Deadlock in Savita investigation as family demand public inquiry

The HSE’s handling of the inquiry into the tragic death of the 31-year-old dentist Savita Halappanavar at University Hospital Galway last month has been slammed as “shambolic” by the chairperson of the HSE West’s regional health forum.

Cllr Padraig Conneely said the decision to include three UHG hospital consultants on the inquiry team - they have since been removed by Taoiseach Enda Kenny as it is understood her husband Praveen would not co-operate with the investigation because of their inclusion - was “ill advised, badly thought out and doomed to fail” from the start.

In his first television interview in Ireland, broadcast on RTÉ's Prime Time last night, Praveen Halappanavar said the family wants a public inquiry funded by the Government. Mr Halappanavar said he has no confidence in the HSE to lead the investigation, saying he fears there could be some bias if it is carried out by people paid by the executive.

Ms Halappanavar, who was originally from India, was 17 weeks pregnant when she died at the west’s biggest hospital on October 28 from blood poisoning. She presented with back pain at the hospital a week earlier and was found to be miscarrying. Her husband, Praveen, an engineer at Boston Scientific, claims she was denied a medical termination despite repeated requests over a three-day period. He alleges this was refused because there was still a foetal heartbeat. Reports claim she spent a further two and a half days in “agony” until the foetal heartbeat stopped. After the dead foetus was removed Ms Halappanavar was taken to the hospital’s high dependency unit and then the intensive care unit. She died there of septicaemia.

Lashing out at the HSE Cllr Conneely claimed it was incapable of making a decision or “getting the very basics right on an issue when a patient died”.

“The public’s confidence in the HSE is in question and the setting up of this inquiry has run into a brick wall even before it starts,” he said.

Cllr Catherine Connolly, a former vice chairperson of the HSE West’s regional health forum, claimed the Minister for Health’s failure to insist on an independent inquiry from the outset raises serious questions about his judgement.

“His failure to insist on an independent inquiry with clear terms of reference and a specific timeframe is a very serious failure on his part and he must be called to account for this failure which has led to a serious crisis in confidence in our health system.

“The original nomination of three consultants from the hospital, which is under investigation, onto the inquiry panel was an extraordinary decision and certainly did not inspire confidence.

“In addition, the decision to appoint a person from the HSE National Incident Management Team has also to be questioned. This is a body which is an integral part of the HSE organisation with very specific responsibilities in relation to risk management and health and safety of patients. It is also the body to whom the hospital reported the matter. Surely it was clear to everyone from the beginning that any of these people could have a role in giving evidence to the inquiry rather than form part of the panel of inquiry?”

She stated there was a deafening silence from UHG, the HSE, the National Incident Management Team in Dublin and the Minister for Health until after the story hit the headlines in the Irish Times last Wednesday.

Cllr Connolly is calling for an expeditious and completely independent inquiry “at the very least”. She said Ms Halappanavar’s family deserve this and it is also essential to restore public faith in the health service.

“The inquiry should look into (i ) the seven day period in University Hospital Galway from Savita Halappanavar’s admission on the 21st October to her unfortunate death on the 28th October.

(ii ) the immediate period after the death, including the risk review/assessment carried out by the hospital itself, and any or all contact between the hospital and outside bodies.

(iii ) the period from her death to when the Irish Times reported the story on 14th November including the role of the hospital itself during that time, the role of the HSE nationally, the role of the National Incident Management Team in Dublin from the point when this team became aware of the case, the role of the Minister for Health who also was made aware of the case, together with a review of all investigations carried out to-date.”

Meanwhile Deputy Derek Nolan, the Labour Party TD for Galway West, wants the X case to be legislated for urgently to safeguard the lives of Irish women.

He said that bringing legal clarity to the issue has been a longstanding ambition of his party. “It is now 20 years since the Supreme Court made its finding on the X case. We as a society have been putting this off for 20 years and it is now high time that we as legislators dealt with the implications of this case.

“This is a sensitive issue but I think that it is high time this saga was brought to a close and that the legal issues around it were cleared up. Six Governments have presided over policy decisions in Ireland since the Supreme Court judgement on the X case in 1992 yet not one had the courage to deal with this situation.

“The death of Ms Savita Halappanavar at University Hospital Galway recently is tragic and heartbreaking and I am very concerned at reports that I have read on the circumstances of her death and of the nature of engagement with consultants. I am aware that a number of investigations are taking place and I have called for a thorough and speedy investigation into what happened. It is crucial that we get answers.

“Whatever the exact causes of Savita’s tragic death it has brought to the fore in such a sad way the ambiguities and uncertainties of the law. We now need to provide legal certainty and legal clarity for doctors, the State, but most importantly for women.”

Galway Pro-Choice group lent its voice to the call to legislate on the X Case. “The lack of swift action from the Government is a concern for many. Government statements that it will take months to get legal clarity are unacceptable. Minister Reilly has indicated that it may take weeks or months for him to bring the Expert Group Report to Cabinet. It has also been stated that the Government will not act until the investigations are completed, which are due to take at least three months. We cannot afford to wait such a length of time for action on lifesaving abortion in this country. The impossible limbo that doctors are in has been illustrated by this tragedy. Legislation must be implemented immediately or more women may die.

“Minister Reilly must instigate a fully independent public inquiry now. The presence of only one independent expert in the HSE’s investigation is intolerable. We cannot expect UHG or the HSE to be truly objective in this situation and to reach independent conclusions. Therefore we are calling for a fully independent public inquiry to be commissioned immediately.

“The Expert Group Report should be released to the public immediately. There is a need for full transparency with an issue as grave as this and we call on Minister Reilly to make the report public. There is no good reason not to share this information with the public.”

Sarah McCarthy, Galway Pro-Choice spokesperson, claimed the Government’s response was a “repetition of history”.

“Once more we have a small group of powerful men keeping information from the public and making decisions about women’s lives themselves.”

Rachel Donnelly, Galway Pro-Choice member, outlined that demonstrations had taken place around the country and across the world following Ms Halappanavar’s tragic death.

“The reaction that we’ve gotten here in Galway has been incredible. It is vital that we don’t let this tragedy pass from our consciousness with the turning of the news cycle. We must honour her memory and continue to exert pressure until the Government listens to the people of Ireland. The vast majority of people agree that we have to legislate for the X Case. There is no reason to delay it another day.”

Fine Gael senator Fidelma Healy Eames said the findings of the investigation into Ms Halappanavar’s death must be made available at the earliest opportunity.

“We need these results to have faith in them and trust them before we consider the expert group’s report. We don’t know what the facts are around her death. Right now this tragic case of Savita’s untimely death is being used to muddy the waters on the whole issue of abortion.

“I’ve asked in the senate for the Taoiseach and the Minister for Health to intervene immediately, if necessary to meet her husband, to get his goodwill so we can move forward. We need confidence in the results of the investigation, we do not want to feel that the truth is buried.”

Independent senator Rónán Mullen wants Professor Sabaratnam Arulkumaran, who will chair the HSE inquiry into the death of the late Ms Halappanavar, to be removed because of what the senator claims is his support for abortion.

“This appointment cannot stand, in the light of what we have now learned,” said Senator Mullen. “According to an RTE news report, Professor Arulkumaran has expressed views about abortion in a joint paper published in 2009 in the International Journal of Gynaecology and Obstetrics, saying he would like ‘to challenge and encourage societies and countries with restrictive abortion laws to look at the evidence available in favour of liberal abortion laws, and debate the possibility of making the choice of termination of pregnancy a legal right for women’.

“It is quite clear, to judge from the comments reported by RTÉ, that Professor Arulkumaran is expressing radical views on abortion here. It is remarkable how the HSE could have deemed a person in this position to be an acceptable choice, whatever his professional competence, given the controversy surrounding what happened in Galway and its linkage with the ongoing abortion debate in Ireland.

“If the presence of Galway-based consultants were deemed to taint the perceived impartiality of the inquiry, leading to their removal, the proposed chairman’s history of advocacy for abortion must surely injure the inquiry’s credibility to an even greater degree.”


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