Shoddy and careless medical practice can cost lives. In the case of the seven Irish hospitals, where it seems hundreds of X-rays were misread, that fatal outcome – hopefully – has been avoided. The Irish Times has highlighted the many errors that were found in the work of three locum radiologists employed by the Health Service Executive at these hospitals. And as a result, hundreds of patients have been recalled for a review of their medical condition.
How can these events happen in a modern health service, where excellence of treatment by medical professionals of their patients is the minimum standard expected? In February, some hundreds of patients who had undergone colonoscopies at Wexford General Hospital were later recalled for further examination. There too the reassessment of patient care had followed concerns raised about the quality of procedures that were carried out at the hospital.
The HSE has in recent months contacted all those affected by the X-ray errors in the seven hospitals. But the agency has been slow to keep the wider public fully informed of developments at these hospitals, and how its investigation was progressing – at least before a report in this newspaper forced it to do so. The HSE has, by way of public reassurance, said the three radiologists are no longer working in Ireland and have been reported to the Medical Council. This latest controversy in the health service raises some tough questions for the HSE and indeed for others – for the Government and the public too.
How well-vetted in terms of professional experience, competence and linguistic ability are the doctors and consultants who are employed on short-term contracts? For Government, the use of temporary staff on short-term contracts – such as locum radiologists – on the grounds of cost savings, may well prove to be a false economy, and for two reasons.
The cost of employing a consultant on an hourly rate contract has in many instances proved more expensive than directly employing a permanent staff member. And if litigation now follows the X-ray debacle – with some aggrieved patients claiming medical negligence – then the cost to the HSE could be very considerable.
In 1968, the FitzGerald report outlined proposals to reorganise Irish hospitals – favouring four regional and 12 general hospitals. This rationalisation plan was rejected, and ever since there has been little political will to engage in such major restructuring, with strong local opposition always raised against local hospital closures.
But this latest debacle, occurring in seven of the country’s smaller local hospitals, should also raise some questions about their continued suitability in an age where the demand, rightly, is for excellence in patient care: something that fewer – larger – hospitals would be best able to provide.