to offer Covid vaccines to teachers ‘made in good faith’

The decision by the Beacon Hospital to provide vaccines to teachers at a school in Co Wicklow earlier this year was incorrect but was made in good faith, a report commissioned by the board of the facility has found.

The review found that the decision was made by Beacon's chief executive Michael Cullen alone. However it says that no-one who was aware of the move to offer the vaccines to the 20 teachers at St Gerard's in Bray "raised any reservations in relation to the decision".

The review finds that the Health Service Executive (HSE) had not given permission for surplus vaccines to be provided to teachers.

However the review concludes that the decision of Mr Cullen was made “in good faith”.

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The report by Eugene McCague, former managing partner and chairman of Arthur Cox, which was commissioned by the board of Beacon, finds that the decision was taken by Mr Cullen “in a time-pressured situation in the mistaken belief that the risk of doses being wasted entitled Beacon to administer the doses to anyone who was available, other than patients”.

The report says this was based on his understanding that people other than healthcare workers including teachers, had been referred for vaccination to the vaccination clinic by the HSE’s community healthcare organisations and an incorrect interpretation of the extent of the discretion permitted in the official guidelines for the sequencing arrangements to apply for the administration of the vaccines.

“While the basis on which Mr Cullen made his decision was incorrect, I am satisfied that he made the decision in good faith,” the McCague report maintains.

“The decision to vaccinate the Bray teachers was taken by Mr Cullen alone. No-one else participated in, or contributed to, the decision. The decision was taken by Mr Cullen quickly, without consultation, and was communicated to the Bray teachers through the principal of the junior school while Mr Cullen was at home and before he returned to the vaccination clinic (at Beacon).”

The report suggests that Mr Cullen in evidence to the review had maintained that his motivation in offering the vaccines to the Bray teachers was to avoid the surplus Covid-19 vaccine doses on the day in question on March 23rd being wasted .

However the review says Mr Cullen’s decision was not in compliance with the HSE’s vaccine priority list.

“Teachers were categorised in priority group 11 on the vaccine priority list (priority group 10 following the amendments to the vaccine priority list on 4 March). It follows that Mr Cullen’s decision was not in compliance with the vaccine priority list.

“The only circumstance in which Mr Cullen and Beacon could have complied with both the requirement of the sequencing guidelines that no dose be wasted and the terms of the vaccine priority list was if they had succeeded in identifying and vaccinating a further 20 healthcare workers at very short notice in addition to the 42 HCWs who were identified and vaccinated.”

The report indicates that Mr Cullen told the school in Bray that the vaccines could be provided with the permission of the HSE.

“The use of the phrase ‘HSE permission’ in the message from Mr Cullen to the principal was unfortunate in that it may have inferred that HSE was aware of the decision and approved of it. This was not the case. I am satisfied that what Mr Cullen intended by the phrase was that, as he believed at the time, it was in line with the HSE requirement that no doses should be wasted and that HSE supported earlier decisions to vaccinate other categories of what he viewed as frontline workers to avoid wasting vaccines. Contrary to what Mr Cullen believed and consequently represented to the Bray Teachers, the decision did not have HSE permission.”

The report says that in principle the vaccination of staff working in crèches was also not in accordance with the HSE’s vaccine priority list.

However it says “a distinction can be drawn in the case of the Beacon crèche on the basis that it (1) is part of the integrated Beacon campus and (2) provides the essential service of childcare to frontline healthcare workers.

“The decision to vaccinate the first nine staff members from the Beacon crèche was made having regard to the zero wastage policy referenced in the Sequencing Guidelines and the fact that the Beacon crèche is part of the Beacon campus.”

It says “Beacon informed HSE of the fact that staff from the Beacon crèche had been vaccinated and HSE raised no issue with it”.

Commissioned

The board said that in line with the finding of the the review it commissioned, it acknowledged that the decision to offer the vaccines to the teachers, “ was not in line with national vaccine priority list and did not have HSE approval”.

The board said on Monday it regretted that the incident happened but having considered the review it had determined it retained full confidence in Mr Cullen.

“The review also finds that there was an incorrect interpretation of the discretion available to Beacon Hospital to make decisions that would avoid any vaccine doses going to waste.

“The Board also acknowledge, as per the Review’s findings, that notwithstanding the lateness in the day, the HSE cohort CHO6 should have been asked to provide health care workers even if there was no expectation that this would have been possible given the time of day,” it said.

“The Board has considered all the facts that led to the situation arising - including the decisions that were made by clinical and operational staff overseeing the clinic that day, the high volume of ‘no shows,’ and the information re: potential vaccine wastage that was shared with the CEO after the last scheduled appointments of the day.

“Having considered these facts, the Board accepts the view of the Independent Reviewer that while the basis on which the decision was made to contact the school was incorrect, it was made in good faith.”

The school faced criticism after it emerged that 20 of its staff members received Covid-19 vaccines at the Beacon hospital.

In a subsequent letter to parents from the school board, it said it “sincerely apologised” for its role in the vaccination controversy.

However, it said no person acting on behalf of the school sought early access to vaccines.

The school said it had been approached by the chief executive officer of the Beacon Hospital and was assured that using the vaccines in order to avoid waste had HSE permission.