Tallaght hospital has said that an estimation by Trinity College Dublin public health specialist Prof Tom O'Dowd that 30,000 GP referral letters were unopened was incorrect.
In a statement tonight, the hospital said: "There was never anything like 30,000 unprocessed letters. All GP referral letters are opened on receipt and processed according to speciality".
The hospital admitted that action was taken in October 2009 to clear a backlog of 3,498 letters which had not been reviewed by a consultant.
"All of these are now actively being dealt with," a spokesman said.
Earlier today Prof O'Dowd said a large number of referral letters to the hospital had not been processed. He said in his estimation roughly 30,000 letters were left lying around “unopened and unanswered”.
He said the referral letters were a “more serious issue” than the x-rays and marked a “major dereliction of duty” which “expose the hospital to long-term legal consequences”. He said this evening that the terms of the review group should be extended to include the unopened referral letters.
Speaking on RTÉ's Morning Ireland Prof O'Dowd said the letters would have contained information about patients that may have led to cancers or neurological conditions being left undiagnosed and patients "would have a very good case for calling the hospital to account", he said.
“There’s a delay in the health service anyway, but if that delay is exacerbated by a managerial inactivity then it exposes the hospital to even greater medical legal consequences than even the X-rays."
Minister for Health Mary Harney this evening said it was unacceptable that referral letters from GPs to consultants in Tallaght Hospital were unopened.
She said waiting times for outpatient appointments should not be prolonged by virtue of referral letters not being opened.
"It is completely unacceptable that referral letters from GPs could remain unopened," she said, adding that while there had been unopened letters in the past “there are now no unopened letters”.
She said the issue of the 23,000 unread X-rays would be investigated by the independent review to be established by the HSE. This review will take around 10 weeks, she said.
Prof O’Dowd had earlier called on the chairman of the hospital board, Lyndon MacCann, to consider his position. Prof O’Dowd said because the chairman had not responded to two separate letters from him warning of the X-ray backlog and referral letters, the question must be asked: “Does he see himself as the person to oversee the governance of a modern healthcare institution?”
In a letter to the chairman of the hospital board Mr MacCann on April 22nd, 2009, Prof O’Dowd said: “I have since been informed, by one of your managers, that ‘two years of GP referral letters’ have not been opened or reached the consultant to whom they are addressed.”
“I think that if Mr McCann is heading up the governance of a modern institution and he doesn’t put a process in place where he sees letters that are of importance and he doesn’t put a process in place to answer those he really has lead his hospital and his staff and his patients into significant trouble,” Prof O’Dowd added.
Mr MacCann said, however, he only learned of this correspondence yesterday. “I learnt this afternoon that Dr TC O’Dowd wrote a letter on 22 April 2009 expressing his concerns. The letter was addressed to me at the hospital and has been stamped as ‘received’ by the chief executive’s office, 27 April 2009. I had not known of this letter until today”.
Pressure on the hospital management mounted when Minister of State Conor Lenihan called for “major changes in the management structures” at the hospital.
He said a management review at the hospital was essential to restore public confidence in the facility.
Mr Lenihan said the hospital needed to change the management structure, to “slim down” the size of the 22-member board and to “fast track” discussions on cooperation for an academic medical centre between Tallaght, St James’s Hospitals and the Trinity teaching school.
This he said would put the hospital in a “wider context of collaboration and cooperation between three reputable institutions.”
Mr Lenihan also called for the staff representative on the board of the hospital to have voting rights.
He refused to blame Minister for Health Mary Harney for the problems at the hospital.
He said: “I’ve no intention of bringing this to the ultimate political level in terms of Mary Harney’s position because at the end of the day it’s the HSE and the hospital that have to resolve and restore the reputation of the damage and the management system here.”
There were heated exchanges in the Dáil today after the Government rejected Opposition demands to allow time to debate the problems at the hospital.
Labour’s Eamon Gilmore said “We now have one Minister who is on a visit to New Zealand for two weeks on an itinerary that reads more like the Lord of the Rings trail than it does 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.”
“It’s one thing to have the country represented abroad on St Patrick’s Day but the abuse of that on this occasion is not acceptable.”
Fine Gael leader said the fact that Ms Harney is not returning from New Zealand until March 22nd to deal with the crisis as “another catastrophe”.
Tánaiste Mary Coughlan responded for the Government saying the hospital disputes the accusations of unopened referral letters.
She said: “All of that is being investigated, we will await the outcome of the investigation so that we can establish the facts.
“Those matters will be raised between the department who are meeting with the CEO who are establishing the facts of the situation and I will not pre-empt that meeting,” she said.