SENIOR executives at the hospital at the centre of the X-ray scandal ignored repeated demands for answers from a patient safety watchdog for almost a year.
The complete breakdown of communications between Tallaght Hospital management and the Health Information and Quality Authority (HIQA) is exposed in a series of letters obtained by the Irish Independent.
The revelations emerged as Health Minister Mary Harney, who is in New Zealand on a 15-day St Patrick's Day junket, faced growing calls for her resignation.
The HSE last night promised an independent investigation into how up to 58,000 X-rays went unread at the hospital.
But in another blow to anxious patients, it confirmed a review of the X-rays would not be completed for another 10 weeks.
This newspaper has learned that letters were sent by HIQA to former Tallaght chief executive Michael Lyons as far back as last October, asking why the hospital had failed to reply to previous correspondence.
At least one of the letters was copied to Professor Kevin Conlon, who was then medical director and has since taken up the post of the chief executive designate.
HIQA wanted to know what the hospital was doing about unread X-rays and what progress was being made in other areas -- but it received no reply.
Last night, it emerged that top executives also failed to reply to HIQA about patient safety in the emergency department and about why there were sacks of unopened mail from GPs clogging Tallaght's post room.
The hospital did not reply to at least two letters and a follow-up phone call, asking for urgent progress reports on what investigating officials at that time thought was an X-ray backlog of only 4,000.
Two planned meetings to discuss the life or death matter were then shelved by executives in December. It was not until January that a mountain of up to 58,000 unread X-rays was acknowledged.
Meanwhile, the Irish Hospital Consultants Association (IHCA) claimed radiologists wrote more than 40 letters to Tallaght bosses over recent years complaining about the growing backlog.
The HSE claimed it has asked other hospitals to report back on whether they have any backlog of unread X-rays.
In response to a series of questions submitted by the Irish Independent, Tallaght Hospital claimed Prof Conlon only found out on Monday about the death of a patient last summer.
The patient who died after their X-ray was not properly read had a delayed diagnosis for nine months.
A spokeswoman said the hospital "did not believe" the delay impacted on the outcome but added: "We are happy to have an independent review of this."
The other patient whose x-ray was not read, who is now battling cancer, had been informed of the delayed diagnosis by her consultant previously. Prof Conlon spoke to her on Tuesday.
The spokeswoman also confirmed the unread X-rays involved private patients amid concerns that only public patients were affected.
However, she was unable to give a detailed breakdown. Opposition parties yesterday united in calls for the absent health minister to be removed from office as the controversy deepened.
Taoiseach Brian Cowen gave his full backing to Ms Harney, however, describing her as a "reforming minister".
Fine Gael leader Enda Kenny said the latest health controversy was a "national scandal".
The party's health spokesman, Dr James Reilly, threatened to put down another motion of no confidence in the minister if she retains her job in the imminent cabinet reshuffle.
Labour leader Eamon Gilmore branded Ms Harney a "hopeless minister".
Ms Harney yesterday claimed she only became aware of the scale of the X-ray crisis this week. The Health Minister, who is in Auckland for St Patrick's Day and to learn more about paediatric care in New Zealand, said : "Obviously it's unacceptable what's happened, but I 've total confidence in Professor Conlon, the CEO of the hospital, and how he's handled the issue."
Responding to demands that she cut short her trip: " I believe it's important that I continue with my official programme that has begun and I'm obviously a long way here and the programme is important ... The prime minister is honouring us with his presence at the banquet on Saturday with his wife and I think it would be very discourteous of me to not be there for that event ... I didn't go away last year for St Patrick's Day because there were issues at the time."
HIQA's director of healthcare quality and safety, Jon Billings, first sent an email to his staff on April 24 last year, asking about concerns raised by a GP over "hundreds" of letters left unopened in the post room at Tallaght.
Mr Billings noted the GP believed a failure over radiology reporting ran to two years and needed to be checked out.
Patients said yesterday they had no confidence in the system. Dublin GP Tom O'Dowd, who blew the whistle on the X-ray crisis, said he was forced to intervene on behalf of his patients.
"We were constantly phoning for results but could not get them," Mr O'Dowd said.
Dr Barry White, HSE National Director of Quality and Clinical Care, said the Executive could not provide reassurance to worried patients until the audit was completed.
Officials had been told there was a backlog of 4,000 unread X-rays. But on Tuesday the hospital said the real figure was more than 57,000 and that almost 35,000 had now been seen.
THE Health Service Executive is to ask all of its hospitals to check whether they are failing to properly check X-rays, writes Edel Kennedy. It ordered the audit after it was found that thousands of X-rays were lying unchecked in Tallaght Hospital.