The Ombudsman, Peter Tyndall, has said that it is a “matter of frustration” for him that he has not been given the power to investigate the tragic and shocking death of Ultan Meehan in Kilbrew Nursing home in Meath earlier this year.
Mr Meehan suffered from dementia and also from cancer of the head which had caused tumours to appear on his face. To the horror of his wife Mary, video footage released to her after his death showed that his facial sores, which her husband had scratched into an open wound, had become infested with maggots. He died of sepsis on June 15th.
Because of Covid-19 restrictions, Mary had been unable to bring Ultan home since February. When a visit was finally allowed on May 14th, she was deeply shocked at the horrific condition of her husband. She later said to the Irish Times, that “the side of his face was black with congealed blood. His nails were long and black from picking at his facial tumours, which had become an open wound and infected.”
Mrs Meehan has spoken of her hurt and anger that the Minister for Health, the Department of Health, the HSE and HIQA have all refused to investigate what happened.
Aontú County Councillor Emer Tóibín recently wrote to the Ombudsman to ask if he would investigate this horrific situation. In a reply to Councillor Tóibín, the Ombudsman said that he has no power to examine the complaint, although he had asked repeatedly that his office be given powers to look into cases involving “clinical decision-making”.
“The Ombudsman Act 1980, as amended, sets out the role of my Office to examine complaints in relation to the administrative functions of services providers, including private nursing homes. In this context, administrative functions would include the everyday executive/administrative activities carried out by staff of the nursing home,” he wrote.
Therefore, in accordance with the legislation, I am not in a position to examine complaints, which in my opinion, relate to actions taken solely in the exercise of clinical judgement by a healthcare official in connection with the diagnosis of illness or care or treatment of a resident of a nursing home. In this context, clinical judgement is considered to be in relation to diagnosis, treatment & care, admissions, discharge and prescriptions. As a result, in a complaint such as this, any decisions or judgements made by a healthcare professional, when they are acting solely in the exercise of clinical judgement in relation to a resident’s diagnosis, treatment and care, or admission/referrals to hospital does not fall within my jurisdiction and are excluded from any examination, which would be carried out by my office,” he explained.
The Ombudsman said that he has asked to be given powers to examine cases such as that of the Ultan Meehan’s, to no avail. He spoke of his “frustration” of having his hands tied by the legislation.
“As you are aware, in response to the issues arising in the context of the COVID 19 health emergency, I have once again raised the issue of extending the remit of my office to include clinical judgement. The vast majority of cases relating to the health care sector involve some element of clinical decision-making. It is a matter of frustration to me and complainants that these cannot be addressed by my Office. As a result, opportunities for learning and improving the delivery of health care are constantly being missed.,” he wrote to Cllr Tóibín.
Aontú leader Peadar Tóibín told the Dáil that: “It is absolutely astounding that the government will not do the right thing for Mary and her family and investigate this. But the government have form. They have refused to date to investigate the shocking number of deaths that happened in the Nursing Home Sector during this time. Almost 1,000 people died from Covid in Nursing Homes. I am not aware of such a shocking loss of life in institutions in such a short period of time ever before. Yet there is such government resistance to investigating what happened”.
Its clear that there is a massive chasm of accountability here. The Ombudsman has been very forthright. He has raised the issue of extending the remit to investigate the clinical judgements at the heart of this case and others. He has stated that the vast majority of cases relating to the health care sector involve some element of clinical decision-making. He has gone as far to say that he is frustrated that he cannot investigate these harrowing tragic cases.