I call on Deputy Jim Higgins who tabled a question on missing medical records to the Minister for Health and Children.
Private Notice Question. - Medical Records.
(Mayo) asked the Minister for Health and Children if he has ascertained from the chief executive officer of the North-Western Health Board the situation regarding the psychiatric records which have gone missing in relation to a person (details supplied); and if he will make a statement on the matter.
The North-Western Health Board has confirmed to me that certain medical records belonging to a person who received treatment at St. Conal's Psychiatric Hospital in Letterkenny in late 1996 cannot be located.
I share the Deputy's deep concern that these records are missing. It is a matter of the utmost public importance that all of the information in relation to this case be made available to the courts and to the tribunal recently established by this House. I would like to assure the Deputy that everything possible is being done, both by the chief executive officer of the North-Western Health Board and by my Department to ascertain the circumstances surrounding this matter.
A senior officer of the North-Western Health Board commenced work on a report into the missing medical notes a number of days ago. His interim report was examined by health board management this morning. On 28 March 2002, the board received a request from the legal representatives of a person for a copy of her hospital notes. The staff of the medical records department at the acute admissions unit, Letterkenny General Hospital, where these notes would normally be stored, were unable to find all of her records. An extensive search has been conducted over the past number of days, including a search of the medical records department, the archives department, the offices and clinic rooms of the clinicians, therapists, nursing staff and clerical staff involved in the mental health services. When the medical records officer discovered that the notes were missing, she immediately traced all other notes belonging to members of the person's extended family and I understand that these have been secured. However, despite this extensive search a part of the medical record concerned is still missing.
Missing from the medical records are the in-patient records covering a period from 14 December 1996 to 7 February 1997 during which time the person was a patient in the acute admissions unit at Letterkenny General Hospital. Other records relating to the person have not gone missing. These include notes recorded on her admissions and contacts with Letterkenny General Hospital and all notes relating to her out-patient attendances as well as reports prepared for the court in 1997 by treating clinicians, therapists and nursing staff. Out-patient records are normally held in a separate location to in-patient records. The notes which are missing would normally be stored in the medical records department at the acute admissions unit, Letterkenny General Hospital. The medical records department is supervised during normal office hours by the medical records officer. The office is locked outside of office hours, but can be accessed by members of staff who have a pass key. For a variety of reasons, relating to the treatment of patients and report writing, a substantial number of staff including medical, nursing and others have authority to use a pass key and access the medical records department as part of the normal working of the unit.
There is no tracer record of the notes. The notes would have been due to be transferred to an archive facility in September 2000. A detailed record of all charts that have been moved from the main medical records department to the archive facility is maintained. However, there is no record of the notes having been passed on for archiving. Given the nature of the services provided, it is not unusual for records to be removed from the medical records department for considerable periods of time during patient treatment or for the purpose of report writing. Occasionally there can be delays in locating medical record files, but there is no previous history of a file from the mental health medical records department remaining untraced.
While the chief executive officer is satisfied that staff have conducted a thorough search, he has assigned a second, fresh team to conduct a further complete search. It seems most unlikely in the circumstances that the missing notes will be located, which is unprecedented for the mental health service. The chief executive officer has emphasised that should the present search prove inconclusive, he will ask the appropriate authorities to investigate the matter further. He is conscious of the upset this is likely to cause the parties involved and wants to assure them that he will make every effort to bring about a speedy conclusion. In view of the seriousness of this matter, I have requested the Inspector of Mental Hospitals to independently investigate the circumstances surrounding the missing medical notes as a matter of urgency. If the outcome of these inquiries is unsatisfactory, I will have no hesitation in appointing an independent investigator of high standing to carry out a full and detailed inquiry into all the circumstances surrounding this disturbing matter.
I add to the sentiments expressed by the chief executive officer of the North-Western Health Board and voice my personal regret at the hurt and inconvenience this must cause the person concerned and the extended family. I assure them of my personal commitment to ensuring that this matter is thoroughly investigated.
(Mayo): Does the Minister accept that the individual in question is Róisín McConnell, one of those who were totally innocent and wrongly accused? She was emotionally destroyed due to the manner in which the Garda arrested her and conducted its inquiries relating to the McBrearty affair and the murder of Richie Barron? This is a disgrace. Hers is the only missing file and it is not a coincidence. The whole saga stinks and is yet another twist in the tangled story of the McBrearty affair and alleged Garda misconduct in Donegal. Were, or are, any relatives of gardaí currently under investigation by the Carty team or who are likely to be called before the Morris team working at the hospital or did any of them have access to the files?
I do not have access to that information today. I share the Deputy's deep concern about this issue and I have articulated that in my comprehensive reply. I have asked the Inspector of Mental Hospitals to independently examine this matter because the mental health service and I, as Minister, are very anxious that records are properly and efficiently kept in the interests of patient care. Those are fundamental prerequisites in terms of record keeping for all patients and we view this matter with very deep concern. That is why the chief executive officer of the health board has assigned his own team to trawl the records again and likewise has brought in a fresh team. I have said from the moment we received news of this that I asked the Inspector of Mental Hospitals to investigate the matter independently. At this time I am not aware of what people have access to the hospital, but that will come to light in due course.
(Mayo): I thank the Minister for his reply and ask him to investigate this aspect of the matter. I do not want to point the finger of blame at anybody, but I am aware that relatives of gardaí who were investigated and interrogated by the Carty team are working in the hospital.
Does the Minister accept that the period from 14 December to February is the vital time in the immediate aftermath of the arrests of Róisín McConnell, Mark McConnell, Frank McBrearty junior and Frank McBrearty senior, which led to the nervous breakdown of Róisín McConnell, her subsequent trauma and her very acute psychiatric illness? She suffered as a result of being mishandled and dealt with in a most inhuman fashion while in custody at Letterkenny Garda station. Does the Minister accept that it is more than a coincidence that of all the files, it is those relating to this crucial period in the immediate aftermath of her arrest, interrogation and maltreatment which are missing?
That period is of crucial importance, though I am not intimate with all the details on the justice side in terms of the precise sequence of events. Obviously, it is very disquieting that records covering the period from 14 December 1996 to 7 February 1997 are missing as that is the exact time the person concerned was a patient in the acute admissions unit of the hospital. It is a crucial period in that person's life and in terms of what happened subsequently. The evidence in the files is obviously very important and those notes would be very important to the person and to any case she is taking in relation to other issues. The reports that are still on file relate to her admission and contacts with Letterkenny General Hospital and all notes relating to her outpatient attendance, as well as reports prepared for the court in 1997 by the treating clinicians, therapists and nursing staff, are still there.
(Mayo): In relation to the inquiries the Minister and the chief executive officer have instituted, what deadline has been set by which it shall be established one way or the other whether the notes can be located or retrieved? In his first reply, the Minister mentioned he would have no hesitation in referring the matter to the appropriate authorities. I presume by “appropriate authorities” he means the Garda. If the matter is referred to the Garda, the investigations should be carried out by gardaí from outside the Letterkenny division.
The chief executive officer has emphasised that should the search prove inconclusive he, as the person with statutory responsibility for what happens in the health board, will ask the appropriate authorities to investigate the matter. I accept the Deputy's point, which is fair, and I will convey that back. More importantly, I have asked the Inspector of Mental Hospitals to investigate the circumstances surrounding the missing medical notes as a matter of urgency. I expect the inspector to come back to me within a matter of days on that and if I am not satisfied I will have no hesitation in appointing an independent investigator of high standing to carry out a full and detailed inquiry into all the circumstances surrounding this disturbing matter. It is a matter of great concern to us as the loss of records of this kind is unprecedented in the mental health service.
(Mayo): I thank the Minister for his decisive reply and action.
Written Answers follow Adjournment Debate.