ANALYSIS:THE LATEST case involving sub-optimal breast cancer care in the Republic is centred on the poor handling of information by health professionals.
Ann Moriarty was originally diagnosed and treated in one of the State's best breast cancer units at St James's Hospital, Dublin. However, a mammogram performed at the hospital during a routine check-up in April 2007 is now missing, creating the first of many information deficits in this case.
But it is the standard of care given to Ms Moriarty at Ennis General Hospital throughout 2007 that raises issues of most concern. It was decided she needed a follow-up surgical consultation on August 11th last year, but that never happened; abnormal blood test results - strongly suggestive of breast cancer recurrence - were filed in her chart without being acted on; and it is unacceptable to take 22 days for a chest X-ray to be read and reported on at Ennis General.
Coincidentally, yesterday was the last day for submissions to the Department of Health by the public on a proposed Health Information Bill. A discussion paper published by the Department of Health in June noted: "At present, the ability of healthcare professionals to access up-to-date health information about a patient, wherever and whenever necessary, is limited and fragmented."
In its submission to the department on the Bill, the Health Information and Quality Authority (Hiqa) says that information in a standardised format should accompany patients on their journey through the healthcare system.
"International evidence suggests that the failure to communicate information between care providers at handover is a major contributing factor to adverse incidents," it says.
In the case of the late Ms Moriarty, a key question must therefore be asked: was there a constant flow of information from St James's to her GP and to Ennis hospital (and vice versa)? And at an even more fundamental level, it is indefensible to order a blood test for tumour markers (in itself a clear indication someone was concerned about cancer recurrence) and not follow up the results. Test results must never be filed without being signed off as either normal or requiring further specified action.
Not to do so means a hospital or clinic has failed in its duty of care to a patient.
This case may reflect a one-off human error. But for the community to have any faith in Ennis General Hospital, an external review of how it processes important patient information is now required.