HSE chief tells staff ‘appalling lapses’ happening too often

O’Brien says staff should treat patients as they would a parent, sibling, partner or child

File photograph from November 2013 of HSE Director General Tony O’Brien. Photograph: Alan Betson / The Irish Times

File photograph from November 2013 of HSE Director General Tony O’Brien. Photograph: Alan Betson / The Irish Times


Health service too often do not deal openly and communicate honestly with patients and their families when things go wrong, the head of the HSE Tony O’Brien has said.

In a letter to all health service staff he said that sometimes there were “appalling lapses in the way we care for people which can be hard to comprehend”.

Mr O’Brien’s letter to HSE staff and those in organisations which are funded by it was written in the aftermath of the RTÉ documentary last week dealing with the deaths of infants at Portlaoise General hospital.

In the letter which Mr O’Brien described as unprecedented, he said that not enough had been done to create a common culture across the health service.

“ Islands of excellence now share the same identity as instances of significant underperformance and serious failure. As we head towards a new set of health organisation arrangements and the post-HSE period it is important that we accept responsibility for our culture, change the way we work and hold one another accountable to remain true to delivering best possible care in every setting and situation.”

“When things go wrong, and in any health system this will happen, those who depend on us are at their most vulnerable. This is when they need us to care and, most of all, to show that we care by what we do. When things go wrong we must be open about this and communicate honestly with patients and families.”

“Far too often it appears that this is not the case. While I am sure that these are exceptions, there are just too many of them. This erodes public confidence in health services, it lets down the public and it lets down the service as a whole.It also lets down the many dedicated and deeply caring staff who every day provide excellent care throughout the service.”

Mr O’Brien urged health service staff to treat patients and families as they themselves would wish to be treated.

“Sometimes there are appalling lapses in the way we care for people, which

can be hard to comprehend. All that is required to put this right is for each one of us, without exception, to commit ourselves to doing one extraordinarily simple thing. What I am asking is that all of us, at all times, look after every patient or client with exactly the same level of consideration that we would if they were our parent, sibling, partner or child. In other words - just as we would wish to be treated ourselves. This is even more important when things have gone wrong, for whatever reason.

“We must ensure that we never again hear about grieving parents being denied the opportunity to treat their dead new-born child with dignity and respect - this is everybody’s right and expectation. That we never again hear that a patient who has had an unexpected outcome or who has been harmed has reason to believe that instead of seeking to address their concerns openly and honestly the health service has responded with apparently unfeeling bureaucracy, excessive defensiveness and in a way that appears to serve only self-interest.”

Mr O’Brien said that inevitably “we will all have to continue to live with the consequences and distress of past mistakes.”

He said the purpose of his letter was not to cast blame but rather to ask all health service staff to see to it that they do not add to these mistakes.

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