HSE chief apologies for ‘trespass’ memo

The head of the Health Service Executive (HSE) has apologised over an internal memo that advised staff how to remove "trespassing" patients who refuse to give up their beds.

HSE director general Tony O’Brien said he absolute regretted and apologised for any concern caused by the memo, which was withdrawn last month after two weeks in circulation.

The legal advice in the document did not reflect general policy and related only to the circumstances that apply in very rare cases, where a patient refuses to move on to other forms of care after their treatment in a hospital bed has been completed, he told the Oireachtas health committe.

The document, which sets out the legal position on the removal of patients who are unwilling to leave a hospital bed but no longer require to be treated, came to light after queries to the Irish Nurses and Midwives Organisation (INMO) from members.

Expresssed concern

They expressed concern about advice in the memo that a nurse has lawful authority to move a patient from ward to ward within a hospital, regardless of the wishes of the patient, and to remove a “trespassing” patient who refuses to give up their bed, using “minimum force” to do so.

Minister for Health Simon Harris said the memo was rescinded after he raised the issue with the HSE in late October, describing it at the time as offensive.

It was not the policy of the health service to interact with patients in the way suggested in the document, or that frontline staff should find themselves in the situation of forcing a patient to leave a bed, he said.

Mr O’Brien said the reference to the use of force was not a suggestion that force should be used, but to what the law states in such situations.

There never has been a direction to staff to use force to move patients, he said: “This is not about using our staff to use physical force to remove patients from ward”.

Where patients refuse to vacate beds, the assistance of the courts may be needed, he said.

In 2012, a hospital sought a legal opinion after a patient refused to leave a bed, according to Mr O’Brien, and further inquiries were received by the HSE more recently.

In 2014, it was reported that St James’s Hospital took legal action against an elderly patient who occupied a bed for four years and was refusing to leave.

The hospital secured a High Court order for her removal to a nursing home, but the patient appealed.