THE TALLAGHT GP and Trinity College Dublin public health specialist who first drew attention to the failure to review large numbers of X-rays in Tallaght hospital has called on the chairman of the hospital board to consider his position.
Prof Tom O’Dowd said that because the chairman, Lyndon MacCann, had not responded to two separate letters from him warning of the X-ray backlog and other problems, the question must be asked: “Does he see himself as the person to oversee the governance of a modern healthcare institution?”
Pressure on the hospital management mounted last night when Minister of State Conor Lenihan called for “major changes in the management structures” at the hospital “in light of the shocking revelation that almost 58,000 X-rays were not reviewed by a consultant radiologist in a four-year period up to September 2009”.
He said an immediate management review at the hospital was “essential” to restore public confidence in the facility.
There were also calls by the Opposition yesterday on Minister for Health Mary Harney to resign or be sacked over this latest debacle when Taoiseach Brian Cowen conducts his Cabinet reshuffle. Ms Harney, who is in New Zealand, has no plans to travel home early to deal with the controversy. Her spokesman said she was being kept informed.
In several other hospitals, it has been confirmed, X-rays are not always reported on by consultant radiologists either. The HSE is now conducting an audit of how widespread the practice is. It also says an investigation into the circumstances which led to the accumulation of unreported X-rays at Tallaght will be carried out. The inquiry will have an independent chairperson with full details announced in coming days.
The Irish Hospital Consultants Association said radiologists at the hospital wrote more than 40 letters to hospital management over the past three to four years seeking extra staff and warning there was a growing delay in reporting on X-rays but nothing was done.
It also emerged yesterday that there were problems within Tallaght hospital over a failure to process large numbers of GP referral letters. 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.”
Speaking to The Irish Timeslast night, Prof O'Dowd said: "I would like to know if the chairman alerted the board of the hospital and what action was taken as a result."
Mr MacCann said, however, he only learnt 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 ”.
The Health Information and Quality Authority (Hiqa) said it was told by the hospital in June last year that about 4,000 X-rays had been unreported and this would be resolved by July. It was only told in January this year that more than 57,000 X-rays had gone unreported.
A spokeswoman for Tallaght hospital said a report on the X-ray backlog was first presented to its clinical governance committee on November 26th last. “This indicated there were 700 issues of concern and that the issue was being resolved,” she said.
Asked who had presented this report, she said it was the former CEO, Michael Lyons. “Following this meeting, the chief executive designate of Tallaght hospital, Prof Kevin Conlon, was not satisfied with this and asked for a full report. “On taking up his appointment some weeks later he received a report indicating that there were 57,921 unreported X-rays. This has proved since to be the correct number,” she added.
The Irish Timesleft a telephone message for Mr Lyons yesterday giving him an opportunity to respond to the issues raised. He did not return the call. He resigned from Tallaght hospital on health grounds late last year.
The HSE said Tallaght hospital is now reviewing approximately 2,000 of the unreported films per day and it is expected the review will be completed in approximately 10 weeks. The hospital could not say whether the unreported X-rays were mainly those of public or private patients.
GPs in the Tallaght area have confirmed they too had concerns about whether referral letters seeking advice on the management of their patients were being processed properly. A number of doctors said they had ceased to refer patients to the hospital as a result. On the basis of normal referral patterns, about 1,600 referrals per week are made to the hospital by family doctors in its catchment area.