In breaking with HSE protocols and giving 20 doses of Covid-19 vaccines to a private school in Co Wicklow in March, the Beacon Hospital dealt a serious blow to public faith in the equity of the programme. The damage was contained thanks to the efficiency and sound management of the vaccination campaign in general by the Health Service Executive (HSE), but the stakes involved mean that understanding the blunder – and holding people to account for it – is essential.
Some light is shed on the circumstances of the Beacon’s decision in the findings of a review commissioned by the hospital’s non-executive directors. But real questions remain unexplored. The hospital has decided that the report, written by Eugene McCague, a solicitor, should remain a secret and has instead published a heavily abridged version. It has also withheld the terms of reference, so the public cannot know what questions the board asked McCague to answer.
The review found that the decision to give spare doses to St Gerard's was incorrect, was not permitted by the HSE and that the hospital should have first contacted the local HSE community area, for which it was running the clinic that day. The HSE community area said it had a reserve list and could have provided sufficient healthcare staff to use the surplus doses available. The decision was taken alone by the hospital's chief executive, Michael Cullen, but McCague largely exonerates him by remarking that he was acting "in good faith". It appears that a sequence of events, including double-bookings and the opening of numerous vials in preparation for the clinic, left the hospital in a difficult position on the day in question.
Without the terms of reference, however, it’s not clear why sincerity of intentions was identified as a relevant test. Nor is it explained why an administrator was in sole charge of deciding on the allocation of this scarce medical resource, least of all one who did not know what discretion his hospital had in making that decision (McCague rather generously refers to “an incorrect interpretation” in this regard). Remarkably, the published findings do not explore why or how St Gerard’s was chosen, giving the impression that the only options the hospital had were letting the doses go to waste or giving them to one particular school on the other side of the county line.
In other words, the findings ignore the reason the debacle ignited such public anger: because a private hospital enabled a private school to skip the vaccination queue, feeding the widespread public impression that those who can afford it can play by different rules from everyone else. The hospital board has expressed confidence in its chief executive, commending his “vision and leadership”. It would not have taken much vision to see that this was a terrible error of judgment. And true leadership would involve admitting as much.