X-ray probe finds hospital row kept patients waiting for years
Published 05/11/2010 | 05:00
MORE than 40 patients caught up in a row between surgeons and management at Tallaght Hospital in Dublin have yet to see a specialist after a wait of up to two years.
The patients were among 3,498 whose GPs wrote to the hospital over several years asking for an appointment with an orthopaedic specialist.
But although the letters were opened, they weren't processed and not responded to -- mainly due to a "combative" row between doctors and management at the hospital, a damning report revealed yesterday.
Although the scandal came to light last March, a hospital spokeswoman confirmed last night that 13 of the patients have yet to see a specialist and 28 would have to wait until December for an appointment with a physiotherapist.
The background was revealed by the inquiry team led by former Northern Ireland Ombudsman Maurice Hayes, who published the Tallaght Hospital Review yesterday.
It expresses serious concern at the possible use of patients as a "bargaining" tool in a row between doctors -- angry at a lack of beds -- and management.
It also examines why 3,498 letters sent by GPs seeking a specialist appointment for their patients were not acted on, and how 57,921 X-rays and scans were not read by radiologists.
One patient whose X-ray was not reviewed by radiologists at the hospital died and another suffered a delayed diagnosis.
The report finds radiologists had been calling for their numbers to be increased since 2003.
A poor response from management meant that the issue persisted over many years and was compounded by outdated radiology technology with no written guidelines on what X-rays could be safely read by a patient's treating doctor alone.
But the report is most hard-hitting about the hospital's failure to process 3,498 referral letters for patients, some of whom may have needed cancer investigations. It reveals the hospital had no formal policy for processing these letters looking for a specialist appointment and anyone not addressed to a named orthopaedic consultant risked being opened but left to lie.
"It was rooted in an ongoing dispute between orthopaedic consultants and senior management," according to the report. The surgeons were angry that beds for non-emergency surgery patients were not guaranteed and could be taken by other specialists or A&E.
A number stopped seeing new referrals two years ago, saying seeing patients at an outpatient clinic was morally unacceptable if they could not get them a bed for surgery.
They said the unprocessed letters accumulated without their knowledge. But clerical staff said the doctors failed to review the letters.
The report criticises management for failing to deal with the situation, adding that, while there was no evidence of any patient suffering an adverse outcome, patients suffered additional anxiety and worry.
The inquiry team says it is not convinced that this will not happen again. A spokesperson for the hospital said last night that the outstanding patients would be seen this month and in December. Their doctors sought appointments in 2008 and 2009.
Dr Hayes said yesterday: "This is a good hospital which serves its community well. I hope the implementation of recommendations will encourage it to move forward."
Referring to the X-ray scandal the report notes that, last year, while the hospital had seven full-time radiologists and two sanctioned posts, it struggled to cope as X-rays and scans became more complex and time-consuming.
The HSE said yesterday it has approved funding for two additional radiologists and guidelines on how to prioritise X-rays were now in place.
It is finalising a report into how other hospitals deal with X-rays.