A senior aide told Minister for Health Leo Varadkar the Health Service Executive appeared to be living in a "parallel universe" in relation to the way it was dealing with a highly controversial report by the Health Information and Quality Authority (Hiqa) into the Midland Regional Hospital in Portlaoise.
The HSE had contended that findings and criticisms of it by Hiqa in a draft report earlier this year were unfair and inaccurate. At one stage the HSE had considered legal action against the health watchdog.
In the run-up to the publication of the final report by Hiqa in May, the Minister's political adviser Brian Murphy wrote to Mr Varadkar in a memo urging that patient safety should be a crucial element in his official response to Hiqa. "I think we need something meaningful but not so distant in the future in terms of its implementation as to engender cynicism."
Fears
However, he warned that a final issue to consider in the context of the report’s publication was “the likely behaviour of the HSE”.
“We have asked for their planned responses to the report. We have got various bits and pieces but not the single, coherent response we need. They have gone off to do some work on it over the weekend. We shall see!!!
“I get the sense that they are still in somewhat of a parallel universe on the issue. Expecting significant changes in the draft report based on their submissions and further interaction with Hiqa on the matter. I think neither are likely.”
The final Hiqa document contained more or less the same findings and criticisms of the HSE as in the earlier draft.
Mr Murphy told the Minister in his memo that he believed the HSE would release the submission it had made to Hiqa in relation to Portlaoise “on the basis that it will help them”.
“I think it also likely that they will try to focus in on the ‘political’ decision to take Portlaoise off the small hospitals list. The bottom line is that the HSE had a responsibility to give Portlaoise, an institution in need of assistance regardless of whether it was a model two or three hospital.”
The Irish Times reported last April that in 2011 the HSE had wanted to include Portlaoise on a list of 10 hospitals across the country which were to be designated as a model two centre rather than model three. However, these plans were dropped after the intervention of the Government.
Some sources have suggested there were fears it did not want the hospital to be seen to be downgraded.
Critical care
Model two
hospitals provide day surgery, some acute medical services, care for minor injuries, diagnostic services as well as specialist rehabilitation and palliative care.
Model three hospitals deal with all types of patients with any degree of seriousness of illness and provide acute medical and surgical services as well as critical care on a 24/7 basis.
In July 2011 the Oireachtas health committee identified that Government policy "determined" Portlaoise was a model three hospital as it provided maternity and paediatric services.
Former minister for health James Reilly told the Oireachtas committee meeting it was "not Government policy" to remodel Portlaoise as a model two hospital, according to the official transcript of the proceedings.
