Fatal errors in health system

The disclosure that an estimated 6,500 people may be the victims of outright medical negligence in the Irish healthcare system…

The disclosure that an estimated 6,500 people may be the victims of outright medical negligence in the Irish healthcare system every year, that 2,000 may die as a direct result of avoidable medical errors and that thousands more may be injured due to preventable mistakes, graphically underlines the need for patient safety to be given much greater priority.

The statistics - revealed by RTÉ's Prime Time Investigates - are based on the extrapolation of data from Harvard University which estimates a medical error rate of 4 per cent in the United States. However, the US research was carried out in 1999 and its authors and other experts have predicted the actual rate of medical negligence may be closer to 10 per cent of those treated in the hospital system. And because these figures relate only to those at the top of the healthcare pyramid, the true prevalence of medical error (when primary care is included) is likely to be even higher.

The patients' stories recounted by Prime Time were truly frightening. A simple mix-up in biopsy specimens means that a 23-year-old man must deal with the life-long consequence of having his stomach unnecessarily removed. The length of time it took a Sligo couple to get an obstetrician to admit that their baby had died at birth because of inappropriate management is not acceptable. The couple's assertion that in their experience, the Medical Council was there to "protect medical people and not the public" confirms the view of many observers that the 1978 Medical Practitioners Act no longer serves the public interest.

One of the lasting impressions from the programme was that many victims of medical malpractice are motivated to seek legal redress not for financial gain but because of the wall of silence and lack of explanation that greet their request for further information.

READ MORE

This sense of a health system not listening to patients is in many ways the most damning fact to emerge. Victims agree that, in the majority of malpractice cases, doctors do not act maliciously. The problem is actually one of doctors who make genuine mistakes, but who are part of a system that closes ranks when the consumer of that system seek reasonable answers.

But the leaders of the medical profession here have shown a willingness to change. A system of competence assurance, whereby doctors' abilities are assessed every five years already exists. The president of the Medical Council has said that he personally would favour a system similar to the licensing of pilots, whereby a rolling assessment of actual ability would be put in place.

The Minister for Health, Mr Martin, must take some of the blame for the lack of public confidence in healthcare. In the autumn, he told this newspaper that the heads of a new Medical Practitioners Bill would be published within weeks. His declaration yesterday that he has a target date of the end of 2004 for the enactment of new legislation is wholly inadequate.