Dáil Éireann debate -
Wednesday, 18 Jul 1962

Vol. 196 No. 15

Adjournment Debate. - Galway Hospital Incident: Sworn Inquiry.

Mr. Coogan

For the benefit of the record, I should like to give the particulars which have given rise to this demand for a sworn inquiry. On the evening of 23rd January last a sick infant, requiring medical attention, was brought to the Regional Hospital, Galway, by its parents. They were asked at the pediatric unit if they had a letter from their family doctor. They said their family doctor was not available and that was why they had brought the child in ten miles to Galway Regional Hospital, where they hoped the child would get treatment. Even with this explanation, they were told they would get no attention for the child; the doctor in charge refused to give any attention.

The father of the child then called to my house and explained the position, whereupon I accompanied him to the out-patients' department of the Galway Regional Hospital. I met the nurse in charge and pointed out that the child was in need of medical attention and that this attention was not available to him at his home and his parents, therefore, could not get a letter from their family doctor. If they could have got the letter, the doctor would have been available; there would have been no need for the letter and there would have been no need for them to go to the hospital.

I should like to point out that a doctor could have relieved the child of pain and distress had he been available. This is evident from the signed statements of the doctors themselves. I have statements to prove my contention. The nurse was, I admit, most helpful. She called the doctor in charge of the particular unit, a different doctor from the doctor in the other unit. He began to examine the child. In the course of questioning the parents he found out that the child had been discharged from the pediatric unit some days previously. He then rang the pediatric unit to get the history of the case before treating the baby. The doctor from the other unit came over and immediately, if I may say so, there was a "down tools" in the unit.

Minister for Health (Mr. MacEntee)

On a point of order, what are we discussing? The action of the doctors or the Minister's failure to order a sworn inquiry? I suggest, sir, it is the Minister's conduct and not the conduct of the doctors that should be discussed.

An Ceann Comhairle

The subject matter of the question was:

To ask the Minister for Health the reasons that influenced his decision to refuse to hold a sworn inquiry into the circumstances surrounding the refusal by the medical staff to give medical attention to a sick child at the out-patients' department of the Regional Hospital, Galway.

Mr. Coogan

I think that covers what I am dealing with. Arising out of his reply—and the Minister had no objection—I said I would give the particulars for record. The doctor from the pediatric unit came over and said: "If you are worrying about your child, I am not." The parents thereupon had to take the child——

Mr. MacEntee

On a point of order, the statements the Deputy is repeating now under the cover of the privilege of this House are challenged by the doctors in question; they refuse to admit that they made such statements.

An Ceann Comhairle

The reasons which influenced the Deputy to put down the question seem to me to be relevant.

Mr. M.P. Murphy

The Deputy is entitled to make his case.

Mr. MacEntee

But he is not entitled to misrepresent——

Mr. Coogan

The Minister will not put me off. The Minister has grown very friendly towards the doctors suddenly.

Mr. Corish

A late marriage, of course.

Mr. Coogan

The parents had eventually to take the child 17 miles where they found a doctor who treated the child and relieved it of pain and distress. I, as a parent, having seen the child, knew that the child was in need of medical attention. As a member of the Galway County Council, I felt had a duty towards these parents. The ratepayers of Galway are responsible for the upkeep of that hospital. It was my duty to ensure that these parents got the benefit of the hospital, for which the ratepayers are paying so dearly.

At a subsequent meeting of the Galway County Council, it was agreed that a sworn inquiry should be asked for into the circumstances of that case. The members were given the particulars. There were letters from both doctors, from the parents and from all concerned. On that basis they agreed to call for a sworn inquiry. It is most regrettable that at that meeting some of the members of the Minister's Party tried to turn this matter into a political issue. Finally, one of the members stood up and said: "You will never get that inquiry." It is a strange thing that that same member at a very recent meeting of the Galway County Council could stand up, before the letter from the Minister was read, and say: "You are not going to get your sworn inquiry." I challenged the secretary of the Galway County Council—a very decent man——

An Ceann Comhairle

Now the Deputy is casting his net very wide.

Mr. Coogan

The point is he said there was no leakage whatsoever. I should like to point out that that episode proves that the Party machine had gone into motion and the Minister has agreed to the Party line in refusing to hold this sworn inquiry. Further, the Minister said in his letter that there was no public disquiet. Will the Minister now tell the House and the people of Galway where he got that information? I know of plenty of public disquiet over that episode and other things as well that occurred in that hospital. I should like the Minister to explain fully and explicitly to the House, particularly in regard to some of his colleagues in the back benches who were at that meeting, on what grounds he refused to hold this sworn inquiry. I hope the explanation will be one that will satisfy the people of my city.

Mr. Carty

As chairman of the health authority concerned, the Galway County Council, my main concern was, and is, to preserve the good name and the high reputation the Galway Regional Hospital enjoys. This hospital is a recognised teaching hospital of the National University of Ireland. I suppose it is one of the best——

Mr. Coogan

On a point of order, what bearing has all this on the sworn inquiry in regard to which the Minister said I was irrelevant?

An Ceann Comhairle

I shall intervene if I think the Deputy is out of order.

Mr. Carty

I think, Sir, you are the person to decide as to whether what I say is or is not relevant. This hospital is one of the most up to date in the country. Its medical, surgical and nursing staffs enjoy the highest reputation in the community.

The first intimation we got in the county council of the alleged incidents that are the subject matter of this debate was a statement made by Deputy Coogan at a meeting of the county council. The allegations he made came as a great surprise not alone to the members of the county council but also to the county manager who was present at the meeting. It appeared that a period of three weeks elapsed between the time when these incidents were supposed to have taken place and the date of the council meeting at which Deputy Coogan made the allegations. The county manager and the members were surprised that a public meeting should be used for the purpose of bringing a series of serious charges against the administration of the hospital and the county manager indicated in no uncertain manner his feelings about the way in which this was brought to his notice for the first time. He agreed to have an inquiry held into the allegations and, in the absence of the resident medical superintendent, the inquiry was conducted by——

Mr. Coogan

How long was he absent?

Mr. Carty

I did not interrupt the Deputy.

Mr. Coogan

You are speaking for the record.

Mr. Carty

I am speaking to the public. In the absence of the resident medical superintendent, the inquiry was conducted by the lay superintendent who took statements from the parents and the people concerned. In all, I think six statements were taken. Two were from the doctors concerned, one from the doctor in charge of the pediatric unit and one from the other doctor in the casualty section. Two were taken from the nurses in casualty and two from the nurses in charge of the pediatric unit. At a meeting of the visiting committee, of which Senator John Mannion is chairman, these documents were presented to the members. I said at that meeting that as the charges were made publicly, they should be refuted publicly and I asked that the documents be circulated to the members of the county council and this was done.

Subsequently, the matter came up for discussion at the meeting of the county council and Deputy Coogan said he was not satisfied with the statements, that he was not satisfied that the lay superintendent was a man competent to take the statements and, in order to vindicate himself, and in this I agree with him, he suggested that a sworn inquiry be held. I asked him to make a formal proposal to that effect and that I would second him and he did so. The Minister has turned down that request for a sworn inquiry. I think he said in his letter that the subject of the charges did not warrant a sworn inquiry, that a sworn inquiry was a very serious matter and that it would also be a very costly matter for the Galway County Council and for everyone concerned.

In actual fact, this child had a slight attack of constipation, and I understand that there are many excellent medicines readily available for dealing with that complaint.

Mr. Coogan

You reared so many of them yourself.

Mr. Carty

It is an extraordinary state of affairs that a good hospital and an excellent staff should be ridiculed publicly and made the target of this very unfair and very unjust criticism. Anyone who has anything to do with the administration of a hospital and who helps to build up its good name does not like to see that good name and reputation destroyed by unjust and unfair allegations. For that reason, I ask the Minister now to agree to have the sworn inquiry.

If the sworn inquiry is too costly and not warranted by the facts of the case, I ask the Minister to agree to an inquiry conducted by one of the medical inspectors of his Department who usually conduct such inquiries. The good name of the Galway Regional Hospital means as much to me as it does to any other member of Galway County Hospital. I refute the suggestion made by Deputy Coogan that any political influence was brought to bear on the Minister. I have not seen the Minister in connection with this matter, and if I were to see him about it, I would ask him to have the sworn inquiry. If he is not prepared to agree to that, he should have an inquiry conducted by one of the men appointed by his Department to do so. Until we clear the air one way or the other and until we vindicate the staff of the regional hospital, the nurses and doctors involved in the case. they will be under a cloud.

I understand that the medical staff in the hospital themselves propose to take action in the matter. There was a meeting of the visiting committee last week at which the Professor of Medicine informed the members that such a serious view had been taken of the allegations that the matter had been referred by them to the Medical Defence Union. For that reason and that reason only, it might be inopportune for the Minister to intervene now and hold an inquiry.

Mr. Coogan

On a point of order, Sir, Deputy Carty has said that I referred to the nursing staff of the hospital——

An Ceann Comhairle

That is not a point of order. The Minister is entitled to ten minutes in which to reply.

Mr. Ryan

There are three minutes to go.

An Ceann Comhairle

There are not; there is only one minute.

Mr. Ryan

One good reason why the Minister does not want a sworn inquiry is that all these things arise out of his continued application of the Health Act, 1953.

An Ceann Comhairle

The Deputy may not discuss the Health Act on this matter.

Mr. Ryan

The Minister wants to preserve that Health Act.

An Ceann Comhairle

The Deputy will resume his seat. He may not continue to discuss the Health Act.

Mr. Ryan

This is a regular occurrence. Here you have the parents of a child——

(Interruptions.)

Mr. Ryan

Why were the parents not told that night what was wrong with this child?

Deputies

Order.

Mr. Ryan

There are Deputies shouting for order who are not in the House at all.

An Ceann Comhairle

The Deputy must resume his seat.

Mr. Corish

Would the Ceann Comhairle say why the Deputy is being asked to resume his seat?

Mr. MacEntee

I must be allowed 10 minutes to reply.

An Ceann Comhairle

The Minister is entitled to reply. I was allowing Deputy Ryan to speak but he continued to refer to the Health Act in general.

Mr. Corish

If that is the reason, it is all right.

Mr. MacEntee

The Leader of the Labour Party is behind Deputy Coogan.

Mr. Coogan

There are Deputies behind the Minister who should be ashamed of him.

Mr. Corish

That is unworthy of the Minister.

An Ceann Comhairle

Order. The Minister.

Mr. MacEntee

I have 10 minutes and the Leader of the Labour Party is deliberately flouting the rules of the House.

Mr. Corish

I shall say my piece. I merely want to ask the Ceann Comhairle why he asked Deputy Ryan to sit down. I do not know anything about this case.

An Ceann Comhairle

This is not a dispute between the Minister and Deputy Corish.

Mr. Corish

I am concerned about the order of the House.

An Ceann Comhairle

The Minister for Health.

Mr. Corish

The Minister is entitled to talk now. It is 11.20. He may talk but less of his blackguardism.

An Ceann Comhairle

Order.

Mr. MacEntee

If Deputy Corish wishes to prevent the facts being made known to the public, that is his look-out but I shall make them known elsewhere, if necessary.

(Interruptions.)

Mr. MacEntee

When the relatives of a sick person find that person does not receive the attention which they believe their patient deserves, or the patient's condition merits, they are naturally annoyed and sometimes they write to me making a formal complaint. Whenever I receive a complaint of that sort, I have it very carefully investigated. I then study the facts as revealed by the investigation and come to my own conclusion as to whether I will or will not have a sworn inquiry. I am not reluctant at any stage to have a sworn inquiry if the facts warrant it, but I do not order such an inquiry lightly. I have to act responsibly and with a sense of proportion. I have to remember, first of all, that a sworn inquiry may be a very expensive business.

Mr. Coogan

So is the death of a child.

Mr. MacEntee

This child did not die.

Mr. Coogan

No, but it could have.

Mr. MacEntee

I have to remember that a sworn inquiry is a very expensive business which may cost all concerned, not only individuals but the ratepayers, for whom Deputy Coogan is solicitous here on other occasions, and the taxpayers for whom on occasion he is also solicitous in this House, a considerable sum, running perhaps into thousands of pounds. I have to remember that it places all those concerned under considerable mental stress, that it may damage their reputation irredeemably, and that in a hospital or other similar institution it may become a source of disturbance and disorganisation which operates to the detriment of the patient.

I am sure that on consideration the House will agree with me that I cannot order an inquiry to be held. I cannot ask people to give evidence on oath, I cannot adopt that procedure unless I am satisfied that the gravity of the circumstances warrant it. What happened in this case? A parent wrote to Deputy Coogan complaining that on the 25th January his child was very ill—the occurrence now under discussion in fact took place on the 23rd January. The first thing about that letter is that it was written a month after the event.

Mr. Coogan

On a point of order, the parents never wrote to me.

An Ceann Comhairle

That is not a point of order.

Mr. Coogan

It is a point of truth.

Mr. MacEntee

In fact the occurrence to which it refers happened on 23rd January. I am not sure who inspired that letter. Perhaps Deputy Coogan may know.

Mr. Coogan

It was signed above in the county council office.

Mr. MacEntee

He went on to say that he brought the child to the Regional Hospital. There are two statements in that letter: the first is that the child was very ill. That opinion was not held by any one of the doctors who saw that child whether at the Regional Hospital or some hours later.

Mr. Coogan

How could it be when they did not examine the child?

Mr. MacEntee

Not one of them described that child as being very ill.

Mr. Coogan

Naturally.

Mr. MacEntee

And the doctor who did finally attend the child said it was not very ill, that it was not in need of urgent medical attention and did not require hospitalisation.

Mr. Coogan

But it needed attention.

Mr. MacEntee

Deputy "Dr. " Coogan knew better. He told us in the House tonight that he knew this child was ill.

Mr. Coogan

And I did know.

Mr. MacEntee

He knew it needed medical attention. Was it in his capacity as a member of the Galway County Council, was it in his capacity as a Deputy of this House, or was it in his capacity as a qualified medical practitioner that Deputy Coogan knew the child was very ill?

Mr. Coogan

As a parent, experience.

Mr. MacEntee

His opinion is at variance——

Mr. Coogan

Deputy Carty will tell you and he never reared one.

Mr. Carty

Not that I know of anyway.

Mr. Coogan

All I can say is——

An Ceann Comhairle

The Deputy will control himself and allow the Minister to continue without interruption.

Mr. MacEntee

We all know that parents quite naturally are apprehensive. I have been very apprehensive on occasions myself just as I assume Deputy Coogan has, but it does not necessarily follow because there is a natural apprehension on the part of the parents that there is any good foundation for that apprehension. In this case two doctors who saw that child in the Regional Hospital, the nurses concerned and the doctor who afterwards treated that child and said it was a simple case of constipation, all agreed that the child was not in need of urgent medical attention or was not in such condition that they would be justified in admitting it to the hospital.

Mr. Coogan

Did he treat the child?

An Ceann Comhairle

Order!

Mr. Coogan

I want to get that fact from the Minister.

Mr. MacEntee

I will tell the Deputy what the doctor said. This child was treated by a Dr. Costello from Headford.

Mr. Coogan

On a point of order. The Minister is reading a letter from somebody who is not concerned with the doctor who treated the child.

An Ceann Comhairle

Would the Deputy please restrain himself?

Mr. MacEntee

Dr. Costello treated this child. He stated he relieved the child's constipation by relatively simple method and the child settled down——

Mr. Coogan

Which was refused at the Regional Hospital.

Mr. MacEntee

It was refused because the child was brought to the casualty department and——

Mr. Ryan

Why did they not tell the parents what the position was?

Mr. MacEntee

Deputy Dr. Coogan would not accept the advice——

Mr. Coogan

I was not there to accept it.

Mr. MacEntee

——of the Galway medical staff.

Mr. Coogan

But "Dr. " MacEntee has accepted the doctors' advice.

Mr. MacEntee

Not only that but the Dr. Costello who treated the child stated that in his opinion admission to the hospital was totally unnecessary and would be needless expenditure.

Mr. Coogan

We never asked for admission. We asked for attention.

Mr. MacEntee

As I stated in my reply today, I did not refuse to hold a sworn inquiry. What I said was that on the facts as submitted to me a sworn inquiry was not warranted. I said:

The holding of a sworn inquiry is a serious matter. It involves much time and trouble for those immediately concerned and considerable outlay of public funds may arise directly and indirectly. Accordingly, it must be recognised that the procedure of a formal inquiry under oath is not one to be resorted to unless the matter to be inquired into is of serious consequence or has occasioned public disquiet. On present information, the Minister is not satisfied that such is the case in the present instance.

That letter was written on my direction, in the terms I directed and I saw it before it issued. I have no apology to offer to Deputy Coogan that the sworn inquiry is not being held.