On December 19th, 2022, 16-year-old Aoife Johnston died of meningitis in University Hospital Limerick (UHL), after she was left for more than 13 hours without antibiotics.
A number of reports were commissioned into her death, the most significant being the investigation conducted by former chief justice Frank Clarke.
Mr Clarke said in his report, published last month, that the Co Clare teenager died in circumstances that were “almost certainly avoidable”. He cited, among other issues, overcrowding and capacity at the midwest hospital as a contributory factor, as well as “ad hoc” protocols within the healthcare facility.
Following its publication, Bernard Gloster, chief executive of the HSE, said there were six individuals in various stages of the disciplinary process, with four placed on administrative leave. One of these individuals is Brian Lenehan, a consultant orthopaedic surgeon, who is also chief clinical director of the UL Hospitals Group.
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His suspension, however, has resulted in a High Court case that he has taken against the HSE. Prof Lenehan is seeking an injunction against him being placed on administrative leave from his role as chief clinical director, pending the disciplinary process. In support of his case, Prof Lenehan submitted an affidavit, in which he said Mr Gloster sent him a letter on July 24th, outlining 22 concerns “which Mr Gloster claims arise from my discharge of my duties”.
According to the court documents by Prof Lenehan, Mr Gloster said the 22 issues raise a concern that there may be “an immediate and serious risk to patients and/or staff and that he is considering putting protective measures in place while an investigation takes place into my actions”.
All but one of those concerns specifically referenced the weekend when Ms Johnston presented at the hospital. However, Prof Lenehan said none of the concerns referenced “any specific action or inaction on my part”.
In further correspondence, dated August 29th, Mr Gloster confirmed to Prof Lenehan that the proposed suspension was only in relation to his role as chief clinical director, and did not relate to his consultant position.
Six days later, on September 3rd, Prof Lenehan and Mr Gloster had a meeting, which was also attended by their legal representatives. During this meeting, Prof Lenehan said he delivered a letter to the chief executive. In this, he stated the 22 concerns were “unspecified, largely unparticularised and do not reference any finding in any of the relevant reports and that none of those reports criticise me in any way”.
On September 11th, Mr Gloster met Dr Joseph Devlin, a consultant rheumatologist and the deputy chair of the medical board at UHL about the proposed action being taken against Prof Lenehan. In an affidavit, Mr Devlin supplied a transcript of his conversation with Mr Gloster, in which the chief executive spoke about building a “just culture” within the HSE, whereby “individual staff should not be held accountable for systems failings over which they have no control”.
In response, according to the transcript, Mr Devlin said he is “wholly supportive of taking disciplinary action against individuals who fall below acceptable standards of care provision”. However, he said he saw “no basis” for “suspecting such deficiencies” in Prof Lenehan. He reiterated this belief in the court papers, stating he could identify “no allegation of actual misconduct” on the part of Prof Lenehan from the reports, nor could he identify any alleged act or omission by him that would lead “to any rational concern that he poses a serious and immediate risk to anyone”.
On September 16th, Mr Gloster wrote to Prof Lenehan again, stating he would be commencing a disciplinary investigation into “alleged serious misconduct” and would be suspending Prof Lenehan from his director role.
“I believe that your continuation in the role of chief clinical director may give rise to an immediate and serious risk to the safety, health and welfare of patients under the care of UHL and its emergency department,” Mr Gloster said in his letter, according to Prof Lenehan’s affidavit.
Prof Lenehan’s solicitors wrote to the HSE’s legal team the following day, claiming the decision to place him on administrative leave was “in breach of my contractual and legal rights”, and requesting it be rescinded.
On September 20th, Mr Gloster replied, upholding his own decision to place Prof Lenehan on administrative leave.
Prof Lenehan made an application to the High Court last week for an order that he be returned to his role pending the outcome of a disciplinary investigation. The case was adjourned to allow the HSE to file a response. In his affidavit, he said the decision that he poses a risk to patients is “both personally insulting and deeply damaging to my professional and clinical reputation”.
Prof Lenehan added that he is “not seeking to delay or frustrate” the proposed investigation into his actions and that he will engage with the investigation “fully and frankly”.
However, he said: “Such a significant period of imposed leave as a result of a risk deemed ‘serious and immediate’ by my employer would be irredeemably damaging to a reputation I have forged with diligent care over 2½ decades in medical practice.”
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