Proposed legislation would add to complexity of inquests, department warns

The Department of Health has warned that new legislation governing the work of coroners could add considerably to the complexity and duration of inquests into deaths.

In an internal briefing note for ministers drawn up over the summer, officials said the proposed legislation would have implications for the Department of Health. It said, for example, that the new coroners' legislation specifically defined MRSA as a "reportable death".

"The proposed Bill also widens the scope of the inquest from investigating the proximate medical cause of death to establishing in what circumstances the deceased met his or her death," the note says. "It also provides for the granting of legal advice and legal aid in proceedings before a coroner where a person has died in, or resulting from being in, State custody or certain institutional care settings," the briefing note states.

The Department of Health briefing paper also says the legislative changes would allow coroners "to call as many medical witnesses as s/he deems appropriate and, inevitably, this will add considerably to the complexity and duration of inquests".

Last week, at a conference on hospital cleanliness organised by the Irish Patients' Association, the coroner for Kildare, Prof Denis Cusack, said if a doctor knew that MRSA was a factor in a patient's death that they should inform the coroner. He said that fear of litigation might be hampering such reporting at present.

The Minister for Health Mary Harney said there was still a shortage of isolation facilities in many hospitals around the country. However, she said new co-located private hospitals to be developed at eight sites around the State would ease the situation.

She said she had recently asked the HSE to ensure that private rooms in public hospitals were, in the first instance, used as isolation facilities. She said that it did not make sense to have some private rooms ringfenced for private patients when very sick persons with infections needed isolation facilities.

The Irish Timesrevealed last month that the Department of Health had proposed that a financial levy should be imposed on hospitals by the HSE to fund measures to tackle infections such as MRSA within hospitals.

The department maintained that the reduction of the incidence of such infections would generate significant savings in the cost of service delivery as well as improving patient care.

Department of Health secretary general Michael Scanlan proposed the introduction of an MRSA levy in a letter to the HSE earlier this year.

Mr Scanlan said the levy would give hospitals every incentive to ensure that savings were realised.

He suggested that measures to tackle healthcare-associated infections such as MRSA, including the appointment of anti-biotic pharmacists to bring about changes in prescribing behaviour, could effectively pay for themselves.

A Department of Health spokeswoman said the MRSA levy proposal was still "live" although had not progressed as yet.