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Health Boards - Case Summaries 1998

Health Boards - Case Summaries 1998

18 March 1999

In 1998 the Ombudsman received 482 valid complaints against the eight regional health boards. This figure shows an increase of 20% over the 1997 figure for health board complaints. In addition to the 482 valid complaints received in 1998, there were 147 health board complaints on hands at the start of the year. This meant there was a total of 629 complaints against the health boards to be dealt with during 1998. Of this 629, the Ombudsman completed his examination in the case of 512 complaints. The outcome in relation to the 512 completed cases was: 72 complaints resolved; assistance was provided in 254 cases; 111 cases were not upheld and 75 cases were either withdrawn or discontinued.

Amongst the cases in relation to the regional health boards, highlighted by the Ombudsman in his 1998 Annual Report, are the following:

o A complaint against the Southern Health Board raised the issue of unfair discrimination against a cohabiting couple vis à vis a married couple. The complaint related to the operation of the Drugs Costs Subsidisation Scheme under which, at the time, eligible people paid only the first �32 per month of prescribed drug costs. In the case of a married couple, only the first �32 per month of expenditure between the couple was payable. The Ombudsman's complainants, though living together as man and wife, were not married to one another and each was being required to pay the first �32 per month of drug costs. This meant that between them they were paying �64 per month towards drugs whereas an equivalent married couple paid only �32 per month. When the Ombudsman raised the issue with the Board, it felt it was complying with Departmental guidelines; so the Board referred the matter on to the Department of Health & Children. Ultimately, the Department took the view that, as health legislation does not clarify how to deal with this type of situation, it would be reasonable to follow the practice of social welfare law where, in certain contexts, a cohabiting couple is treated as if it were a married couple. On this basis, the Ombudsman's complainants were given the advantage of paying only the first �32 per month between them. They were paid a refund of �1,000 to cover the extra costs incurred in the two years prior to the new decision. The Ombudsman asked the Department to ensure that all health boards are told of the new decision (P.23 of Report).

o A complaint against the North Eastern Health Board raised the issue of misuse of statutory power by the Board. A widow complained that the Board had deducted an amount of �120 from her pension to meet a disputed hospital charge. As a former employee, she was being paid an occupational pension by the Board. The Board had sought payment from her of outstanding hospital charges which actually related to her late husband. The widow felt that these charges were now a matter for the executors of her late husband's will and she declined to pay them. The Board, however, did not accept this and decided to deduct the claimed amount, at a rate of �20 per week, from the pension it was paying the widow. When the Ombudsman examined the case he felt that what the Board was doing constituted an abuse of power and that it should not exploit the widow's position as a recipient of a pension from the Board; he felt that whatever debt collection arrangements are used generally should be applied in this case also. Ultimately, the Board accepted that its action was untenable and refunded the �120 already deducted. The Ombudsman regards the principle, that powers may not be used, other than for the purpose for which they are given, as extremely important. Public bodies must resist the temptation to use powers, given for one purpose, to deal with a perceived problem in an unrelated area. (P. 22 of Report)

o A complaint against the Western Health Board and Castlebar General Hospital related to a mistake in identifying the correct hospital record for a particular patient. The complainant claimed that, on a particular admission to Castlebar Hospital, his late mother had been treated by reference to the hospital record of a different patient. Because of this mistake, he claimed, his mother had been treated as if she were a diabetic (and had insulin and morphine administered) though she was not a diabetic. When the Ombudsman examined the complaint, the Hospital acknowledged that, initially, an incorrect hospital record had been used in treating the patient. It acknowledged that, initially, the patient had been treated as if she were diabetic and had her sugar levels monitored. However, the Hospital denied that insulin or morphine had been administered. Furthermore, the Hospital said that it had improved its hospital record retrieval system and that the likelihood of a similar mistake recurring were now much reduced. The Ombudsman had one of his staff visit the Hospital to inspect both the particular hospital records and also to examine the records system in general. The Ombudsman concluded that there was no reason to doubt the veracity of the hospital records (the correct ones) which made no mention of either morphine or insulin having been administered to the patient. The Ombudsman also established that this conclusion was in line with that of the Chief Medical Officer of the Department of Health & Children who had separately looked into the issue. However the Ombudsman, in reaching his conclusions, acknowledged the real anguish suffered by the patient's family as a result of the mistake which the Hospital, on its own admission, had made in relation to the records. (P. 24 of Report)

The full text of the Annual Report, including the above cases, is available on the Ombudsman's Internet site ( http://www.irlgov.ie/ombudsman/ ).[

Enquiries to Fintan Butler at 01-6785222,