BACKGROUND:Referral letters getting lost in the system was a recurring problem for at least the past five years at Tallaght, say doctors
THE CASE that precipitated a family doctor writing to Tallaght hospital with his concerns about its performance involved a young woman with cancer, it has emerged.
Prof Tom O’Dowd, a GP in Tallaght and professor of primary care at Trinity College Dublin, said his letter to the acting chief executive of the hospital, dated January 22nd, 2009, was prompted by “a young woman whose mole I excised that needed wider dissection and whose urgent referral letter got lost in the system”.
The woman was subsequently diagnosed with skin cancer. She returned to the practice when a referral to a surgical consultant at Tallaght did not prompt an outpatient appointment and she was referred by her doctor to another hospital for treatment.
Prof O’Dowd said he didn’t have confidence the original consultant had seen his letter.
In a separate case a GP described how, when he referred a young person with disabling and painful joint disease to Tallaght hospital, nothing happened. When the GP subsequently contacted the consultant to whom the urgent referral was made, he told his GP colleague he had never received the referral letter.
A number of family doctors have told The Irish Times that referral letters getting lost in the hospital system was a recurring problem for at least the past five years at Tallaght.
Many have ceased referring to the hospital and have been sending their patients to St James’s Hospital instead. However, it is understood that St James’s has written in the last number of weeks to GPs informing them they will no longer accept referrals from outside the hospital’s catchment area.
In a letter summarising his concerns, Prof O’Dowd said: “Things had not improved and I wrote to the chairman of the hospital board, Lyndon MacCann . . . In it, I outlined the new information given to me by a middle manager in the hospital which indicated that two years of GP referral letters had not been opened or reached the consultant to whom they were referred.”
He subsequently heard at a hospital meeting that there were “thousands of unread X-rays” in the radiology department. “I asked Mr MacCann to confirm or deny the situation as I felt it will be necessary to tell patients and have them re-referred appropriately. I have not had a response.”
In a statement issued last night by Tallaght hospital, however, Mr MacCann said he had not known of the letter, sent to him by Prof O’Dowd on April 22nd last, until yesterday.
Prof O’Dowd phoned the Health Information and Quality Authority (Hiqa) and spoke with Jon Billings about his concerns after he sent the April letter.
In a statement yesterday, Hiqa confirmed it was contacted on April 24th, 2009.
It wrote to Tallaght on May 8th and met the hospital’s former chief executive on June 24th, 2009.
Hiqa said it met the former chief executive and the then medical director of Tallaght, Prof Kevin Conlon, in August 2009.
“At that meeting the authority was given assurances the backlog was being reduced,” it noted.
However the statement points to delays in receiving replies to letters it sent until December when Prof Conlon became chief executive-designate.
Finally on January 14th, Hiqa was informed the scale of the X-ray backlog was now in the region of 57,000 films – this was much greater than previously indicated.