Written Answers. - Appointment of Locum.
Alan Shatter
Ceist:
19
Mr. Shatter
asked the
Minister for Health and Children
if the review of work undertaken by a person (details supplied) in Tralee, Sligo and Letterkenny general hospitals has been completed; the outcome of the review; if any additional hospitals have been identified as having employed this person as a locum; the details of any such employment; if a patient review has been completed in relation to any such additional hospital; the hospitals concerned in this regard; the total number of people who were misdiagnosed; the effect of such misdiagnosis; and if all of those who have been misdiagnosed have been informed and have been provided with the medical care to which they are entitled.
[18417/00]
Liz McManus
Ceist:
46
Ms McManus
asked the
Minister for Health and Children
if an inquiry has been held into the work record in this country of a British pathologist (details supplied) who was found to have been responsible for misdiagnosis of some 230 patients in Britain; if all cases handled by the consultant here have been re-examined; the outcome of any such re-examination; the procedures now in place to monitor the qualifications and work record of consultants from abroad who may work as locums here; if any review is now planned; the number of consultants still working here who are aged over 70; and if he will make a statement on the matter.
[18528/00]
Liz McManus
Ceist:
186
Ms Manus
asked the
Minister for Health and Children
the inquiry which has been held into the work record here of a British pathologist (details supplied) who was found to have been responsible for misdiagnosis of some 230 patients in Britain; if all cases handled by the consultant here have been re-examined; the outcome of any such re-examination; the procedures in place to monitor the qualifications and work record of consultants from abroad who may work as locums here; if any review is now planned; the number of consultants working here who are aged 70; and if he will make a statement on the matter.
[18560/00]
I propose to take Questions Nos. 19, 46 and 186 together.
Concerns in this country first emerged in relation to the work of a locum consultant histopathologist who had provided holiday cover in the pathology department of Tralee General Hospital for short periods at various times from 1991 to 1999 in August of last year. It subsequently emerged that this person had also worked in a locum capacity in Sligo and Letterkenny General Hospitals at various times since 1997. The Southern Health Board advised all hospitals within its region of its concerns, including the Bons Secours Private Hospital in Tralee where the doctor in question also worked for a short time.
As soon as this information came to light, both the Southern and North Western Health Boards put in train measures to identify all work undertaken by the locum pathologist. Arrangements were also made to have the work in question prioritised and reviewed with the assistance of the Faculty of Pathology of the Royal College of Physicians of Ireland on the basis of a standard clinical protocol used in similar reviews which were undertaken in the United Kingdom. The over riding priority in this matter has been to ensure that the work of the pathologist in question was reviewed, to identify any problems arising from the review, and to ensure that appropriate action was taken to safeguard the interests of the patients affected.
In the context of the review it was established that the pathologist in question had provided holiday cover as a locum pathologist in Tralee General Hospital for two to four week periods D522–B10
on 18 occasions since 1991. He had also provided holiday cover in Sligo and Letterkenny General Hospitals on six occasions for short periods totalling 14 weeks since July 1997. A total of approximately 3,000 pathology tests undertaken by the locum pathologist during his periods of employment in Tralee between 28 January 1991 and 27 June 1999 were identified. In the North Western Health Board a total of 945 tests reported on by the doctor in question were identified.
All tests which were classified as more serious on the basis of the clinical protocol for the review have been reviewed and in addition, due to the considerably smaller number of tests involved, a review of all the less serious tests in Sligo and Letterkenny has been completed. A review of less serious tests is currently under way in Tralee and the Southern Health Board has advised me that this phase of the review is expected to be completed by the end of August 2000. To date, a total of 625 tests have been reviewed in Tralee, including 268 of the most recent less serious tests.
In relation to the 625 tests reviewed in Tralee, the review identified 27 tests where a disagreement with the original report was identified on review. However, in all but one case the patients were treated appropriately because the doctor treating the patient had correctly diagnosed the patient's condition. There was, therefore, one case where a change in treatment was required.
Of the 945 tests reviewed in North Western Health Board, 11 cases were identified which needed to be reviewed by the doctor treating the patient. Of these 11 cases, none gave rise to significant changes in treatment other than a change of diet or minor change in medication.
The Bons Secours Private Hospital, Tralee has indicated that a review of the tests reported on by the doctor in question has also been undertaken there. The hospital has stated that 150 tests were reviewed and that patient care has not been affected in any case. The Southern Health Board has advised my Department that it has written to the hospital seeking further details of the review.
I am determined that the lessons of this case will not be lost and I have already put in train a range of measures to identify any further action required to ensure, as far as is possible, that such situations do not arise in future. Firstly, I want to ensure that appropriate measures are in place to ensure the competency of all doctors. I have, therefore, initiated a review of the Medical Practitioners Act. This review will consider proposals that re-certification and re-accreditation for doctors should occur on a regular basis throughout their careers, as a competency assurance measure.
Furthermore, the issues under review in this case arose from the work of a locum consultant who was engaged to maintain services during holidays. My Department is, therefore, establishing a working group which will consider existing recruitment procedures for locum consultants with the aim of ensuring that the highest standards are in place for the employment of locum consultants. All consultants employed in permanent capacity in public hospitals must retire at 65 years of age. There are, therefore, no consultants over the age of 70 employed in public hospitals on a permanent basis. The extent to which doctors over the normal retirement age provide locum cover in public hospitals and the question of age limits for doctors providing locum cover will need to be considered by the working group.
A primary focus on the interests of patients is evidenced by the action already taken by the Southern and North Western Health Boards to review the work of the locum consultant pathologist in question. Arrangements have been put in place by the health boards to respond to any concerns on the part of patients or their families arising from this case. In addition to the action taken by the health boards to review the work of the locum consultant pathologist, the follow-up action which I have outlined will help ensure that situations like this do not occur in the future. I want to see rapid results on the issues which arise from this case with a view to taking any necessary follow-up action as soon as possible.
