Pro Life Campaign IRELAND welcomes THE HSE REPORT
GROUP SAYS REVIEW HIGHLIGHTS ’MULTIPLE FAILURES’ THAT CONTRIBUTED TO SAVITA DEATH
The Pro Life Campaign welcomed the publication of the HSE review of Savita Halappanavar’s death and said efforts by the political establishment and the media to use it to bolster calls for abortion legislation had been “opportunistic”.
The group said the report clearly indicated that it was a series of medical shortcomings that were at fault.
It’s spokeswoman Dr Berry Kiely said the review “highlights yet again that the key issues in the death of Ms Halappanavar were multiple failures to properly assess and monitor her condition which resulted in a tragic failure to recognise the very real risk to her life posed by serious infection.
“If this risk had been recognised, the outcome might have been very different.”
She said the media and political response to her death had sought to take advantage of the case.
“This confirms what the Pro Life Campaign has always claimed, that the way some politicians and media fastened on Savita’s tragic death as somehow bolstering their call for abortion legislation was misplaced and even opportunistic,” she said.
“Surely it is a moment for reflection on the rush to judgment in this tragic case? The Government has plans to introduce very radical abortion legislation and so far there has not been anywhere near the level of scrutiny needed.
“I hope the findings of the HSE and inquest reports will give some measure of comfort to Praveen Halappanavarand Savita’s extended family and that all the lessons to be learned will be implemented,” she concluded.
The Catholic Bishops Conference of Ireland, which has been vocal in the wider debate surrounding abortion legislation, did not respond to a request for comment on the HSE report this evening.
Meanwhile:
The University Hospital Galway apologises over the death of Savita Halappanavar
Hospital says it has implemented changes to avoid a repeat of events surrounding death of Savita Halappanavar
University Hospital Galway today apologised to Savita Halappanavar’s husband Praveen and the Halappanavar family “for the events related to his wife’s care that contributed to her tragic death” .
In a statement issued on behalf of the hospital, Dr Patrick Nash, who was clinical director and commissioner of the inquiry into the death of Ms Halappanavar, said the hospital is “committed to operating to the highest standards” and wanted to reassure all concerned that changes have been implemented “to avoid the repeat of such an event.”
Dr Nash noted Mr Halappanavar has stated that he does not want any other woman to go through what happened to his wife. “The recommendations from this review will result in changes and improvements that will minise the risk of this ever happening again in Ireland, ” Dr Nash said in the statement.
Ms Halappanavar’s death was the first direct maternal death at the hospital in 16 years, Dr Nash said, adding that “it is clear from the report that there were failures in the standard of care provided at University Hospital Galway.”
The hospital has undertaken “a number of significant improvements” in response to the interim safety recommendations issued to the hospital.
These include:
the implementation of early warning scoring systems
the education of all staff in the recognition, monitoring and management of sepsis and septic shock; and
the introduction of new multi-disciplinary team-based training programme in the managment of obstretric emergencies, including sepsis.
The hospital has also improved communications processes and are implemening procedures for doctors’ handovers.
Dr Nash said the hospital and the HSE will “work to fully implement all of the recommendations arising from the report”.
THE HSE: In a statement issued by the HSE accompanying the publication of the report, the HSE and University Hospital Galway apologised “unreservedly” to Mr Halappanavar “for the tragic and untimely death of his wife”.
The HSE said it had commissioned the report “to establish the facts and contributory factors” leading up to the death of Ms Halappanavar “and to provide recommendations”.
“The investigation to identify key causal factors involved a systems analysis of relevant records, interviews with 19 members of staff involved in Ms Halappanavar’s care and the review of local, national and international guidelines.
“Mr Halappanavar inputted to the investigation process through his representatives,” the statement said.
Outlining three causal factors identified by the investigation team, the statement said University Hospital Galway has already undertaken “significant measures in response to the interim recommendations.”
The three causal factors were:
- Inadequate assessment and monitoring of Ms Halappanavar that would have enabled the clinical team in UHG to recognise and respond to the signs that her condition was deteriorating
- Failure to offer all management options to Ms Halappanavar who was experiencing inevitable miscarriage of an early second trimester pregnancy where the risk to her was increasing with time from the time that her membranes had ruptured.
- UHG’s non-adherence to clinical guidelines relating to the prompt and effective management of sepsis, severe sepsis and septic shock from when it was first diagnosed.
The statement said UHG has “improved communications processes” and is “implementing new procedures for doctors’ handovers”.
“Both University Hospital Galway and the HSE will work to fully implement all of the recommendations arising from the report in all hospitals,” the statement said.
Praveen HALAPPANVAR to seek a meeting with Minister for Health
Further legal options to be considered
PRAVEEN HALAPPANVAR IS SEEKING AN URGENT MEETING WITH MINISTER FOR HEALTH JAMES REILLY FOLLOWING THE PUBLICATION OF A HSE INQUIRY INTO HIS WIFE’S DEATH.
His solicitor Gerard O’Donnell said his client, who is out of the country until the end of next week, was pleased the process of finding out what had happened to his wife Savita, had “come this far” but added he was still seeking accountability for her death.
“Praveen is still in search of that. We will want to discuss the findings of this report with the Minister and to hear what he has to say.
“We note that the Minister has sent the report to theMedical Council and the nursing board [An Bord Altranais] and that will offer some level of accountability perhaps.”
There was a number of further avenues open to Mr Halappananavar and these would be discussed with junior and senior counsel in coming weeks, Mr O’Donnell added.
“The possibility of taking a case to Europe is still there, though first we would consider a constitutional action within Ireland, where we would be seeking a declaration that Savita was deprived of her statutory right to have her life protected.
“There is also a possible negligence case, about which we have done nothing as yet. It would be unusual to have a constitutional and a negligence case running in parallel so we may pursue one and not the other or one first and the other later, or just one. These are all going to be discussed.”
A negligence case would have to be lodged within two years of Ms Halappanavar’s death, which would be October next year.
Mr O’Donnell said Mr Halappanavar was “surprised and very disappointed” that the HSE report appeared to have been published “in such a rush”.
Mr Halappanavar had gone away on Monday and had no idea publication was imminent.
“We had the impression we would get copies of the report and that he would be able to give one to her parents and to read it before everyone else in the country did.
“So I had to call him on Tuesday and tell him to get in contact with her parents and his own parents and just to warn them it was about to be published.”
He said his client was “very stressed and burnt out” but was pleased the report gave further vindication, after that already achieved at the inquest in April.
Ireland agrees to early review of its troubled banks loans
IRELAND HAS AGREED TO A DETAILED REVIEW OF ITS TROUBLED BANKS‘ LOAN BOOKS THIS YEAR TO PLACATE ITS INTERNATIONAL LENDERS AND WILL HAVE ITS STRESS TESTS BEFORE A EUROPE-WIDE EXERCISE IN 2014.
The move is designed to appease concerns of the European Union and International Monetary Fund, which wanted the banks to get a clean bill of health before the end of Ireland’s sovereign bailout in December.
Ireland’s financial regulator, Matthew Elderfield, said the country would conduct two exercises – one on the quality of assets before the end of 2013, followed by full stress tests in the first half of 2014.
The comments confirmed in a report in May that Ireland had resolved a standoff with its lenders over the timing of the stress tests, which aim to gauge banks’ resilience to economic shocks.
“What we will see is towards the end of this year a kind of first phase of work – asset quality review, look at provisioning levels, look at the risk models the banks have got,” Elderfield told a parliamentary committee on Thursday.
“That will feed into the asset quality review of the ECB and then the stress tests will come after that. So it will be a phased process with some deliverables before the end of the year.”
Ireland’s banks have not been stress-tested since 2011 when consultant BlackRock identified a 24 billion euro ($32 billion) capital hole.
Dublin had wanted the tests carried out in conjunction with a European-wide exercise, expected in mid-2014.
The finance ministry said it would produce a final report on the banks’ implementation of their deleveraging plans, and compliance with asset disposal and run-off targets will be discussed with the European Commission, IMF and European Central Bank.
Irish mental health service becoming stagnant and in danger of slipping backwards
Dr Patrick Devitt above left, inspector of mental health services, said nursing staff numbers continued to dwindle last year, while unfilled vacancies were resulting in professionals being pulled out of community services to plug gaps in inpatient care.
Watchdog says failure to hire community-based staff will hamper services
The country’s mental health services are stagnant and in danger of slipping backwards as a result of dwindling staff numbers and poor governance, the inspector of mental health services has warned.
His comments are in the annual report of the State’s watchdog on mental health services, the Mental Health Commission, which raised concern about the state of community based services.
Dr Patrick Devitt, inspector of mental health services, said nursing staff numbers continued to dwindle last year, while unfilled vacancies were resulting in professionals being pulled out of community services to plug gaps in inpatient care. This is despite the Government’s policy of investing in community-based treatment rather than institutional care.
Community services with access to a range of therapeutic services are considered by most experts to be more suitable than the older “medical model” of hospital-based care.
His comments were echoed by the chairman of the commission, John Saunders, who warned that standards of care would worsen unless community mental health posts were filled.
Community services
Mr Saunders said only a third of the 414 promised community mental health posts due to be filled last year to strengthen community services were in place at the beginning of this year. These posts include psychologists, occupational therapists and social workers.
Mr Saunders said only a third of the 414 promised community mental health posts due to be filled last year to strengthen community services were in place at the beginning of this year. These posts include psychologists, occupational therapists and social workers.
While most have since been filled, he warned that a backlog was threatening to delay the appointment of hundreds of community-based personnel.
“There is a real danger that standards will fall unless these posts are filled promptly,” Mr Saunders said.
“We have incomplete mental health teams trying to provide multidisciplinary care. In many cases they’re football teams with half their players missing.”
The commission reported progress in several areas such as the development of new inpatient centres for children and adolescents who require acute treatment.
Despite these new services, there were 106 admissions of young people into adult units last year, a practice previously criticised by the commission as “inexcusable and countertherapeutic”.
The commission also expressed concern at “slippage” in the compliance of services with their legal obligation to provide quality psychiatric services.
While many services performed well, the commission used its legal powers to attach conditions to the registration of nine psychiatric services last year. These included a failure on the part of services to have individual care plans for patients or to provide sufficient training for staff.
If these issues are not resolved the commission has the power to deregister or close down a service.
Nine centres, Six of the nine centres have since tackled these shortcomings in care. However, three centres – the psychiatric units at Connolly Hospital Blanchardstown in Dublin; St James’s Hospital, Dublin; and UniversityHospital Galway – have yet to address them, according to the commission.
Dr Patricia Gilheaney, the commission’s chief executive, said in general there was a high level of compliance with regulations.
“This is a very effective method at our disposal and, as we work to improve standards, we will continue to use it whenever it is appropriate,” she said.
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