HIQA's Tallaght Hospital report critical of State and former hospital board

Friday 18 May 2012 12.15
The injured man was taken to Tallaght Hospital
The injured man was taken to Tallaght Hospital

A HIQA investigation has severely criticised Tallaght Hospital, saying patients' lives were put at risk because they were being treated on trolleys in corridors.

The Health Information and Quality Authority's executive summary and report also identified problems with financial governance at Tallaght.

It accused the State of failing to hold the hospital to account on how taxpayers' money was spent.

Minister for Health James Reilly has said he is confident that the limit of a six-hour wait in emergency departments can be met by next year as long as co-operation is received from frontline staff.

Speaking on RTÉ's Six One, Mr Reilly said he has sent the HIQA report to the CEOs of every hospital and the CEO of the HSE and he said he would bring them all in shortly to assess where they are.

The report found there was "persistent tolerance" of patients lying on trolleys in corridors for long periods.

There was also a lack of clarity as to who was accountable for patients.

It says that all hospitals should stop using hospital corridors or parking areas for trolleys to accommodate patients receiving clinical care.

The report suggests that no patient should spend more than six hours in an emergency department.

The review identified “significant concerns” in relation to waiting times for some hospitals and the amount of absent information to manage performance.

It severely criticises the old Tallaght Hospital Board for allegedly failing to direct and govern the hospital and for not acting on concerns raised by emergency consultants and nurses.

From January to August last year, over 80% of patients awaiting admission were put on corridors.

The report makes 76 recommendations, including a call for the current interim Tallaght Board to be dissolved and for its Charter to be replaced with a new fit-for-purpose substantive Board.

It says new accountability legislation is needed to deal with all hospitals where there is persistent poor performance of the Board or the executive management, which are in receipt of public funds.

During the HIQA investigation, patients described experiencing long delays and said they did not know who was in overall charge of their care.

Financial governance

It was found that an outside consultancy contract costing over €1.8m was entered into by Tallaght Hospital with no evidence that quotations were sought from other interested parties.

The contract was for a review of clinical governance and organisational change.

It was agreed at a time that Tallaght was forecasting a deficit of over €7m and had a carry-over deficit of over €20m.

And it says supplementary payments were made to five staff over five years - totalling nearly €740,000.

The report said the Board minutes did not record where the pay for the CEO and management team was discussed.

In one case, an extra payment of €150,000 was made.

It was not clear how these decisions were made.

HIQA Chief Executive Tracey Cooper said it was wholly unacceptable that any patient in the State should be treated on a hospital corridor despite recommendations against this being in place since 2007.

She said she was expecting substantial improvements from all hospitals in the next six months.

In relation to other hospitals, HIQA says nine out of 33 hospitals examined could not provide the emergency data sought.

And it expressed ''significant concerns'' about waiting times in other hospitals - with some patients waiting 137 hours on a trolley before admission.

Tallaght Hospital accepts recommendations

Tallaght Hospital has said it is now a safe and effective hospital where no patients are kept on trolleys in corridors.

It says it accepts the recommendations of the HIQA report, which it said are serious and far-reaching.

In a statement, the hospital said patients are no longer accommodated on trolleys in corridors since the end of August last year and emergency department trolley waiting times are down by 60%.

The senior management team has been restructured to include four clinical directors.

It said staff had repeatedly warned of the problems with patient care and it was highly regrettable these had not been responded to by management and the then board.

On a €1.8m consultancy contract, CEO Eilish Hardiman said it was awarded to PricewaterhouseCoopers in 2010 for advice on governance issues.

The hospital says an external pay facility amounted to €739,000 to five people over five years.

It says this extra payroll ceased in 2010 with an ongoing obligation of €35,000 per year moved to the main payroll. Ms Hardiman said she could not say how long it would run for.

Hospitals 'must be held to account'

Minister James Reilly has said all hospital CEOs and Boards of Management must be held to account for the workings of their hospitals.

Dr Reilly said he was setting up an oversight committee to study the recommendations of the HIQA report.

He said there needed to be a new way of putting boards together as there was a history of appointing people because of their relationships and not their skillset.

The minister also said he was sending CEOs and board members on training courses.

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