Clontarf Hospital

CONCERNS HAVE BEEN raised at a Dublin hospital after a psychiatric patient, who had professed to have suicidal ideation, left his ward and attempted to take his own life in a staff pantry.

The man was prevented from taking his own life after staff reacted quickly upon discovering him engaging in self harm on an evening last year.

The incident, which occurred at Clontarf Hospital on the city’s northside, involved the man in question leaving a shared ward and wandering through the hospital to the pantry where he engaged in self-harm with a breadknife.

The man, who was recuperating in Clontarf after undergoing a surgical procedure at another hospital in the city, had made multiple suggestions to staff that he was planning to hurt himself if he could in the days leading up to the incident and had been behaving erratically on the ward.

Multiple sources claim that staff subsequently made management at the hospital aware of the situation on multiple occasions, but that no additional supervision of the patient was put in place.

TheJournal.ie requested comment from Clontarf Hospital regarding the incident and those staff claims, specifically as to whether they were aware of those warnings from staff that the patient in question could be a risk to himself and that he would require extra supervision.

“CHO (Community Healthcare Organisation) Dublin North City and County has regular performance meetings with management from Clontarf Hospital,” a spokesperson for the hospital said in response.

“In 2017, Clontarf Hospital complied with the HSE Safety Incident Management Policy and as such all incidents were reported and actions taken in line with this policy. All staff in Clontarf Hospital are expected to report incidents in line with the HSE policy in this area.”

“Clontarf Hospital has an admission criteria in place so that the hospital can safely meet the care needs of admitted patients,” they said.

The hospital declined to say whether or not the HSE or gardaí had been made aware of the incident in question, but said it “does not comment on individual patient cases”.

“When concerns arise with patients with mental health issues they are referred to the appropriate service,” the spokesperson added.

Clontarf is part-funded by the HSE, but is not operated on a day-to-day basis by the executive.

Health watchdog HIQA (Health Information and Quality Authority) has meanwhile confirmed that it has yet to perform an inspection of any sort of Clontarf Hospital.

Rehabilitation

Primarily an orthopaedic hospital, Clontarf offers ‘step-down’ services (eg convalescence from surgical procedures and rehabilitation) from Beaumont and the Mater Hospital, together with Cappagh National Orthopaedic Hospital. It also operates a non-urgent x-ray department.

In recent years, Clontarf has also served as a rehab facility for ‘frail elderly’ patients, and some psychiatric patients also, categories of patient who had hitherto not been taken on by the hospital.

Since 2013, the hospital has experienced high levels of staff attrition, losing more than a quarter of its staff in just two years between 2016 and 2017.

It’s believed that the staff who have left have been replaced.

A further five nursing staff are understood to have left the hospital since TheJournal.ie published an article detailing the staff turnover rate there in July of this year.

The overall number of staff at the hospital is understood to be in the region of 160.

“Back as far as last February I brought my concerns with regards the clearly dysfunctional situation in Clontarf hospital to the attention of the Minister for Health,” said Peadar Tóibín, the Sinn Féin TD who first queried the levels of staff turnover at the hospital earlier this year.

Staff turnover in the hospital was way off the scale in the hospital and it was clear that there was something radically wrong. The Department of Health bounced back a standard reply ignoring the glaring facts that the hospital was an outlier in terms of shedding staff.

“Shockingly seven months later allegations are still emerging that staff are being tasked with life and death situations that they are not equipped to deal with,” he said, adding “the only evidence missing is that the Minister for Health Simon Harris is dealing with it” (TheJournal.ie has requested comment from the Department of Health – the department referred the matter to the HSE).

Previously, the hospital told TheJournal.ie that its high levels of staff turnover were attributable in the main to “relocation to home country or closer to home, availing of promotional opportunities, moving into specialist areas of expertise such as acute hospitals  or returning to full-time education”.

Departures

“These reasons would largely be in keeping with the reasons for staff departures in the wider health care system and also reflects the results of the lifting of the moratorium on employment and increased competitiveness in the wider healthcare market,” a spokesperson said at the time.

Multiple staff, both current and former, claim the perceived issues of staff-patient ratios and staff training have been raised with management at the hospital, particularly with regard to the care of vulnerable elderly patients.

One such situation ended up at the Workplace Relations Commission (WRC) after a senior clinical nursing manager was transferred from their ward after raising concerns over a perceived lack of adequate resources and procedures being in place in order to deal with the medical needs of the elderly patients that had recently come under that ward’s remit.

(The woman won her case over her treatment by her employers following her complaint, and received a payout of €10,000. That was reduced on appeal by the Labour Court to €1,500 as the material conditions of her employment hadn’t changed due to her transfer.)

The hospital has been subject to a number of industrial relations disputes at both the WRC and Labour Court in recent times, while at least one former senior member of staff is also involved in a litigation with the hospital in the High Court at present.

One of these cases, which went from the WRC to the Labour Court, involved staff seeking a ‘geriatric allowance’ due to having to care for frail elderly patients as the hospital is not a dedicated elderly care facility. The court said it was not in a position to rule on the matter as it had “insufficient information” on a matter that could have “national implications”.

If you need to talk, contact:

• Samaritans 116 123 or email jo@samaritans.ie

• Aware 1800 80 48 48 (depression, anxiety)

• Pieta House 01 601 0000 or email mary@pieta.ie – (suicide, self-harm)

• Teen-Line Ireland 1800 833 634 (for ages 13 to 19)

• Childline 1800 66 66 66 (for under 18s)