Madam, - We wish to comment in a personal capacity on your report of the inquiry into the death of Tania McCabe at Our Lady of Lourdes Hospital in Drogheda (The Irish Times, April 16th). The finding that various services were "significantly under-resourced to cope with the current demands" will find an echo in many aspects of the health service.
We note that the report recommends, inter alia, the appointment of a clinical microbiologist. The report on recent deaths in Ennis General Hospital due to Clostridium difficile also highlights the need for clinical microbiology expertise.
As consultant microbiologists in a busy Dublin hospital, we are frequently contacted by colleagues in hospitals without microbiologists, seeking advice on the management of complex infections, often in very seriously ill patients.
We offer the advice reluctantly: we cannot assess the patients; we are dependent on the information conveyed, which may be incomplete; and we have no involvement in the microbiological examination of patient material. Hence our advice cannot be optimal, despite our best efforts, and patient care may be compromised.
The Strategy for the Control of Antimicrobial Resistance in ireland (SARI), launched by the previous Minister for Health and Children in 2001, clearly indicated the need for additional microbiologists, as did a submission to Comhairle na n-Ospidéal before its incorporation into the HSE. Several years ago, we wrote to the management in each of these hospitals without microbiologists expressing our concern and highlighting the risks to patient care. But there are still many hospitals without on-site access to clinical microbiology advice.
This is unsatisfactory and compromises patient safety.
Finally, we wish to extend our condolences to the family of Tania McCabe. - Yours, etc,
Dr EDMOND SMYTH,
Wellington Road,
Dublin 4;
Prof HILARY HUMPHREYS,
Rathdown Road,
Dublin 7.