A former vice-chairperson of the HSE West’s regional health forum insisted this week that there is “an absolute necessity” to hold an independent inquiry into the death of Savita Halappanavar, the 31-year-old dentist who died at UHG following a miscarriage last month.
City councillor and former mayor Catherine Connolly was speaking after senior management at the west’s biggest hospital read a statement outlining the action taken following the young woman’s death.
The meeting of the forum at Merlin Park Hospital on Tuesday was told that investigations are being carried out into the tragedy by HIQA, an investigation team established by the health authority and the coroner.
Cllr Connolly questioned why it had taken the HSE a month to provide clarification on its actions and asked why was there such an “absence of comment” and “utter silence”.
She told this newspaper that its statement confirmed “in the most acute way” that the health authority “cannot investigate” itself. She also called for Health Minister James Reilly to consider his position in relation to this tragic case.
Her comments came as members of the 40-person forum which covers nine counties - Donegal, Leitrim, Sligo, Mayo, Galway, Roscommon, Clare, Limerick and North Tipperary - voted to defer a call for a public inquiry until the findings of the other investigations into her death are known.
Cllr Connolly claimed the HSE and the National Incident Management Team [which ensures that “incidents are reported, investigated and acted on effectively and with the appropriate level of urgency”] was “compelled” into action by the publication of the story of Savita Halappanavar’s death in a national daily newspaper.
“Given the contents of this written address one can only conclude once again that the HSE/NIMT was compelled into action by the publication of the story of Savita Halappanavar’s death in The Irish Times on the 14th November,” she said.
“In these circumstances now more than ever a swift and fully independent inquiry is an absolute necessity not just for the family but in order to restore confidence in the HSE as an institution. The terms of reference of such an independent enquiry must include an investigation into the role of the HSE/NIMT and the Minister for Health after they were notified of Savita Halappanavar’s death up to the 22nd November when the HSE finally requested HIQA to carry out an investigation.”
She said the information given by hospital management to the health forum members was “very helpful”.
“The address confirmed that the hospital established an internal review into the death of Savita Halappanavar on the 30th October and also notified the HSE’s National Incident Management Team on the same day. It also confirmed that the medical director of the hospital wrote to Mr Halappanavar on the 31st October offering his condolences and confirming that there would be an internal investigation into his wife’s death and a coroner’s inquiry.
“The written address from management also confirmed that UHG commenced the process of identifying suitably experienced clinicians in the appropriate/relevant fields and preparing terms of reference for the internal review. Inexplicably, however the written communication then jumped to the 14th November when on the same day as the story of Savita Halappanavar’s death appeared in The Irish Times, the HSE confirmed that the National Incident Management Team would oversee the investigation and the internal review would be subsumed into that process.
“Having completely failed to clarify what happened during the period of time between the establishment of the internal review on the 30th October and the HSE announcement on the 14th November that the NIMT were taking over, the written address moved to the 19th November and simply recorded the HSE’s announcement of the appointment of an independent international expert in obstetrics and gynaecology as chair of the investigation team as well as the other members of the investigative panel (three of whom have since been replaced ).”
Bill Maher, the CEO of Galway and Roscommon University Hospitals Group, stated he had privately and publicly expressed its condolences to Mr Praveen Halappanavar and again extended its heartfelt sympathy to he and his family and friends.
He said Savita Halappanavar’s death was the first maternal death at University Hospital Galway in 17 years.
Tony Canavan, the chief operating officer for the group, speaking in his capacity as general manager of UHG, stated it was co-operating fully with the HIQA investigation at UHG, the investigation team established by the HSE and with the coroner.
Outlining the key actions taken by the hospital in response to the tragedy, he said on October 31 the group medical director wrote a letter of condolence to Mr Halappanavar in which he also advised him there would be an internal investigation into his wife’s care and a coroner’s inquiry. The letter was sent to him via a friend and via his solicitors. Mr Canavan said the medical director and hospital counsellors will provide him with any support he might require.
“As is the normal legal requirement in the case of maternal and other untimely deaths, the coroner was immediately informed by University Hospital Galway and the coroner is conducting a separate legal enquiry into the cause of death. As you are aware, the role of the coroner is a very important independent legal process. We always co-operate fully with the coroner and he has been reassured of our full co-operation in this matter.
“In line with national and international practice, an internal review was established by UHG on October 30 and the HSE’s National Incident Management Team was verbally notified, followed by a formal notification on November 1. UHG commenced the process of identifying suitably experienced clinicians in the appropriate/relevant fields and preparing terms of reference for the review.
“On November 14 the HSE confirmed that the National Incident Management Team (NIMT ) would oversee the investigation and the internal review was subsumed into that process. On November 19, the HSE announced an independent international expert in obstetrics and gynaecology as chair of the investigation team and provided details of the other team members.”
He emphasised that UHG is co-operating fully with the investigation team and with Mr Halappanavar’s legal representatives in his requests for medical records. He said because the medical records will be considered by the three investigations it is not appropriate to make any comment on this.
“The past weeks have been very difficult for everyone connected with this tragic event, not least of all Mr Halappanavar and his family and friends. They have also been very difficult for the staff at University Hospital Galway and we are assisting and supporting them in every way. We must ensure continuity of the highest levels of care and we know that we can count on all staff to deliver an excellent service to our patients.”
He went on to thank the people who have “not rushed to judgement” on this issue and said the hospital was “fully committed to taking on board all of the learning that will come out of this difficult time”.
Meanwhile Cllr Brian Meaney (Clare ) urged the HSE to accede to Praveen Halappanavar’s request for a sworn public inquiry.
Cllr Mary Hoade (Headford ) felt the investigations should be given due process. She said it was important that a message was sent out that UHG had an “excellent” maternity department.
Forum chairperson Cllr Padraig Conneely offered his condolences to Mr Halappanavar, as did other forum members, adding that his wife’s death had made world headlines.
Cllr Richard Butler (Limerick ) urged forum members to “ hold counsel” until the findings of the reports by the three investigating bodies were known.
“Until we have one or other of the report, hold fire,” he said.
Cllr Sean McManus (Sligo ) said the issue had been handled “extremely poorly” since Ms Halappanavar’s death. He claimed that because of the way it was handled “significant damage” had been done to Ireland’s reputation.