A DOCTOR WRITES:The least any patient should expect is that the proper process is followed after an X-ray, writes MUIRIS HOUSTON
THE FAILURE of Tallaght hospital to adhere to even minimum standards of care by not analysing and reporting on some 58,000 X-rays carried out since 2005 places a major question mark over the quality of public hospital services in the Republic.
If such a significant failure can occur in one of the State’s premier teaching hospitals and not be addressed for over four years, it may well have happened in other hospitals also.
Initial reports have referred to a “failure to review” X-rays by consultants at the hospital. The use of the word “review” is disingenuous and risks down-playing an extremely serious situation; what has happened in Tallaght represents a fundamental failure to complete a process that starts with any hospital doctor ordering a test and only finishes when a specialist doctor formally examines the X-ray film and commits his opinion to paper.
This is the least any patient should expect from the process and it is the minimum the system must deliver.
Until such time as the formal test result is filed in a patient record or is forwarded to a GP, then the minimum standard has not been met.
Yes, junior doctors on the ward of a hospital may look at the films and decide they are normal. But this is no substitute for the opinion of a highly trained consultant radiologist; it is his report that is the definitive one, upon which treatment and future patient management will be based.
While we are being told that many of these X-rays were carried out on orthopaedic patients as checks following fractures – with the expectation they will be normal – the decision to seek the X-ray represents clinical doubt. The only valid answer to it is a formal report from a radiologist. Allowing any X-rays to pile up unreported in a system can only be described as negligent.
But there is much we do not yet know about this monumental failure.
How many of the unreported X-rays are of chests and abdomens, a minority of which will contain abnormalities suggestive of cancer? Are there unreported CAT and MRI scans in Tallaght? Does the backlog include tests ordered by GPs in the Tallaght area?
If so, this is an additional concern because patients in primary care may presume the test result is normal if they are not contacted by their practice.
When was the health standards watchdog, the Health Information and Quality Authority (Hiqa), informed? How long has the board of the HSE known? Did anyone tell the Department of Health?
And crucially, how long has the Minister for Health been aware of this major deficiency in one of the Republic’s flagship hospitals? Only a fully independent examination of Tallaght hospital’s radiology services will suffice.
The most important people in this scandal are the thousands of patients whom no one thought of contacting since late last year, when we are told the hospital authorities first became aware of its black hole of X-rays.
Anyone who had any form of X-ray investigation carried out in Tallaght from 2005 until the end of 2009 would be well advised to contact the hospital helpline and ask for a copy of the radiologist’s report to be sent to their family doctor.
Tallaght hospital has set up a freephone helpline for patients and their families who may be concerned, 1800-283059, open from 9am to 5pm