Tallaght concerns led to report

THE BOARD of Tallaght hospital was so concerned about the way the hospital was being run, it commissioned an independent report…

THE BOARD of Tallaght hospital was so concerned about the way the hospital was being run, it commissioned an independent report on the operation of the facility from Pricewaterhouse Coopers (PwC), it has emerged.

The Irish Times has learned that the PwC report presented to the hospital board late last year recommended a much smaller senior management team and a smaller board.

“It was too big and inflexible and clear accountability was not there,” an informed source said.

The news comes as criticism of the hospital intensified yesterday over its failure to deal swiftly with thousands of GP referral letters.

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While Tallaght GP Prof Tom O’Dowd claimed he had been told by a manager at the hospital that two years of GP referral letters had gone unopened at the hospital in 2009, which he estimated amounted to about 30,000 letters, the hospital said the backlog of unopened letters last October was 3,498. It said there were never 30,000 unopened letters.

Prof O’Dowd said last night the 30,000 figure was always an estimate and “time will tell” if the hospital is now being honest in saying there are no unopened GP referral letters at this stage.

He added that the acting chief executive of the hospital, Dr Gerry Fitzpatrick, acknowledged in a letter to him as far back as January 2009 that the hospital had problems with its patient-referral process. In that letter, Dr Fitzpatrick said: “We have identified a number of major issues in relation to OPD and the whole referral and appointment process.”

Following a review, it is understood it was found an incoming letter from a GP had to pass through more than 20 separate stages before the hospital sent an appointment to the patient who had been referred. The hospital has now streamlined the process to three steps.

Minister for Health Mary Harney, speaking from New Zealand, said she had no intention of resigning over the debacle of the unopened letters and the fact that close to 58,000 X-rays had gone unreported by consultant radiologists at the hospital over a four-year period.

But she said: “It is completely unacceptable that referral letters from GPs could remain unopened . . . While there were, in the past, unopened letters . . . there are now no unopened letters”.

The executive management committee of the hospital met last night and it is likely a meeting of the full hospital board will be called shortly.

A member of the hospital board, who did not wish to be identified, said yesterday there was widespread consensus on the board that things needed to change in the hospital and that they were now changing.

The source said the inquiry, which was now to take place into the failure to report X-rays at the hospital, should be independent of the Health Service Executive (HSE) which funds the hospital and had left it short of radiologists for the amount of work coming through.

Last night the HSE could not say if there was any national protocol in place for how GP referral letters should be handled by hospitals.

A Monaghan GP, Dr Illona Duffy, claimed Tallaght hospital was not the only one leaving referral letters unopened. She said when she referred a patient to Our Lady of Lourdes Hospital, Drogheda, two years ago and got no reply, a member of staff told her referral letters were being put in a box as the waiting list was too long.

The problems at Tallaght hospital prompted angry exchanges in the Dáil as did Ms Harney’s two-week trip to New Zealand for St Patrick’s Day celebrations. Labour leader Eamon Gilmore said her itinerary in New Zealand “reads more like the Lord of the Rings trail than it does like a State visit. The only thing missing from it is dinner hosted by Bilbo Baggins . . . meanwhile the health service for which she is responsible is falling apart.”

Fianna Fáil TD Mary O’Rourke said Ms Harney should cut short her trip to New Zealand to deal with the controversy at Tallaght hospital but a spokesman for Ms Harney said she had no plans to do so.