‘Dysfunctional’ HSE wrongly told anorexic treatment not funded

The president of the High Court has criticised the HSE after it emerged that a breakdown in communication resulted in a man with severe anorexia nervosa being wrongly informed his specialist treatment in the UK would not be funded.

The HSE has presented as a “dysfunctional” organisation in a number of legal cases, Mr Justice Peter Kelly said, as he asked lawyers for the health body to inform it of his view about the need for “proper” internal communications.

The HSE letter, addressed to the “profoundly ill” hospitalised man whose life and health remain at serious risk, was opened earlier this month by his mother and one could “only imagine her despair”, he said.

This was indicative of communications failures that appeared “endemic” within the organisation, he added. Such a letter should never have been sent to a ward of court and the man’s treating doctor was also unaware of it.

The HSE has apologised to the man, his parents and the court over the error which arose because its funding branch was not told until this week that the man, on the HSE’s own application, was made a ward of court last January. This was at the same time as orders were also made for him to receive HSE-funded specialist treatment in the UK.

The man has the most acute form of anorexia – treatment resistant – which carries a mortality rate of one in five. He has suffered from the illness for years and doctors believe it is directly related to having been assaulted as a teenager.

His weight is about 42.5kg and he was found to have hidden away a large number of supplemental drinks he was supposed to consume, the court heard.

He was made a ward of court arising from findings, due to his illness, that he lacks capacity to appreciate the severity of it and to make appropriate decisions in the best interests of his health and welfare.

As there is no facility in the State to treat this most severe form of the illness and his condition has not improved, orders were made last January for his transfer to the UK, where a specialist bed has only now become available.

The judge noted that he had dealt with several cases arising from this form of anorexia but all of those, until this case, involved women who, like this man, appeared to be high achievers.

He had made orders for several of those women to receive treatment in the UK, the results were generally good and sometimes “spectacular” and he hoped the man would also fare well.

Gratitude

The man’s mother told the judge she was upset when she read the HSE letter but both parents said they had put the matter behind them and wanted to focus on helping their son. They expressed gratitude to the judge, the general solicitor of wards of court who represents the man’s interests, the wards of court service, doctors and others dealing with him.

Such involvement made them feel “less alone”, the mother said. The father said they appreciated the judge’s understanding of the nature of anorexia and the compassion he had shown them as parents.

Ms Justice Kelly welcomed the man being moved to the UK within days and made a range of orders to facilitate that. The man would retain all his rights as a domiciled Irish citizen while in the UK, he added.

Peter Finlay SC, for the HSE, said it would fund regular visits to him by his parents while David Leahy, for the general solicitor, said she would continue to visit him.