Sir, – Further to your editorial "Let the health watchdog bark" (March 25th), while the editorial makes a number of incorrect assertions regarding the HSE that can be debated at some other juncture, of particular relevance to this letter is the incorrect assertion made by your editorial writer, "Efforts to prevent publication of its findings are unacceptable because they signal an unwillingness to undertake fundamental reform". The HSE has no objective or desire to prevent the publication of this important report. The HSE has always regarded Hiqa reports as valuable tools towards service improvement and reform. The HSE is seeking only that this report, when it is published, is accurate, contextual and has followed fair procedures.
The HSE wrote a total of five letters to Hiqa seeking a meeting, further information, and supporting documentation in order to allow the HSE and its staff members to respond appropriately to inaccuracies and certain findings contained within the draft report. This is in a context where a significant number of staff members have not been informed by Hiqa of adverse findings or inferences against them nor given an opportunity to respond.
Furthermore, as reported accurately by The Irish Times (in a news article in the same edition as the editorial) the HSE requested that a mediator be appointed in order to create a mechanism that would offer staff an opportunity to provide a balanced reflection of all findings in the report ("Department asked to 'urgently intervene' in Portlaoise row", March 25th). Any consideration of legal action would have been as a last resort and was not a preferred course of action. The HSE is currently engaged in a process with Hiqa.
The HSE is in wholehearted agreement with one point that the editorial writer makes – “let the health watchdog bark” as this is in the best interests of improving health service delivery. However, when it does “bark” it should do so having considered all of the available information and having followed fair procedures in arriving at its findings. – Yours, etc,
PAUL CONNORS,
National Director
for Communications,
Health Services Executive,
Dr Steevens’ Hospital,
Dublin 8.
Sir, – I find the impasse between the HSE and Hiqa deeply disturbing and unprecedented. While the report remains unpublished, patients remain in the dark about any potential patient safety issues. HSE director general Tony O’Brien’s intervention this week deserves some scrutiny. He published a tranche of correspondence between himself and Hiqa on the HSE website. These letters show that this draft Hiqa report may carry implications for management at all levels. In one letter dated March 3rd, 2015, he states that “serious findings have been based on unverified reports”.
One presumes that these reports were generated by the collecting narratives from the women and families involved. This is practice in all Hiqa reports where the families involved are interviewed and these exchanges will appear in the final report. The tone of Mr O'Brien in this letter is in stark contrast with correspondence he sent to all health service staff, the contents of which you published on February 6th, 2015 ("HSE chief tells staff 'appalling lapses' happening too often").
In this letter, he states “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”. More importantly, he goes on to say “When things go wrong we must be open about this and communicate honestly with patients and families.”
The final paragraph in that letter shows perhaps just how far the HSE has turned. “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.”
This unseemly and very public spat shows the kind of unfeeling, bureaucratic and defensive approach that only one month ago Mr O’Brien stated he wanted to avoid. – Yours, etc,
TRIONA MURPHY,
Chairwoman,
Tallaght Hospital
Action Group,
Tallaght, Dublin 24.