The Need for Transparency Around Health Data

[Speaking in the Seanad during Order of Business]

I wish to comment on reports over the weekend about wide disparities in survival from cardiac events or heart attacks in hospitals across the country. This had a particular resonance for me because in the early years of this particular Seanad, similar specific allegations were made about Roscommon hospital and at the time, it appeared as though those allegations were being used in defence of a policy of changing the status of that hospital. Subsequently, Members found out that the figures upon which those assertions were made were incorrect.

There appears to be a strategy of selectively leaking some as yet unsubstantiated figures to the press, which sometimes seems to resonate with certain policies that are being advocated by some of the folks who run the health service. I do not refer to the Minister, Deputy Varadkar, in this regard but more to the longer-standing administrative policies. It is important that the air now be cleared and that Members find out precisely what was the basis for the figures, what methodology was used and what is the true position.

It now transpires that in the case of the event in Roscommon several years ago, what was happening was that junior doctors were writing heart attack as a cause of death on death certificates because ultimately, that is what everybody dies from at some stage. One could argue that the last thing that occurs to people while they are alive is their heart stops beating but these deaths were going into the record as heart attacks and in that situation, a heart-attack of course would have a rather high mortality rate and this tended to distort the figures. Moreover, it was not gelling with the figures being produced by Dr. Paddy McHugh’s unit for patients who were admitted to cardiac care in Roscommon and who were found to have heart attacks.

The HSE subsequently stated the figures and assertions were incorrect and it has been a long-standing bone of contention of mine but I believe an apology must be made to Dr. Paddy McHugh and his staff in Roscommon hospital, about whom it was suggested there was an untowardly high incidence of fatal outcomes associated with cardiac events, which was not true. In the future, however, it is of critical importance to have disclosure. What was the basis for these figures, what methodologies were employed and can the health authority stand over the methodologies? Moreover, if they are true, what corrective action is being taken?

I note in passing that the waiting list figures are not getting better and the great open sore in Irish health care is still gaping wide. It is not specifically the fault of the present Government any more than it was of its predecessor but it certainly should send a message that something very different must be done. We have had such waiting lists in times of booms and busts, in recessions and depressions, as well as in times of high and low public spending. There is something wrong with the way in which health care is funded and this has been pointed out. Will the Leader make representations to the Department of Health that there be a public registry? The Department has come under terrible pressure from, and has stood forthrightly against, the tobacco industry. I am very conscious that the Minister for Health, Deputy Leo Varadkar, and his predecessor, Deputy James Reilly, have taken correct positions in opposing and fighting the tobacco industry’s incursions. It would be useful for the rest of us if we knew exactly who was being put under pressure and at what level. The United States Chamber of Commerce has engaged in this. Have agencies of the US Government or politicians made representations? We know of at least one, the former Governor of Virginia, who did. This should be a matter of public debate because we need to be able to challenge the people concerned and put the matter in the public domain.

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