Dangerous Hospitals Not Caused By Cutbacks

By Cian O'Carroll, Wednesday, 17th December 2014 | 0 comments
Filed under: Medical Negligence, Hospital Acquired Infections, Personal Injuries.

There are far more people killed by negligence in our hospitals that die on our roads and yet we hear almost nothing about it. Why is that? It seems that almost every type of accident that can befall a person and that could be attributed to the wrong or negligence of another is investigated by one or another state safety agency except medicine. We have the Marine Casualty Investigation Board, the Road Safety Authority, the Rail Accident Investigation Unit, the Irish Aviation Authority’s Air Accidents Investigation Unit, the Food Safety Authority of Ireland, the Health & Safety Authority and on and on. Every non-medical critical event gets investigated so that lessons may be learned. Why then don’t we investigate accidents in medicine, and lets leave out the majority of the 80,000 or so adverse events that happen in our state-funded hospitals each year – let’s just focus on the top 1% of those being the mistakes that cause catastrophic injuries or serious harm up to and including death.

Wouldn’t you think that if you were killed or brain damaged by your medic’s negligence, the hospital management would be interested enough to investigate what happened but that doesn’t happen in our system – at least save in the rarest of cases. In the UK, doctors guilty of negligently causing the death of a patient are frequently subject to criminal charges and several UK doctors are in prison at present while here in Ireland, we don’t even ask questions.

Over the last 12 months alone I have dealt with 6 cases where the patient was very clearly killed by the negligent medical care they received yet in only one of these cases has there been any investigation by the health services and its conclusions shielded the doctor involved from any blame and instead concluded there was a ‘system failure’ due to a lack of resources.

True, when someone dies, there is the coroner but in none of the above cases was the coroner’s office informed by the hospitals involved of a causal link between poor care and the death and so the issue was not investigated. Where an issue does arise, usually the Inquest only hears evidence from the doctors involved in the care so there is little surprise that the outcome in an unsatisfactory investigation lacking any credible independent expert opinion. Even if there is independent expert opinion given, an Inquest is prohibited by law from making a finding of fault so it is clearly not an effective means of dealing with the problem.

This is an appalling way to treat patient safety. In a health service where funding cuts are the order of the day, if patient safety is not the absolute priority, then it becomes the first casualty. This problem seems to be escalating. In my practice I have noted a definite increasing trend towards what you might call ‘unforced errors’ over the last 18 months or so. These are cases where the patient was seen, was examined but the clear evidence of illness was not recognised by the doctors and the patient is sent home with an undiagnosed but deteriorating condition and they either die or suffer significant harm as a consequence.

Such unforced errors are not occurring due to a lack of funding because the patient has received all the necessary investigations to make the correct diagnosis. They occur because of a lack of care; they occur because the medical staff are not focused on patient safety.

The state funded hospital system we currently have is not dysfunctional in terms of patient safety; it is non-functional. This is because we have designed a hospital system where no matter how many serious injuries or deaths are caused to patients, neither the HSE’s nor the hospital’s budgets are affected. No doctor or nurse will suffer any increase in Professional Indemnity insurance premium because they don’t pay any insurance premium. The HSE doesn’t even have to fund the cost of running the legal cases that arise from the careless healthcare they preside over because our ingenious system has created the Clinical Indemnity Scheme who defend all these cases, pay for the legal cost of defending the indefensible (usually to the steps of court so they can maximize both the distress they cause to negligently injured patients and waste yet more money on  otherwise unnecessary legal bills). I don’t think there could be a more idiotic, wasteful and dangerous system for patient safety than the one we currently have.

Then you have HIQA, the Health Information & Quality Agency. They run the hygiene inspections on hospitals. It all sounds quite reassuring until you read the reports. They actually note the number of times their inspectors see care staff failing to clean their hands between patients. Nobody gets disciplined or reported and this is with an inspector standing there. They don’t go in disguise or anything. Imagine what it is like when the inspector is not there?

In contrast to the state hospital/ HSE system, we also have a publicly funded primary care system which is run through GP practices. Here you have similarly trained medical professionals but they work in sole trader or partnership arrangements where there is accountability through insurance. If a GP causes harm to a patient and it results in a claim, their insurance will go up. Surprise, surprise, medical negligence statistics show that GP care is vastly safer than hospital care. GP care works and works really well. It is so obvious; it is just human nature that we are more careful when we are accountable for our actions.

We need an effective state agency with teeth to investigate medical accidents. We need a system that incentivises hospitals for good care and punishes those who fail their patients. Otherwise we are condemning ourselves to the current system where only the patient pays the price for careless medicine.

Cian O’Carroll Solicitors, A Medical Negligence & Personal Injury Law Firm. FREEPHONE 1-800 60 70 80 | WWW.TIPPLAW.COM

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