The Ombudsman's Office receives about two hospital-related complaints each week since its remit was extended in 2007, but that number is expected to rise as people become more aware of the office's powers to investigate complaints in the health area, reports EITHNE DONNELLAN, Health Correspondent
A LARGE Dublin hospital has apologised for going against the expressed wishes of a family by telling their 87-year-old mother she had a terminal illness shortly before she died.
But the apology was only forthcoming following an investigation by the Ombudsman into a complaint from the dead woman’s daughter. She claimed her mother had been put through untold stress in her final weeks because the hospital failed to heed the request to protect her from the devastating news.
Ombudsman Emily O’Reilly found that the health professional who was told of the family’s wish didn’t document it in her medical chart.
That meant that the consultant who told the patient of her prognosis could not take it into consideration when he decided to speak to the patient directly.
When the consultant claimed he was acting in accordance with hospital policy in breaking the news, the policy was checked and it was found that the policy was to offer a warning to the patient that news may be forthcoming and that they should be given a chance to have someone present.
This meant the policy had not been fully adhered to, and the hospital apologised.
According to O’Reilly, it’s often only an apology that people are looking for in situations like this, as well as explanations.
“What people often want to know is, quite simply, what happened. Sometimes they come because they’re feeling very guilty, they’re feeling that they could have done something or been more proactive.
“When they don’t get answers they feel incredibly frustrated, hurt and often angry. A lot of these things can be dealt with at source. It just takes somebody to sit down with the family and take them through the case.”
Her office has had about two hospital-related complaints a week since the Ombudsman’s remit was extended, in 2007, to cover voluntary hospitals (that includes the large Dublin hospitals, and centres providing services to the HSE).
She says that as people become more aware of her powers to investigate such complaints, these will increase. “I think we should and could be getting a lot more if there was more awareness.”
People must first have tried to have their complaint dealt with at a local level, but if they get no satisfaction there, O’Reilly says that going to her office is easy, accessible and free.
Critically, she has the power to see every record, including medical records, and to interview everybody from the consultant to support staff.
“We are a much more user-friendly, accessible and certainly cheaper alternative to expensive investigations, consultants and the courts,” she says.
O’Reilly stresses that clinical judgment falls outside her remit, unlike in Britain and Northern Ireland, but errors in healthcare facilities she uncovers in her investigations can have major clinical impact.
In her last annual report she highlighted how an elderly woman was heavily sedated, which affected her ability to communicate with her family over the last days of her life. She was given three times the dosage of anti-depressants she should have got because a mistake was made transcribing handwritten drugs records at Beaumont Hospital. She ended up referring her findings on to the Health Information and Quality Authority.
O’Reilly is examining a number of other complaints: one includes a misunderstanding over when a “do not resuscitate” order should have been implemented; this caused a family a lot of upset.
There is also an allegation that a man with Down syndrome had to wait six weeks after hospitalisation for a visit from a social worker to assess his needs. In another case a family says that they got no privacy while their relative was dying of cancer. O’Reilly is also looking at whether a postmortem should have been conducted after a man died some time after falling out of a hospital bed.
Furthermore, a number of complaints in relation to long- stay charges remain to be dealt with by O’Reilly’s office. Several complaints were lodged in recent years by people who had to pay for private nursing home care, because the free public long-stay beds they were entitled to weren’t available.
O’Reilly says her office had held off on dealing with them because it was anticipated the matter would be clarified by the High Court after a case was taken against the State on this issue, but the case was settled out of court.
There were also promises that the Government would sort out the issue under the new Fair Deal scheme, which still hasn’t come into effect.
“We are now going to have to sit down and grapple with what we are going to do with this,” she says.
But she stresses that her office has had success in sorting out several complaints in relation to nursing home subvention payments. “Frequently we have been able to either get somebody a subvention or have it increased.”
The effect of the downturn has been noticed at the Ombudsman’s office, with complaints in relation to social welfare entitlements rising in recent months.
The number increased by 18 per cent from 450 between January-November 2007 to 530 in January-November 2008. This upward trend is expected to continue as the recession deepens.
O’Reilly, a former political correspondent, has spent nearly six years in the Ombudsman’s office, having been appointed for a six-year term in 2003.
Would she like to stay on or go back to being a hack? She is very diplomatic in her response. “I would like to stay on, but it is a matter for the Government.”
She says that the job is hugely rewarding when she can resolve issues of great importance to individuals.
She recently upheld a complaint from a woman about a midlands nursing home which failed to ensure the woman’s mother was properly fed and hydrated.
She got a letter from the complainant saying she felt that she had achieved something for her late mother after having blamed herself for letting her enter the nursing home in the first place.