Hospital at centre of scandal is 'damaged by vested interests'
THE hospital at the centre of the scandal involving the re-check of 58,000 X-rays is riven with mistrust and damaged by vested interests, a damning report seen by the Irish Independent reveals.
Tallaght Hospital in Dublin also suffers from "unconvincing leadership at board and management level", the report warned. Senior management at the hospital have poor morale and there is a serious "emasculation" of their authority due to the powerful board.
The hospital is also victim of a "legacy of vested interests" with a failure by the board to delegate real power and accountability.
The hospital was formed after the amalgamation of three other hospitals, and the board is still largely divided along those lines. The report also warned that the board has been used as a forum to lobby for the allocation of hospital resources "to particular consultant staff members".
And it found that Tallaght did not understand the importance of the HSE having a say in how it was run.
The stark conclusions, in a report by PricewaterhouseCoopers, were presented to an emergency meeting of the hospital board on Monday night, prompting major changes in the way the hospital will be run.
It follows revelations that up to 58,000 patient X-rays were not properly read and nearly 3,500 letters from GPs seeking appointments for their patients were not dealt with -- for up to seven years in some cases.
The report -- commissioned by the board -- will now see much of the power wrested from the board's 22 members and given to a slimmed-down 10-person board of management.
It was agreed at the meeting that the changes would be implemented urgently and that a new director of quality would be appointed to prevent patient safety risks -- such as the X-ray or referral letter fiasco -- happening again.
The new 10-person board of management is to be set up within three months and will see a dilution of influence from the Adelaide Society, the Meath Foundation and National Children's Hospital Foundation, each of which can only nominate one member.
Nobody who was on the staff of the hospital in the last year can sit on the board and it will have to include a worker representative. Three people representing patient interests, business expertise and financial skills must be on the new board of management.
The report is scathing of the existing board, saying there is evidence its members and committees are "engaging in operational issues" in breach of good governance practice.
The report also warned:
- Too many doctors are on the board at the expense of people with business and financial skills. A number of holders of senior office on the board are current or former employees at the hospital.
- The 10-member interim board of management must be delegated the powers of the full board. It will act a sub-committee of the full board.
- The new board of management will present a written report and oral presentation at each hospital board meeting.
- If legislation changes are needed, consultation should take place between the hospital's solicitors and the Department of Health.
- The board of management will function until the new permanent structures are put in place.
- The current management team needs to be cut, with a small core team instead.
Hospital chief executive Kevin Conlon said yesterday: "We have come up with sweeping changes both at board and management level and we are open to any help we can get so that we can deliver excellent care in the organisation because every patient deserves that."
Health Minister Mary Harney, who is on a St Patrick's Day visit to New Zealand, said yesterday she welcomed any steps that could be taken to improve the governance of the hospital so that roles were clarified and procedures streamlined.
"The only priority must be that the new arrangements are to the benefit of patients," she added.