HSE makes new plans for hospice patients


The controversy at the Galway Hospice has taken a new turn with a decision by the Health Service Executive (HSE) West to make new interim arrangements for some patients.

A letter to Galway GPs says the hospice's palliative care consultant, Dr Dympna Waldron, will support patients being cared for at home, or at an "interim" palliative care out-patient clinic at Merlin Park Regional Hospital.

The hospice's home-care team will continue to provide a full nursing service. The letter indicates there will be no direct communication between the HSE's medical palliative-care team and the home-care nurses in relation to patient care, and changes in care should be relayed by the GPs to the nurses.

Four patients are being treated at the 12-bed establishment in Renmore, but there have been no new admissions since last week.

Following the submission of a report outlining instances of alleged bullying of hospice nurses by Dr Waldron, legal representatives of the hospice wrote to Dr Sheelah Ryan, chief officer of the HSE West. "Our client believes that it is essential for the safety of all concerned that Dr Waldron be reassigned elsewhere pending the completion of the investigation ," says the letter, dated March 29th. Dr Ryan met with Dr Waldron, who withdrew voluntarily. The bullying allegations are denied by Dr Waldron.

The medical board of University College Hospital, Galway, last night described Dr Waldron as "a committed and expert specialist physician and team leader. Her dedication to patient care and to the alleviation of symptoms is appreciated by patients and their families and her colleagues. She is a fine and popular member of the consultant staff."

A number of sources have confirmed no disciplinary proceedings against Dr Waldron have been initiated by HSE West.

A bullying complaint filed by a nurse at Portiuncula Hospital, Ballinasloe, against Dr Waldron three years ago was referred to the Labour Court. A hearing in February 2004, found the delay in handling the nurse's complaints was "wholly unreasonable and inexcusable", and recommended it be completed within two months. The HSE West says a report on bullying claims at the hospice, including that of the nurse, is "being written".

On the bullying allegations, the secretary general of the Irish Hospital Consultants Association, Finbarr Fitzpatrick, said: "It seems to be impossible . . . to use one's medical authority where appropriate without being charged with undermining or demeaning them."

In a separate development, one of two GPs employed by the hospice to work with its home-care team has left and the second has taken a sabbatical. Dr Ray Doyle and Dr Fergus Glynn wrote a joint letter to the hospice board. They said they did not wish to comment on their actions.

Galway Hospice, which employs 60 people, was initially established with a home-care service in the mid-1980s.

An in-patient unit was built with voluntary fundraising and donations, but it was closed to all new admissions for over a year from May 2003. This followed concerns expressed by Dr Waldron over medication.

An independent review published in March 2004 found that four of 15 cases involved maladministration of drugs to patients involved emergency intervention, and patients were "harmed" in five cases.

Sources close to Dr Waldron say she is concerned about the inappropriate use of medication and the late referral of patients to specialist care.

Asked whether progress had been made on dealing with management and medication issues, Galway Hospice said: "Any reported adverse incidents are dealt with in a prioritised and focused manner. The process of review ... ensures that there is objectivity in managing the incidents and identifying the appropriate remedial action."