The Department of Health and the Health Service Executive (HSE) were informed of concerns about the manner in which breast cancer services at Barringtons' Hospital in Limerick were being run as far back as 2005. Eithne Donnellan, Health Correspondent
But neither body was sure how to deal with the concerns, given that it was a private hospital.
The Irish Timeshas learned that, acting on the concerns in January 2006, the Department of Health wrote to the chief executive of the HSE, Prof Brendan Drumm. It pointed out to him that the director of cancer services in the midwest, Prof Rajnish Gupta, had raised issues in relation to the care of women with breast cancer at Barringtons' Hospital.
The letter outlined some of Prof Gupta's concerns and these included the fact that women attending Barringtons' were not being assessed by a multidisciplinary team, that the hospital was doing only small numbers of breast cancer operations and that mastectomies were being done on a day case basis. The department suggested, in its letter, that the HSE look into the situation.
The HSE wrote back to the Department of Health in February 2006 saying that Barringtons' Hospital was not a HSE hospital. It pointed out, however, that Barringtons' was being used by the National Treatment Purchase Fund to reduce waiting lists for public patients and it asked the department what steps it was going to take to address the concerns raised with it regarding the quality of care provided in the hospital.
In a further letter to the department in April 2006, the HSE said it had no jurisdiction over Barringtons' as it was a private hospital and therefore it was not in a position to investigate the concerns raised about breast cancer services there. It suggested the issues raised might be referred to the Health Information and Quality Authority (HIQA) or perhaps even the Medical Council.
Prof Gupta confirmed yesterday that he raised concerns about the breast cancer services at Barringtons' a number of times over the years with a range of authorities.
"It appeared they did not know how to handle them because I was talking about a private hospital. The impression I was given was that it was not their problem," he said.
He added that it was suggested to him that he take up the matter with the Medical Council. "They were saying, you know about it, you deal with it," he said.
Asked about all the toing and froing on the matter before action was taken, a spokesman for the department said: "During 2005, issues of a general nature in relation to breast disease services at Barringtons' Hospital, Limerick, were raised by Prof Gupta with the department. At the time, the department sought legal advice and consulted with the HSE in order to identify the best mechanism to address the issues raised.
"Prof Gupta was advised by the department on a number of occasions to bring his concerns to the Medical Council. Until August of this year, the department did not have specific information which it could bring to the Medical Council."
In early August Prof Gupta wrote to the HIQA giving details of his concerns about the manner in which 10 named breast cancer patients had been treated at Barringtons'. The HIQA had the cases independently evaluated and when concerns were also raised by those who reviewed them, the department put pressure on Barringtons' to stop seeing breast cancer patients.
The hospital's breast cancer services are now suspended pending a review of the care given to all breast cancer patients seen there between September 2003 and August 2007.