Category: Uncategorized

Hundreds of family doctors have threatened to use their surgeries to campaign against Fine Gael election candidates.

The unprecedented move would see GPs lobby their patients to vote against the Government party. The threat is made in a letter to Taoiseach Leo Varadkar’s TDs, which demands a meeting by Friday for representatives of the National Association of General Practitioners (NAGPs).

It says NAGP members will begin “informing their patients personally about the health policies of Fine Gael TDs and councillors in the upcoming local and general elections, and the detrimental effect that these policies are having on patient services in the community”.

The dispute centres of the NAGPs exclusion from talks with the Government on a new deal for GPs. The Irish Medical Organisation is in discussions about reversing cuts to GP fees during the economic crash – but the NAGP, which claims to have 2,100 members, is not recognised by the Department of Health or the HSE.

The correspondence, signed by chief executive Chris Goodey, warns Fine Gael chiefs of action unless they agree to meet “by the end of this week”.

A spokesperson for Fine Gael said last night it had “no comment” to make in relation to the demands.

Irish independent

The impact on tens of thousands of patients of escalating unrest in the health service continues today with members of the public asked not to use out of hours GP services as hundreds of family doctors gather in Dublin for a protest.

Nurse Jodie Murphy with her one-year-old daughter, Alexandra, on picket line duty at Cork University Hospital on the second day of the nurses’ strike. Picture: Dan Linehan
Instead, patients are being asked by the National Association of GP Co-ops to travel to emergency departments in the case of emergency, or to wait to see their own GP tomorrow.

The latest disruption follows cancellation of outpatient appointments, non-urgent surgery, and respite, rehabilitation, and day centre services, affecting 50,000 patients in the past week.

Up to 75,000 are likely to be affected by the weekend if members of the 37,000-strong Irish Nurses and Midwives Organisation (INMO) go ahead with a third day of national strike tomorrow.

As of last night, there seemed little hope of a breakthrough in the pay dispute, with the INMO accusing the Government of “recycling” ideas and calling on them to “come to the table unconditionally”.

Adult mental health services will also come under considerable strain today and tomorrow due to a ban on overtime, including night rosters, as members of the Psychiatric Nurses Association (PNA) engage in industrial action. The union has warned that services are heavily dependent on overtime. The PNA’s 6,000 members are also seeking improved pay.

Doctors will join the unrest with a National Association of General Practitioners-organised cavalcade of cars set to travel to the Dáil to protest at conditions and pay cuts.

The NAGP is calling for the unconditional reversal of pay cuts enforced during the recession. It claims the Government has abandoned general practice to the point where it is almost “beyond resuscitation”.

However a second doctors’ union, the Irish Medical Organisation, said it hopes to be able to agree a new deal for GPs with the Government “over the coming weeks”.

In a memo to members, it said the reversal of FEMPI measures must happen but GPs must be willing to offer something in return. What it was not prepared to do was “sign up and agree to a whole new contract that will be foisted on GPs struggling with capacity issues”.

The nurses’ dispute dominated a meeting of the Fianna Fáil parliamentary party last night where a number of TDs, including Marc MacSharry, said the current situation is not sustainable.

Mr MacSharry told the meeting that ministers are simply expensive commentators who are on auto pilot.

However, party leader Micheál Martin called for patience, adding that he had been through many crises in his political career and that the nurses’ dispute could be resolved.

In a separate development, Health Minister Simon Harris announced his intention to appoint Fred Barry, former chair of the National Roads Authority, to chair the National Paediatric Hospital Development Board. Mr

Fred Barry will chair children’s hospital development board.
Barry replaces Tom Costello, who resigned at the weekend amid growing concerns around the escalating costs of the new children’s hospital, which now stands at €1.7bn.

The minister said Mr Barry’s “experience and leadership will be invaluable to ensuring the next phase of this project is delivered for future generations”.

The minister also confirmed that revised terms of reference for the PWC review into the cost escalation have been finalised.

The controversial reference to stopping short of holding individuals culpable has been removed and PWC has been given the additional task of developing recommendations around possible cost saving, as well as bringing “greater oversight of performance and value for money”.

The review will be completed by March 29, instead of March 22, “subject to availability of relevant documentation and personnel” and “will inform any governance or other changes required”.

The review will deal with the accountability of key parties, functions, and roles.

Source: Irish Examiner
By: Catherine Shananhan

A 37- year old mother of two with terminal cancer has launched a High Court action against a GP claiming alleged negligence over a visit to the doctor after she found a small lump under her arm while in the shower.

Christine Rossiter, Mr Justice Anothony Barr was told, has only months to live after a tumour was found in her breast in 2016 and she has developed secondary cancer including in her brain.

The young mother told the High Court today that she feels like a “ticking time bomb” after a new tumour was found in her brain last year.

Ms Rossiter has sued GP Norma Donlon over a consultation she had with the doctor in 2014.

Christine Rossiter pictured leaving the Four Courts today. Photo: Collins.
Opening the case, John Gordon, SC for Ms Rossiter, told the court Ms Rossiter contends the doctor did not examine her breasts but the doctor’s note said ‘declined breast exam.’

Counsel said the visit lasted 12 minutes and Ms Rossiter would say she was made feel she was worrying too much and was like a “little bit of a hypochondriac”.

Counsel said Ms Rossiter also felt embarrassed and the doctor told her at her age she had nothing to worry about.

The woman claims the doctor did not examine her breasts but the doctor’s note said ‘declined breast exam’.

Some smear tests offered in wake of CervicalCheck scandal need to be repeated, Taoiseach says
Counsel said Ms Rossiter left feeling a little foolish but very relieved after the 2014 visit.

In August 2016, Ms Rossiter felt a little lump on her left breast and went to another doctor who referred her for further investigation.

It turned out she did have a cancerous tumour in her left breast and was referred to a consultant.

Counsel said the cancer found was Stage 2 and while it was significant it was not life-threatening and would require chemotherapy.

Ms Rossiter went for immediate treatment and had a number of scans which showed she had secondary cancer in various parts of her body.

“What was a dreadful situation unfolded as absolutely calamitous,” Mr Gordon said.

The secondaries in her lungs she was told lit up like a Christmas tree on the scan. It was Stage 4 breast cancer and it was terminal.

He said Ms Rossiter was devastated and she began a form of palliative care and treatment.

Counsel said Ms Rossiter was shell shocked and angry and embarrassed to be a dying person.

Counsel said at that stage it was confirmed she was unlikely to live more than five years and the cancer has since proved to be relentless.

Her prognosis at this stage counsel told the court is now a number of months.

“The tragedy here is the missing of the opportunity to detect the problem in September 2014,” Counsel added.

He said Ms Rossiter will say she was not asked by Dr Donlon to examine her breasts and his side will contend it is highly unlikely Ms Rossiter would have refused a breast exam.

“If the examination occurred it would have identified a tumour in the left breast. That sadly did not happen,” Counsel said.

“That little lump under her arm,” he said, “never went away, it was found to be malignant in September 2016,” Counsel said.

Christine Rossiter, Ceanchor Road, Baily, Howth, Co Dublin has sued GP Norma Donlon who was a doctor at Hilltop Surgery which is now known at Raheny Medical Centric Health at Hilltop Shopping Centre, Station Road, Raheny, Dublin.

It is claimed there was an alleged failure to perform an adequate examination of Ms Rossiter’s armpit and an alleged failure to recommend examination of Ms Rossiter’s breast.

It is further claimed there was an alleged failure to adhere to the HSE National Breast Cancer GP referral guidelines and that Ms Rossiter was allegedly exposed to a risk of developing serious illness and injury.

The claims are denied and Dr Donlon contends that Ms Rossiter declined a breast examination when she came for a consultation on September 2014.

In evidence, Ms Rossiter said there was no way she declined a breast examination and it would be silly to do that.

She said when she was told her cancer was terminal she burst into tears and her partner Peter did the same.

“I don’t even remember most of it. It was very distressing. I felt sick,” she said.

The case before Mr justice Anthony Barr continues.

Source: Breaking News
By Ann O’Loughlin

A 33-year old man with cancer who had sued claiming there was an alleged failure at Cork University Hospital to pick up on a pancreatic tumour during a CT scan fourteen months ago has settled his High Court action.

Ben McGuire claimed his scan taken in November 2017 was reported as normal but three months later he had another CT scan in Lithuania which revealed a tumour.

When the case came before the High Court today Mr Justice Kevin Cross was told the case against the HSE had been settled without admission of liability.

Ben McGuire, of Strawhall, Fermoy, Co. Cork, pictured leaving the Four Courts today after he settled his High Court action for damages. Picture: Collins Courts
Mr Justice Cross congratulated the side on the settlement of what he called a difficult case.

Ben McGuire, The Loft, Strawhall, Fermoy, Co Cork had sued the HSE.

It was claimed that upon his admission to Cork University Hospital on November 2,2017, he had a CT scan of his kidneys, bladder and pancreas. The scan was reported as normal and Mr McGuire was discharged from hospital.

His abdominal pain persisted and in February 2018, Mr McGuire sought another CT scan in a Lithuanian Hospital. This scan reported a pancreatic tumour.

It was claimed there was an alleged failure to diagnose his pancreatic cancer which he contended was visible in the November 2017 CT scan taken at Cork University Hospital.

There was it is claimed an alleged failure to treat his pancreatic tumour at a stage before it became further enlarged and he alleged he was denied the opportunity of receiving treatment in respect of the pancreatic tumour before it became metastatic.

He had claimed that on return from Lithuania,he attended at the Mercy University Hospital where it is alleged the findings of the clinic in Lithuania were confirmed. Mr McGuire then began a course of chemotherapy treatment which is ongoing.

The HSE denied all the claims and contended it was not negligent, in breach of duty or in breach of statutory duty. It further contended that while a non contrast CT scan was taken, it is not a recognised method for diagnosing pancreatic cancer.

The tumour, it said, was subtle, so dense to the pancreas and difficult to differentiate from the pancreas. Neither did it have ancillary signs associated with a pancreatic tumour, it contended.

Source: Irish Examiner
By Ann O’Loughlin

A High Court judge has found there was no negligence by a surgeon in his care and treatment of a man who claimed he developed paralysis in his right leg and severe pain after undergoing a spinal fusion procedure in March 2010.

Eugene McCormack, a retired butcher and farmer of Clongowney, Dublin Road, Mullingar, Co Westmeath, previously settled his claims against the Mater Private Hospital and Mater Private Healthcare in relation to a specific incident post-surgery where part of a catheter was left inside him.

A hearing proceeded of his claim of negligence against Dr Marcus Timlin, a consultant orthopaedic surgeon with a practice at the Mater Private Hospital.

That claim was dismissed by Mr Justice Kevin Cross in a judgment today.

Mr McCormack, the judge noted, had a significant past medical history including, from 2007, operations for back pain performed by other doctors.

He was referred in April 2009 to Mr Timlin with back problems “as bad as ever”.

His claim against Mr Timlin concerned the latter’s care of him between March 11 and March 19, 2010.

It was alleged he had developed Cauda Equina Syndrome (CES) which was not addressed until March 19 and, as a consequence of failure to address it in time, suffered significant personal injuries.

The cauda equina nerves spray out from the bottom of the spine leading into the lower limbs and a patient can develop CES if pressure is brought to bear on them.

CES can result in total loss of function of the lower limbs or significant injury and incapacity.

Having assessed the evidence, the judge found, after index surgery on March 10th 2010, Mr McCormack was suffering from a developing CES resulting in pressure on his nerves.

Had a revision operation carried out by Mr Timlin on March 19th been done on March 16th, 17th or possibly 18th, the developing CES would have been dealt with earlier and without, at least, a considerable number of the resulting symptoms, he found.

Had the intervention occurred earlier, Mr McCormack would not have developed the post-operative CES, neuropathic pain in both lower limbs, right-sided foot drop as well as some of the bladder pain, urinary dysfunction and other difficulties, including a considerable amount of his significant depression and two suicide attempts, he accepted.

He also accepted the developing CES was there to be interpreted from films of a MRI scan of March 16.

Despite those findings of fact, the plaintiff had failed to show, on the balance of probabilities, Mr Timlln was negligent, he ruled.

The plaintiff had not shown Mr Timlin’s diagnosis, based on his discussions with the radiologist and an orthapedic colleague, that the MRI films did not demonstrate any haemotoma which might put pressure on the cauda equina nerve, was of such failure no medical practitioner of equal expertise would be guilty of it if acting with ordinary care.

Mr Timlin’s approach was a “gold standard” one confirmed by an independent expert professor and, together with an orthopaedic colleague, conservative management was proposed, he said.

The developing CES was “a marginal thing” and Mr Timlin could not be faulted for his interpretation of the MRI and the course of action he took arising from his opinion.

Had Mr Timlin been made aware of “potentially alarming” findings in a physiotherapy report of March 11th on Mr McCormack, which reported numbness in both buttocks, he was satisfied he would have acted sooner, he said.

It was also “unfortunate, to say the least” that Mr McCormack’s own complaints and concerns to nurses were not fully noted and passed on to Mr Timlin.

He could not conclude Mr Timlin’s decision not to operate until March 18th, where there was a deterIoration of neurological signs, and the operation being carried out as soon as possible on the 19th, was negligent.

Costs issues of the 12-day case will be decided later.

Source: Breaking News
By Ann O’Loughlin

The Minister for Health Simon Harris has declined to announce a catch-up vaccination programme for the meningitis B strain, despite pressure from parents and doctors.

Mr Harris said politicians “don’t make decisions in relation to who we do and don’t vaccinate and what we do and don’t vaccinate for”.

A vaccination against meningitis B has been offered by the HSE to infants up to 12 months since October 2016. Children born before this have not been immunised against the B strain but will have received the C vaccine.

Almost 30,000 people have signed an online petition calling for Simon Harris to implement a catch-up vaccination programme for the meningitis B strain for “all children and teens” in light of the recent cases.

The National Association of General Practitioners (NAGP) has also called for a catch-up programme and said it had been inundated with calls from concerned parents.

Mr Harris said the National Immunisation Advisory Committee (NIAC) provides information to the Minister for Health of the day on what vaccinations should be introduced and who they should be introduced for.

“I and the Government have implemented in full the advice of the National Immunisation Advisory Committee and I will be taking advice from nobody else in relation to vaccinations other than that committee,” he told reporters on Monday.

The NIAC has not recommended a catch-up programme for children born before October 1st, 2016 while the Department of Health has said the majority of cases of meningitis B are seen in children less than one year of age.

Eleven cases of meningococcal meningitis have been notified to the Health Protection Surveillance Centre since the last week of December. Three people have died from meningitis though the HSE has said none of those could be attributed to meningitis B.

The HSE’s Director of Public Health, Dr John Cuddihy, said the uptake of vaccinations “could be a little better”.

No outbreak
Dr Cuddihy said of the 11 cases notified, “all the strains have been evenly represented”, but would not give the specific strains “for confidentiality reasons”. He said there hadn’t been a meningitis “outbreak” but there had been six more cases compared with the same period last year.

“So for parents the key message is to, particularly the 12 and 13-month vaccinations, just to make sure that they bring their children for those, just to complete the schedule,” he said.

Mr Harris also said he wanted to reassure patients that medicines would continue to be supplied “even in the case of a no-deal Brexit”.

“This country is doing everything it possibly can to be prepared for a no-deal Brexit whilst at the same time hoping that that’s not where we arrive at and hoping that the British House of Commons gives careful consideration to this matter tomorrow,” he said.

Nurses strike
Separately, the Minister for Health said there needs to be clarity from the nurses unions how their claims “can be addressed within the context of the public sector agreement”.

Members of the Irish Nurses and Midwives Organisation (INMO) and the Psychiatric Nurses Association (PNA) are scheduled to stage a series of strikes in the weeks ahead. Talks between the unions, HSE and Department of Health are set to take place on Tuesday.

“I have huge time and respect for the INMO and indeed for the work of our nurses and midwives right up and down the length and breadth of the country but I’m also very conscious of the fact that we have a public service pay agreement in place – that is a collective agreement public servants have signed up to and that we can’t have side pay agreements in relation to that,” Mr Harris said.

Mr Harris said strike action was “not good for patients, not good for midwives and, in my view, is unwarranted”.

“There is a way forward, we can find a way forward but that involves willing partners and involves everybody working together and working within the confines of the public sector pay agreement,” he added.

Source: The Irish Times
By: Sarah Burns

Medical Council confirmed its Ethics Working Group is continuing to work on ethical guide

The Medical Council has deleted four paragraphs of its ethical guide and amended another to remove “any conflict” with the newly introduced legis­lation facilitating for the medical
termination of pregnancy.

The deleted paragraphs numbered 48.1 to 48.4 were listed under a section of the ethical guide, last updated in 2016, dealing with abortion.

Paragraph 48.5 under this section has, however, been retained,but in a slightly edited version. The word “abortion” has been replaced by “termination of pregnancy”. It reads: “You have a duty to provide care, support and follow up for women who have had a termination of pregnancy”.

The revision of the abortion section of the Guide to Professional Conduct and Ethics came into force from the commencement of the Health (Regulation of Termination of Pregnancy) Act 2018, on January 1, 2019.

The deleted paragraphs state: 48.1 You have an ethical duty to make every reasonable effort to protect the life and health of pregnant women and their unborn babies; 48.2 During pregnancy, rare complications can arise where a therapeutic intervention is required which may result in there being little or no hope of the baby surviving. In these exceptional circumstances, it may be necessary to terminate the pregnancy to protect the life of the mother while making every effort to preserve the life of the baby; 48.3 Abortion is legally permissible where there is a real and substantial risk to the life of the woman which cannot be prevented by other means.

This risk, while substantial, may not be immediate or inevitable in all cases. This risk should be assessed in light of current evidence-based best practice and 48.4 With regard to abortion abroad, it is lawful to give information in Ireland subject to strict conditions. However, it is not lawful to promote or advocate an abortion in such cases.
Meanwhile, the Council confirmed its Ethics Working Group is continuing to work on the Guide. The Group is reviewing a number of sections, including the four sections it went to consultation on already with the profession and key stakeholders.

They were “Paragraph 7 Dignity of the patient”, “Paragraph 8 Equality and diversity”, “Paragraph 48 Abortion” and “Paragraph 49 Conscientious objection”. After this process, the Group is will make further recommendations to the full Medical Council.

Source: IMT.ie
By Valerie Ryan

THREE legal cases have been initiated in relation to failures at Kerry University Hospital which saw 11 patients given a delayed diagnosis.

A review on more than 45,000 images taken by one radiologist was sparked after a number of patients were found to have cancer after being given the all clear.

Both Fianna Fáil and Sinn Féin raised the issue with Tanáiste Simon Coveney during Leader’s Questions today and urged that there would be efforts made to ensure families did not have to face court battles.

Mr Coveney said that three cases relating to the cases identified in the review have been commenced.

He said the State Claims Agency will manage the claims on behalf of the State and said it was always the objective of the SCA to avoid going to court if it was possible.

Fianna Fáil deputy leader Dara Calleary said 2018 has been marked with a series of tragic incidents including CervicalCheck and the issue of non qualified doctors working in hospitals.

He pressed the Tanáiste on vacancy rates across consultancy posts in the health service, and the impact those vacancies are having on staff and standards of care.

Mr Calleary said there are 500 consultants posts filled by non consultants – some 16pc of the total consultancy posts across Ireland.

In relation to the radiologist whose work was the subject of the review Mr Coveney said the Medical Council were informed about concerns about the radiologist who has resigned from the hospital but that assessment is ongoing.

He did not confirm if the radiologist was still working in the health service.

Pearse Doherty who also raised the issue criticised the fact that there was no timeline for implementing the recommendations made in the review.

Source: Independent.ie
Online Editors

With an overall percentage drop in this year’s HSE budget, primary care’s minuscule share of health spend will continue

Staff shortages and emergency department overcrowding are the top challenges facing the health services, according to a recently published survey by Ipsos MRBI for the Irish Pharmaceutical Healthcare Association. Just over one fifth, (23 per cent) of 1,000 adults surveyed said a lack of staff, including doctors and nurses, was the biggest challenge, followed by 22 per cent who cited overcrowding and the trolley crisis. Waiting times for procedures were seen as the major problem facing the health system by 17 per cent of respondents.

The survey results coincided with the publication of end-of-year hospital trolley figures by the Irish Nurses and Midwives Organisation (INMO). Last year was the worst on record for overcrowding in the public hospitals, nurses said, with more than 108,200 patients who required admission having to wait on trolleys in emergency departments or on wards. The level of overcrowding recorded last year was a 9 per cent increase on 2017.

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Overcrowding on the first working days after Christmas was significantly down on 2017, with between 350 and 370 patients waiting for admission to hospital. However, statistics released by the INMO yesterday showed that that figure had risen since by 150.

Will the Health Service Executive’s 2019 National Service Plan (NSP) address public concerns about the health system? Not according to the Irish Hospital Consultants Association, which says the plan fails to provide the resources to address the system’s overwhelming capacity deficits and manpower shortages.

With just €4.5 million – a 0.5 per cent increase – allocated for new developments in primary care this year, the NSP fails to support the widely agreed need to enhance primary care infrastructure to relieve pressure on acute services. Indeed, with an overall percentage drop in this year’s HSE budget, primary care’s minuscule share of health spend will continue.Based on such a narrow focus, the NSP for 2019 is unlikely to bring about the major changes needed to allay concern about the challenges facing the health service.

Source: The Irish Times