I thank you, a Cheann Comhairle, for giving me time to raise this important matter. I should like to share my time with my colleagues, Deputies Boylan and Carey.
Adjournment Debate. - Neurological Paediatrician's Removal from Dublin Hospitals.
Is that satisfactory? Agreed.
I raised this matter this evening because of the deep concern and the great sense of helplessness expressed to me by numerous parents of small children who were treated by Mr. Patrick O'Neill and who now feel very let down by the sequence of events that have taken place in Beaumont and Our Lady's Hospital for Sick Children, Crumlin, since March of last year.
Many questions surrounding this matter demand a response and the time available this evening does not allow me go into them all. First, I might give a brief background to the problem for those who are not familiar with it. Mr. Patrick O'Neill is a brilliant paediatric neuro-surgeon, born in Tralee, who studied medicine in UCC, specialising in neuro-surgery. He worked in the Hospital for Sick Children in Toronto and has a clinical fellowship in paediatric neurosurgery. In March 1988 he took up his position in Beaumont Hospital and was also available from that time to patients of Our Lady's Hospital for Sick Children, Crumlin, and Temple Street Children's Hospital. Poor work relations developed during Mr. O'Neill's time in Beaumont Hospital.
It is now history that he was sacked by the hospital, in March 1989 allegedly because of bad temper. He has also ceased to function in Our Lady's Hospital for Sick Children in Crumlin. Mr. O'Neill is now out of the realm of public hospitals and functioning in the private sector. He is employed solely by the Mater Private Clinic available only to the children of the wealthy who can afford the necessary fees to consult him there.
I listened to the appeals of parents whose children were treated by Mr. O'Neill. Those children had had brain and spinal tumours. He performed 260 operations on children in the past 18 months. Those parents want to continue their relationship with Mr. O'Neill. I am seeking an assurance from the Minister that he will make that possible. After all, if it were mine or the Minister's child would not we want the best medical service available?
I might now quote from an article in The Irish Times of 8 September 1989 in regard to what one mother said about her child:
Alison Bailey from South County Dublin telephoned The Irish Times after seeing a reference in an article to a parents support group. Her first child, born with a growth at the back of her neck, had to be operated on at less than a day old. “The prognosis was as bad as it could be; even if she survived she would be mentally handicapped.” Her child is now perfect —“and not just perfect for someone born with that growth. She is simply perfect in every way.” Alison Bailey remembers small things with gratitude — like the way Patrick O'Neill used to stroke her baby's cheek while he talked to them. “I cannot believe that this is the person I've been reading about in the papers. It's as if they're talking about somebody different. I found him incredibly courteous.”
It is a disgrace that there is now no paediatric neurosurgeon here and that the Minister has assumed no role whatever with regard to this row.
According to an article in the Irish Medical Times of 6 October 1989 there is concern about this lack of paediatric neurosurgery. One neurosurgeon, Mr. Seán Ó Laoire, has expressed his grave concern, which is reported in this article as follows:
...He said that while he had training and expertise in the management of tumours in older children he was concerned that in the absence of a formally trained paediatric neurosurgeon, such as is the case in the vast majority of European and North American centres, the provision of "best standard" treatment may be difficult to achieve.
I contend the Minister must become involved and take immediate action restoring the confidence of public patients in the service of neurosurgery. I have been informed that there are many children in the country whose parents now want to send them abroad for neuro-surgery. I ask the Minister the straight question: how much will that cost the State? There are other questions to which I want answers, such as: if a baby under four years old is admitted to Beaumont Hospital now requiring neurosurgery what will happen that child? There is, from what I have heard, a six weeks waiting list for operations in Beaumont Hospital. Is it true that many parents are mortgaging their homes to pay for treatment for their children? Is this not another classic example of the two-tiered health system?
This problem will not disappear. The Minister cannot absolve himself or his Department with regard to it. We here have a responsibility to voice the concerns of ordinary people. Ultimately this is the place of accountability for public spending and public servoice. The Minister will hear a great deal more about this issue because it is my belief that the argument is only beginning.
I thank Deputy Fennell for having allowed me some time to join her call and that of many other Members for the reinstatement of Mr. Patrick O'Neill to Beaumont Hospital. It is nothing short of a national disgrace, of a national tragedy, that this man has been made the scapegoat of gross incompetence in the administration of the affairs of Beaumont Hospital and for internal political wrangling.
There is nobody with the surgical knowledge of Mr. O'Neill, his surgical know-how or experience in this country available to the ordinary people, to the children of ordinary people whom he has treated in a manner that enables them to lead a meaningful life. I have had numerous letters, as I am sure has the Minister, from grateful parents wanting to express their gratitude for the marvellous work he has done. This is not the man about whom they read in the papers, who has been so maligned by people totally opposed to him. Indeed, it is unbelievable that such could happen in this country.
Nothing short of reinstatement will restore the good name and reputation this nuerosurgeon has earned for himself by being considerate, polite and caring to the patients he has treated over a great number of years. His services are now available only to people who can afford them. This is not good enough and is not in the best interests of medical care for young people.
I should like to share my time with Deputy Carey who wants to join in this debate.
I should like to join with Deputy Boylan in thanking Deputy Fennell for giving me some of her time in order to express my dismay at the lack of initiative in the Department of Health whereby there is no paediatric neuro-surgeon in this country.
A child in my constituency has been diagnosed as having cranial stenosis. This child was to have been operated on before it was six months old. The child is now eight months old and its parents have no idea of when this operation will take place. They have been in contact with qualified people in the medical profession who believe they are not competent to carry out this operation. The only surgeons available who can look after this child are in the UK — in Glasgow, Birmingham and Nottingham. It has not been established whether these surgeons will be available. I believe a crisis point has been reached in regard to this child and it is a most traumatic time for the parents. The lack of initiative in the Department of Health leaves much to be desired so I expect some positive answers from the Minister tonight.
I am glad of the opportunity to set the record straight on this issue and to assure this House and the public as to the adequacy of the neuro-surgery facilities which are available at Beaumont Hospital.
Deputy Fennell referred to requests for children to be sent abroad for neuro-surgery. We have had no request in the Department of Health from anybody who wishes to send their child abroad for neuro-surgery.
Deputy Boylan made extremely serious allegations against Beaumont Hospital. These allegations are most unfair and cannot be substantiated.
I stand over them.
I will not comment further on that.
I can give the Minister facts——
The Deputies who presented their cases on this subject were heard without interruption. The Minister will be accorded the same courtesy in his reply.
The position is that the consultant in question was appointed as a consultant neuro-surgeon with a special interest in paediatric neuro-surgery in March of last year. The appointee's main commitment was to Beaumont Hospital with a lesser commitment to Temple Street and Crumlin Children's Hospitals. As is usual in these instances the appointment was in a probationary capacity for one year. At the end of the one year probation period the appointment was not confirmed by Beaumont Hospital and subsequently was not confirmed by Temple Street and Crumlin Children's Hospitals.
I must emphasise that the consultant's contract of employment was with the three hospitals concerned and not with the Department of Health or myself as Minister. The matter of confirming or discontinuing the consultant's appointment was determined between the consultant and the hospitals involved after detailed consideration. In the case of Beaumont Hospital this involved hearings in the High Court and the Supreme Court.
It would be entirely inappropriate for me as Minister to become involved in a matter which has been before the courts and been decided on by the boards of the three hospitals involved. As the Deputy stated, the consultant in question has recently taken up employment with a private institution and it would not be proper for me to comment on any arrangements which might have been entered into in this regard.
I should like to mention the medical implications of what has happened in case there is any disquiet among the Members of this House or the public at large. The position at present is that services for children in need of neuro-surgery are being provided by the consultant neuro-surgeons at Beaumont Hospital——
That is not true.
Not the paediatric services.
——on referral of the patients from consultants in the children's hospitals or direct from general practitioners.
The consultant neuro-surgeons at Beaumont Hospital have dealt with a large volume of children's cases over the years and were entirely responsible for the service for children before 1988. I am satisfied as to their competence to provide a high quality level of service in this instance. In other European countries neuro-surgeons who do not specifically specialise in paediatric surgery have been fully recognised as being competent to perform neuro-surgery on children. Indeed the British Institute of Neuro-Surgeons have confirmed that all accredited neuro-surgeons are competent——
This is disgraceful.
——to deal with all aspects of neuro-surgery including paediatric surgery.
So we do not need specialists?
They do not need to specialise in it and indeed the normal practice——
We are entitled to——
Let us hear the Minister without interruption.
——in the United Kingdom is that surgeons with a special interest in paediatric surgery are appointed only in the much larger centres. Therefore, it is not the norm in European countries or in Britain. As I have said, the consultant neuro-surgeons in Beaumont Hospital dealt with all these cases prior to 1988——
(Interruptions.)
Please, Deputy Carey——
The senior surgeons have said they are not competent——
Deputy Carey was heard without interruption.
If Deputy Fennell was serious about giving us the information in the House she should have read the Medical Times to see the comments from the other competent people on the staff in Beaumont Hospital who are quite satisfied with the level of service.
Gross incompetence in administration is the root of the evil.
I know that Beaumont Hospital have addressed all queries that were addressed to them by interested parties including the media, patients, the parents of patients, other hospitals, medical staff and public representatives. I also note that the hospital will continue to deal sympathetically with all questions which may be addressed to them and will be happy to assure all patients and the parents of patients who may be worried——
It is extremely worrying.
——as to the adequacy of the service available.
In conclusion I should like to say that once the issue of the consultant's employment had been clarified finally, every effort was made to speed up the appointment. Application has been made to Comhairle na nOspidéal for the permanent filling of the vacancy and I expect a positive decision on this at this month's meeting of an comhairle.
What is the waiting list?
As I have said I am quite satisfied that an adequate service is being provided in Beaumont——
What is the waiting list?
——for those who wish to avail of it.
I asked the question: how long is the waiting list?
The Minister's reply concluded the debate.
The Dáil adjourned at 9.20 p.m. until 10.30 a.m. on Thursday, 9 November 1989.