A hospital consultant asked by the Health Service Executive (HSE) to review deaths at the Leas Cross nursing home in north Dublin reiterated yesterday that his findings require "urgent and substantive attention for the most frail and vulnerable section of older people in Ireland".
Prof Des O'Neill, who was asked last year to review some 95 deaths at the home or immediately after transfer to hospital from the home between 2002 and 2005, also revealed he saw "a body of correspondence involving senior clinical practitioners which concerned comments, warnings and responses to issues of concern over care at Leas Cross" during the course of his as yet unpublished review.
There have been calls for the publication of his report but the HSE claims it cannot be published in its current format.
Leas Cross, a private nursing home in Swords, closed in August 2005 after the HSE withdrew public patients from it following a Prime Time Investigates TV programme on the treatment of a number of patients there.
In a written statement yesterday, Prof O'Neill, a consultant geriatrician at Tallaght hospital, stressed that, while the HSE has been saying his review is not complete and therefore cannot be published until he incorporates into it responses from those criticised in it, he is adamant his report is finished.
"I have finished my review," he said emphatically, adding that "the controversy that has now arisen seeks to doubt that". The completed review, he said, was furnished to the HSE last May.
What the HSE was now seeking from him, he said, was that he go outside his terms of reference and hear oral and written submissions from people mentioned in his report which was akin to the setting up of a tribunal of inquiry, at which these people would be legally represented.
"In fact, what appears to have been mooted is that I agree to revisit this defined review and instead embark on the commencement of a judicial form of tribunal involving the adoption of judicial procedures with the weighing of post-hoc written submissions (as opposed to contemporaneous documentation) and oral evidence. That was not what I was asked to do in my review, and is a different task which lies within the sphere of judicial training."
He explained that the HSE drew up the terms of reference for his review and these required him to review deaths at Leas Cross through inspection and analysis of documents such as medical and nursing notes, post- mortem summaries, correspondence to the health services regarding concerns over Leas Cross, nursing home inspection reports and other relevant documents. He saw the report about the home compiled by a UK consultancy for Leas Cross owner John Aherne during his review.
He found none of the deaths over the period were preventable but that the annual death rate was somewhat higher than might be expected. He made several recommendations regarding proper standards of care in all nursing homes.
"As it turned out, the review that I conducted gave me cause for grave concern not only as to the standards within that particular nursing home but also, as the specific terms of reference required me to consider, the wider issues as to the setting of appropriate standards and their systematic monitoring and enforcement. As I have previously stated these concerns were grave, disturbing and system-wide, and required urgent attention," he said.
The HSE has indicated it may, on legal advice, now have to appoint somebody else to marry Prof O'Neill's report with the responses from individuals criticised in it or perhaps even start another review all over again. However, Minister for Health Mary Harney said last week she hoped a way could be found to ensure the report was published quickly. Age Action Ireland called again last night for Prof O'Neill's report to be published as a matter of urgency.