Monday 23 September 2019

Whistleblower row erupts over doctor's A&E 'torture' expose

Emergency Medicine consultant Dr James Gray
Emergency Medicine consultant Dr James Gray

Eilish O'Regan and Kevin Doyle

The decision to subject a doctor to an internal review after he turned whistleblower to highlight the plight of a 91-year-old A&E patient who endured 29 hours on a hospital trolley was condemned last night.

Dr James Gray, an emergency consultant at Tallaght Hospital, was so worried by conditions endured by the patient who has Parkinson's disease and was surrounded by noise and light "torture", that he wrote a strongly-worded memo to management and Health Minister Leo Varadkar.

The man's wife, who is also in her 90s, was also on a trolley for more than nine hours on Monday night.

A spokesman for Tallaght Hospital said yesterday they are now conducting an internal review into the circumstances surrounding the disclosure and characterisation of certain "confidential patient information" in the national media.

Neither the male patient nor his wife were named.

The statement made no reference to any inquiry into the circumstances of severe overcrowding which contributed to the delay in getting both patients a hospital bed.

Responding to the move, Fergal Hickey, who is spokesman for the country's emergency consultants, said: "While I have no information about how this man's information got into the public domain, it is a cause of very serious concern if Tallaght Hospital does not regard this prolonged stay on a trolley as a very serious clinical incident.

"Ireland has a long track record of shooting the messenger rather than listening to the message. Well-intentioned whistleblowers' concerns should be listened to rather than attempts made to silence them, especially when there is clear evidence that any patient over the age of 75 years detained on a trolley in an emergency department for more than 12 hours is likely to have a poorer medical outcome," he said.

"Rather than focus on the circumstances of how this information got into the public domain, it would be far better if the hospital were to ensure there was no recurrence of such significant risks to patients," he added.

Responding to the latest statement from Tallaght Hospital Dr Gray told the Irish Independent: "The hospital should concentrate on the solutions to the failures themselves rather than on who is highlighting them, whoever the messenger is."

The hospital spokesman said the elderly man had expressed dissatisfaction with the way in which his personal circumstances were revealed and elements of his care misrepresented.

Health Minister  Leo Varadkar said he has spoken to the 91 year old man who spent 29 hours on a trolley in Tallaght Hospital but admitted the case is inot unique.

The reality is now the majority of medical patients in emergency departments are older people, he added.

"Somebody being on a trolley for more than 24 hours is not an isolated incident.

There are dozens of people waiting that long every day and most of them are elderly."

Speaking at the launch of new ambulances for the HSE fleet he said:

"What we want is a comprehensive solution to this."

The focus has to be on solutions and we are driving forward as best we can providing more beds, more staff and supports to primary care, he added.

The incident led to heated exchanges in the Dáil after Taoiseach Enda Kenny was tackled by Fianna Fáil leader Micheal Martin on A&E patient conditions. Mr Kenny said he agreed with Dr Gray's concerns.

Fergal Hickey told today’s Morning Ireland that the hospital’s statement was “deeply disingenuous” and he described it as “a case of shooting the messenger”.

He said the problem of patients having to wait for long periods on trolleys “didn’t just happen yesterday, it’s been happening for 15 years.”

He added: “Dr Gray has done this patient and many other patients a service by highlighting it.”

“He had taken the appropriate step and he would be failing in his duty if he were not to do that.”

Meanwhile, Liam Woods from the HSE told Morning Ireland that the 91-year-old man's trolley wait was "unacceptable".

 “Clearly the experience is unacceptable, I would concur with that.”

He added that the HSE is working to make sure it “makes a difference this winter”.

“So far we’ve engaged in really extensive winter planning… to ensure we have the maximum services available and the gradual opening in November, December, and January of beds in the system.”

“Our target is to reduce over nine-hour stays.”

“The population is ageing, we are all living longer, and this is placing increasing stress on the health system.”

The HSE is focusing on investment and patient flow, and it is developing pathways for frail older people to move back outside into the community, he said.

He identified eight hospital sites in the country “where we’re really challenged” and a dozen hospitals “where performance is improving”.

“Performance across the country is differential,” he said.

Irish Independent

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