The Department of Health was aware of seven separate issues concerning the quality of breast cancer services at Barringtons' Hospital, Limerick, some 19 months before it took action to address these concerns, it has emerged. Dr Muiris Houston, Medical Correspondent, reports.
According to correspondence seen by The Irish Times, Paul Barron, assistant secretary of the Department of Health, wrote to Prof Brendan Drumm, chief executive of the Health Service Executive (HSE) on January 16th 2006, asking that specific issues be examined at the hospital including the fact that mastectomies were performed on a day case basis and that breast surgery was undertaken without prior imaging (the use of X-ray and ultrasound to define the breast lump).
The letter appears to contradict comments by Minister for Health Mary Harney, who said after Barringtons was ordered to cease breast cancer services last month that concerns about the hospital were not forthcoming "until the start of August of this year".
Other concerns outlined in the letter to Prof Drumm include the fact that there was no multidisciplinary team working in relation to breast services; that the consultant radiologist worked single-handed, meaning there was no guarantee that mammograms were "double read", and no quality assurance framework was in place.
The fact that patients who "encountered difficulties" at Barringtons were referred to symptomatic breast services in Dublin rather than the Mid-West Regional Hospital in Limerick, led to trauma for patients, the letter also said.
Mr Barron's letter was written on foot of concerns raised by Dr Raj Gupta, regional director of cancer services in the mid-west.
The letter states that "while it is appreciated that Barringtons does not operate under the aegis of the HSE . . . the Department considers nevertheless that these concerns should be examined by the HSE".
In reply to the letter, Tommie Martin, national director of the CEO's office at the HSE reminded Mr Barron that as a private hospital, Barringtons "does not operate under the aegis of the HSE".
The correspondence suggests that the issue was lobbed back and forth between the HSE and the department at the highest level. On April 7th 2006, some four months after the letter to Prof Drumm, the director of the National Hospitals Office at the HSE, John O'Brien, wrote to Mr Barron advising that the HSE was not in a position to carry out an investigation.
Asked to comment on the adequacy of the department's response to concerns raised by Dr Raj Gupta, a spokesman for Ms Harney said: "The Department of Health was of the view it had not been given any specific patient information which could have formed the basis of a complaint to the Medical Council. Nor could the department, on the basis of legal advice sought and received, have allowed for any other specific action to be taken at the time."