Maternity hospitals and medical data
Sir, – We are surprised by the accusation of censorship against the masters of the three Dublin Maternity Hospitals in your editorial “Maternity services – information is power” (March 1st). The three Dublin maternity hospitals have led the way nationally and internationally in the publication and transparency of clinical outcome data, publishing detailed annual clinical reports for over 200 years. The level of comprehensive clinical detail already provided in these reports is unique in Ireland and throughout the developed world. It should be noted that the range of other acute hospitals in Ireland currently produce only a fraction of these data and that the chief medical officer does not receive as detailed an annual clinical report from these hospitals. We might also point out that the three Dublin maternity hospitals were the first to produce maternity patient safety statements, which are available on our hospital websites for all to see. We already furnish a wide range of clinical data to a number of other organisations, including the State Claims Agency, the National Perinatal Epidemiology Centre, the Vermont Oxford Network, the Confidential Enquiry into Maternal Deaths and the HSE Quality Assurance Programme in Obstetrics and Gynaecology. This is hardly evidence of censorship.
Together with collection of data comes responsible management of data. When rare clinical outcomes are individually reported publicly in, for example, a smaller hospital, there is a significant risk that a particular patient will be easily identifiable in that community.
Would anybody wish to attend a local hospital seeking medical care and subsequently find personal health outcome data published on a website that is clearly identifiable as their own? We believe patients deserve to have a reasonable expectation of confidentiality. Are we to accept that women in Ireland may expect to read about themselves in our newspapers while still accessing complex care in our health system?
Information is power, but it must be used and presented appropriately. There are many examples of information being presented in an inappropriate context that have led to totally inaccurate representation and inappropriate use of intimate patient details. Every effort must be made to avoid the use of data in a context that has the potential to exploit women who require care provision in sensitive circumstances.
As masters of the Dublin maternity hospitals, we will continue to lead the way in the publication, in a clinically meaningful and relevant way, of highly detailed and comprehensive clinical outcome data. In doing so, we will continue to protect and defend women’s rights to privacy and confidentiality. – Yours, etc,
Dr RHONA MAHONY,
National Maternity Hospital,
Prof FERGAL MALONE,
Dr SHARON SHEEHAN,
Coombe Women and Infants