Strong case for role for outside expert in review of Halappanavar care

Disciplinary processes are not uncommon in any workplace but nothing on the scale of what has been initiated on foot of the death of Savita Halappanavar has been seen before in the Irish health service.

Up to 30 doctors, nurses and midwives at University Hospital Galway who were involved in the care of Ms Halappanavar will be called before the proceedings over the coming months.

The process, which follows a standard procedure within the HSE, will be led by the chief executive of the West/North West Hospitals Group, Bill Maher.

Those called to interview, who may be accompanied by union or legal representatives, will be given the opportunity to explain their actions.

The range of outcomes could vary from no case to answer, to a requirement for mentoring or training, to suspension or dismissal.

Individual cases could also be referred to the Medical Council or the Nursing and Midwifery Board of Ireland, which have already begun preliminary hearings.

'No case to answer'
Mr Maher, in his statement, was quick to assure affected staff that in many instances "there will be no case to answer". On the face of it this could be seen to be prejudging the issue; against this, some staff who will be interviewed are from intensive care, where it is acknowledged that Ms Halappanavar received excellent care, even if it came too late to save her life.

More important, arguably, is the lack of outside involvement in the disciplinary process. When the HSE first announced its inquiry into Ms Halappanavar’s death last year there was uproar over the fact that no independent figure was involved.

The result was an embarrassing climbdown and the appointment of additional members, including an independent chairman from the UK, to the inquiry team.

Given the importance of this case there would seem to be a strong argument for involving an outside expert in the process, as suggested by lawyers for Ms Halappanavar’s husband, Praveen.

After three inquiries, it is becoming increasingly clear that understaffing is a persistent problem in maternity services, and the issue was signalled again yesterday in Mr Maher’s reference to “resource issues”. Just where the money is to come from to pay for more obstetricians and midwives is unclear.