Alternatives not considered by Beacon Hospital before teachers given vaccines, review finds

The Beacon Hospital in Dublin provided surplus Covid-19 vaccines to a number of teachers last March without considering alternative people or groups who were higher up the official sequencing list, a HSE report has concluded.

Controversy arose earlier this year when it emerged that around 20 teachers from St Gerard’s School in Bray were vaccinated ahead of their place on the official priority list in operation in March. They came to the hospital on March 23rd from from the private school, which was attended by some of Beacon Hospital chief executive Michael Cullen’s children.

The report says it would have been feasible for others who were considered a greater priority for vaccination under the sequencing guidelines in place then to receive the surplus vaccines if they had been considered by the Beacon.

It says the HSE’s community healthcare organisation, CHO 6, had said it could have sent staff to the vaccination centre at the hospital on March 23rd within the appropriate timeline to avail of the surplus vaccines.

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The report says the Beacon disputed this claim by CHO 6 during the process that led to the report, but that the reviewer’s opinion was that this was “not a correct assertion”.

“The reviewer has considered a range of alternative persons or groups that might have been considered viable in the context both of the location of the Beacon Hospital and the time of the day at which the issue was identified,” the report says.

‘Other options’

“The reviewer is of the view that there were a number of other options available that could have been considered before the teachers taking into account the sequencing guideline in place.

“CHO 6 confirmed to the reviewer that if contacted at that time on the 23rd March they could have sent staff to the Beacon Hospital Vaccination Centre (BHVC) within the timeframe suggested.

“In response to the draft report, the Beacon Hospital advised the reviewer based on their experience, CHO 6 in their view would not have be able to respond to a request for staff at such short notice in a time-pressured situation. In the opinion of the reviewer, this is not a correct assertion; the identification of excess vaccine took place within ‘office hours’ which meant that a sufficient number of Category 2 or Category 4 staff would have been available to fill the 20 slots.

“In addition, given that CHO 6 was able to book in 600 of its staff at short notice for the purposes of the re-scheduled clinic on the 23rd March, it is reasonable to conclude that they would have been able to ‘pull staff from their listing’ to fill the 20 slots.”

Crowded conditions

The report says that in the absence of the HSE’s CHO 6 being considered, other alternatives should have including those living or working in crowded conditions where social distancing was difficult to maintain, or key workers in the food supply system, public and commercial transport or other vital services .

"Where the Beacon Hospital is located there are a number of retail outlets within the hospital complex itself and both the Beacon South Quarter and Sandyford Industrial Estate are proximal. There is also a large Garda station less than 3km away which may also have represented a viable option at that time of day," the report says.

“The reviewer is therefore of the opinion that, had the Beacon Hospital considered the allocation of these vaccines to groups higher on the sequencing list, that this would have been feasible.”

It adds: “The Beacon Hospital responded to the draft report advising that they do not believe they could have found other suitable individuals at such short notice and in their view, all of the alternative groups suggested would have been out of sequence.

“In addition, the CEO acknowledged during interview that in the limited timeframe available, he did not consider other categories of workers for vaccination. However, he was aware that teachers, admin personnel and facilities staff from two schools had been vaccinated in the clinics held for CHOs in the BHVC on 23rd of March and that this goes to the CEO’s thought process at the time. “

Disability centres

However, the reviewer maintained that the two schools referred to by Beacon were actually organisations in receipt of HSE funding which provide a range of services to children with intellectual disabilities.

“These organisations operate on a social care model rather than a medical model, so a wide range of supports including educational supports are provided to these children,” it says.

“In line with the national standards for children with disabilities, a focus is placed on maximising personal development and quality of life. Covid-19 placed significant constraints on the achievement of these outcomes with many intellectually disabled persons losing access to key supports.

“When the vaccination programme commenced, there was significant concern placed by professionals and intellectual disability groups that these vulnerable service users - many with underlying health conditions- would regain access to a normal level of service. It is therefore the opinion of the reviewer that the comparison drawn between teachers from a private school with teachers, administration personnel and facility staff of organisations providing supports to the service users with intellectual disabilities is not a valid comparison.”

Not solicited

The report says there is no evidence that the school where the teachers who received the vaccine at Beacon worked had solicited the BHVC for vaccines prior to being offered the vaccines on March 23rd.

“The reviewer is therefore satisfied that on the 23rd March the school acted in good faith and on the assurances received from the CEO of the Beacon Hospital, that the offer of the vaccines was entirely legitimate, above board and with the permission of the HSE.”

A separate report commissioned by the board of the Beacon Hospital found that the decision to provide vaccines to teachers at the school was incorrect and not in compliance with the HSE’s vaccine priority list.

The review conducted by Eugene McCague, a former managing partner of law firm Arthur Cox, found the decision was taken by Mr Cullen alone but it had been made “in good faith”.

The report found that the decision was taken by Mr Cullen “in a time-pressured situation in the mistaken belief that the risk of doses being wasted entitled Beacon to administer the doses to anyone who was available, other than patients”.