Sunday, May 25, 2008

CDA Corner – with photos supplied
In an effort to communicate better the work of the Ballymore EustaceCommunity Development Association (CDA) and its subcommittees, we intendto have a standard slot and this feature slot 'CDA Corner' monthlyin The Bugle.Hopefully these articles will help to inform people as to what our function is, the kind ofwork the CDA committee and indeed the sub committees of the CDA are involvedin, who we are and how to get your comments, views and suggestions to usso that we can work better on your behalf.

Even though we are a couple of months into 2008, the CDA committee felt that it was a good idea to communicate to you make up of the CDA committee members for 2008 and the positions people hold on the committee. Hope the photos help you identify us!

The 2008 CDA committee is made up of nine people and these are:
Fiona Breslin (chairperson), Patricia Donnelly (vice chairperson), Kay Nolan (secretary), Margaret Mc Donald (treasurer), Fintan Smith, Rachel Edwards, Maurice Mason, Eric Firth and Mary Deegan.In the last few weeks we have also been trying to gather details of the subcommittees of the CDA (names, positions and contact details) so that we arebetter positioned to communicate with the subcommittees and assist personswishing to contact any of these sub committees. We would kindly requestthat when sub committee members change (which is usually an annual event)
that this information is communicated to the chairperson of the CDA (contactdetails on page 2 of bugle) so that all information we have is up to date.In future editions of the Bugle we hope to bring you more indepthinformation on how the CDA operates and what type of work we are involved in.As always we welcome your comments and suggestions as to:- what you would like to see us working on, on your behalf- how we can improve the way we operate- how we can improve communications with you the people of Ballymore Eustacewhom we represent.Many thanksFiona BreslinChairperson CDA

on passing by- again
I am not even going to comment on the following.
Eddie O’Sullivan after the match against Wales.
“Yes, I accept that we lost but that’s not necessarily a negative outcome”. ?????????????.
What exactly are we to make of the cancer treatment, or the lack of treatment, in Midlands Regional Hospital.
After some staff at the hospital expressed serious concerns, late last August the hospital undertook to carry out a review of its cancer services, and suspend breast radiology services pending an outcome. The review was to cover both mammography and ultrasound and yet within days there was already confusion as to whether these were one review or separate reviews. This confusion became totally obvious when the HSE gave evidence to an Oireachtas committee in late November about the review it had carried out and within a short space of time the Minister for Health called for an independent report of the HSE review.
This report, which was compiled by a former Dublin city manager, John Fitzgerald, is a damning indictment of an organisation which he says is riddled with failings from the very top to the very bottom.. Mr Fitzgerald said he had identified systemic problems with governance, management and communication within the HSE.
His report was to examine what went on between the decision of the hospital in late August to suspend breast checks until the review was presented in late November. Despite what I can remember of media reports at the time the hospital was initially worried that it was over diagnosing i.e. the hospital was finding cancers that on a second examination were not cancers. This it felt was putting the patients involved to unnecessary anxiety and delay in relation to a proper diagnosis, and the hospital requested St Vincent’s Hospital to review all its mammography files back as far as November 2003.
This was only for mammography files as they have a photographic record of the scan, unlike the ultrasound scans which have no permanent record except for written notes, which Portlaoise were going to re examine.
This is where the HSE started to put its foot in it. To allay what it felt was rising public concern it issued a press release on September 3rd saying “all breast diagnosis patients” were to have their cases reviewed and that they would contact any affected patients directly. Four days later another HSE release again said that “ any patient affected “ would be contacted.
At this time concerns were being raised about the need to coordinate the review so another body, the Review Facilitation Group, was set up, even though by this stage there were in effect two reviews going on, one in St Vincent’s and a review in Portlaoise of the ultrasound notes.
Around this time a draft protocol for the review was circulated to all concerned but it seems this was never properly discussed or adopted so the now separate reviews continued on their own paths.
By the middle of September press releases from the HSE referred almost exclusively to the mammography review and indicated it would be finished in a “ couple of weeks”. By the middle of October, a month later, the ultrasound review had recalled 48 women for further examination but HSE press releases continued to refer only to the mammography testing, and continued to contradict themselves. On November 2nd they said that test indicated that of the women recalled 7 had now been diagnosed with cancer but on November 7th said that they could not anticipate any of the findings. So which release was right?.
On November 6th the HSE gave information to the department concerning the review of “ all “ breast diagnosis services at Midland Regional and that it was being led by the consultant radiologist at St Vincent’s, even though we now know they were in effect separate reviews. On the same day a different HSE source sent further information to the department re a singular review of mammograms and ultrasound, which means that even after weeks of two reviews somebody in the HSE thought there was still only one review, and was unaware that Vincent’s had in fact finished their review. Even with this obvious contradiction it took until November 21st for someone in the department to notice and query the HSE, which replied that there were in fact two reviews, one of which was still ongoing.
The following day the HSE told an Oireachtas committee that a total of 97 women were being recalled after the ultrasound review, even though they were aware that the review wasn’t finished, and none of the women concerned had been notified. The eventual figure for recalls was 130 and no misdiagnosis were found.
Mr Fitzgerald says that for both reviews the amount if work carried out in the timeframe available was extraordinary and attaches no blame to the people on the ground, most of whom were also doing their normal daily duties. No, the whole debacle as far as he is concerned can be laid squarely at the feet of the HSE. Just consider some of his comments:
“Communications throughout were inconsistent, and often contradictory”
“ Different people had different views of what was going on, with a lack of clarity about the nature and status of the terms of reference and methodology”
“ There was a lack of urgency from corporate and local HSE to the review process.
“ There were too many people involved, from too many levels of the HSE, without clarity about their roles and responsibilities. Decision making was fragmented ,with insufficient clarity about decisions, who was making them, why they were being made, or when they were signed off”
“ In my view the inconsistency and lack of clarity on communications was an inevitable result of the deficiency in the overall management of the process”.
“The communications difficulties that arose cannot be separated from the weakness of management and governance in the process. In the intense activity surrounding the review, the needs of the patients potentially affected receded”
And at the end of all the reports, interviews and wringing of hands it appears that yet again no one is responsible for anything that went wrong . Minister Harney and HSE chief Brendan Drumm while apologising to the affected patients for the lack of care they received still feel that the responsibility for the whole debacle rests with others.
All for now. Mike Edmonds.

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