The Minister apologises to this woman and her family for the distress and trauma caused to them.
The Minister has decided that a prompt investigation is required into all aspects of this woman's care, and any other issues that may arise, in line with best international practice following reports of adverse clinical events. She has asked officials to examine the most appropriate and effective mechanism for this investigation, including the option of a statutory inquiry under the Commissions of Investigations Act, 2004, which would require Government approval.
She also intends that the Medical Council be fully briefed on the circumstances surrounding this case and to request it to examine relevant aspects under its own statutory powers.
Role of HIQA
The powers of the recently established Health Information and Quality Authority (HIQA) extend to publicly-provided services. HIQA is, therefore, in a position to undertake an inquiry only into the components of this woman's care provided in HSE-funded institutions.
The Minister has consulted with HIQA on how a prompt and wide ranging review of all aspects of this woman's care, including those components provided in the independent hospital sector can be progressed. She plans to draw on the expertise of HIQA to advise on and support any resulting process.
HIQA is taking part in the Commission on Patient Safety, established by the Minister in January and chaired by Dr Deirdre Madden. Its work, which has an 18 month timeframe, includes developing proposals for greater accountability within our health system for performance in relation to patient safety, more effective reporting of adverse clinical events and complaints in order to learn from them, and a statutory system of licensing of all providers of health care.
The best advice made available to the Minister has been that a licensing system for independent providers should be in place in order for HIQA to carry out investigations into non-publicly-funded health care provision.
Standards for Breast Cancer Care
In May this year, the Minister approved "Quality Assurance Standards for Symptomatic Breast Disease Services in Ireland", which were prepared by a multi-disciplinary expert group and submitted to the Minister by HIQA. The Minister accepts the strong advice of HIQA and the expert group that care provided in accordance with these standards enhances quality reduces the likelihood of clinical errors and improves a woman's chance of surviving her cancer and maximising her quality of life.
These standards require significant reorganisation of breast cancer services to ensure that each centre providing breast cancer care
-- Manages a minimum of 150 new cases each year
-- Ensures that such care is provided by a team made up of a surgeon, a radiologist and a pathologist
-- Has a minimum of three consultants in each of these specialties
The Department of Health and Children has asked the HSE to progress the full and prompt implementation of these standards. HIQA will monitor and review the HSE's implementation of these standards and report directly to the Minister.
The Minister calls on hospitals in the independent sector and on the organisations that fund and insure care in that sector to take immediate steps to ensure that breast cancer services provided in non-HSE funded institutions are in compliance with these standards.
