We need your help now
Support from readers like you keeps The Journal open.
You are visiting us because we have something you value. Independent, unbiased news that tells the truth. Advertising revenue goes some way to support our mission, but this year it has not been enough.
If you've seen value in our reporting, please contribute what you can, so we can continue to produce accurate and meaningful journalism. For everyone who needs it.
Sign in. It’s quick, free and it’s up to you.
An account is an optional way to support the work we do. Find out more.
By continuing, you are indicating that you accept our Terms of Service and Privacy Policy.
Updated 11.20pm
THE PATIENT SAFETY report by HIQA into the death of Savita Halappanavar states that there was a failure to recognise that she “was at risk of clinical deterioration” at University Hospital Galway (UHG).
The report details the care received by Savita Halappanavar leading up to her death in October 2012 in UHG. The full report can be read here.
The hospital has since apologised to Praveen Halappanavar and family for the care Savita received in October 2012.
There were widespread vigils held around Ireland when the news of the expectant mother’s death broke late last year.
Marty Whelan and Dr Tracey Cooper of the Health Information and Quality Authority (HIQA) deliver the findings of their report. Pic: Niall Carson/PA Wire
Failure in care
The damning report concludes that there was “a failure in the provision of the most basic elements of patient care to Savita Halappanavar and also the failure to recognise and act upon signs of her clinical deterioration in a timely and appropriate manner”.
It details a number of missed opportunities that were not identified but could potentially have changed the outcome of her care.
It also states that blood tests were not followed up on and there was a failure to recognise that she was at risk of clinical deterioration.
The report contains a number of recommendations and says that an urgent review of maternity services nationally is needed.
Missed opportunities
The report identified a number of ‘missed opportunities’ which, if they had been identified and acted upon, “may have potentially changed the outcome of her care”.
These include:
following the rupture of her membranes, four-hourly observations including temperature, heart rate, respiration and blood pressure did not appear to have been carried out at the required intervals.
HIQA said that at the various stages when these observations were carried out, the consultant obstetrician, non-consultant hospital doctors (NCHDs) and midwives/nurses caring for the pregnant woman “did not appear to act in a timely way in response to the indications of her clinical deterioration”.
The report states that in summary, of the care provided to the Indian-born dentist there was a:
It said that the consultant, NCHDs and midwifery staff “were responsible and accountable for ensuring that Savita Halappanavar received the right care at the right time” – but this “did not happen”.
A chart that had been developed by UHG for the identification and management of a patient who was clinically deteriorating was not used in St Monica’s Ward in October 2012.
Emergency protocol
HIQA found at the time of the investigation that there was no formal clinical escalation protocol and no emergency response team in place at the UHG.
It said that though UHG had a guideline in place for the management of suspected sepsis and sepsis in obstetric care, the clinical governance arrangements were “not robust enough to ensure adherence to this guideline”.
The care pathway for patients who required access during core hours to maternity services “was not always timely or appropriate”.
There was no formal clinical pathway in place to refer high risk obstetric patients to an antenatal high risk service operated by an obstetric anaesthetist at the time of the investigation.
The care pathway for patients who required emergency access to maternity services outside of core hours “was not always appropriate and effective”.
Pic: Niall Carson/PA Wire/Press Association Images
Healthcare notes
When it came to patient healthcare records, there was evidence of a number of retrospective entries of information in the case of Savita Halappanavar. Notes were found to have been entered two weeks following her death.
UHG did not have a hospital-wide guideline in place for the management of sepsis in adult patients and there was no consistent definition of sepsis, severe sepsis and septic shock in use across UHG.
This investigation found “concerning deficits” in how learning, particularly in the areas of maternity services and clinically deteriorating patients, has been adopted and implemented following previous investigations and inquiries.
It says these include “an inability to apply system–wide learning from adverse findings in one part of the system to minimise clinical risk for all patients”.
HIQA notes that the sequence of events that led to the death of Savita Halappanavar will constitute a difficult read for her husband Praveen Halappanavar, his wider family, the public and healthcare staff across the country.
What is critically important is that we must learn from this tragic event and ensure that the findings, learning and recommendations of this investigation, and of the HSE inquiry, are effectively implemented across the health service.
HIQA notes that this investigation shows that where responsibility for implementation of learning is not clearly owned, then learning nationally does not happen.
This is demonstrated in the enquiry into the death of Tania McCabe and her son Zach in 2007, “the circumstances of which have a disturbing resemblance to the case of Savita Halappanavar”, said the report.
What happens next?
As a result of the findings of the investigation, HIQA has made a series of recommendations. These don’t just focus on UHG, but all other maternity hospitals in Ireland.
These changes include:
the need to review and improve maternity services in respect of the management of sepsis, clinically deteriorating pregnant women, patient choice, models of care and providing a suitably skilled and competent workforce that can deliver safe and effective care at any given time.
It recommends an urgent review of maternity services, which should take account of the outcomes of this investigation and the other investigative processes initiated as a result of Savita Halappanavar’s death.
The review should inform the development and implementation of a National Maternity Services Strategy, said HIQA.
The chairman of UHG apologised to Praveen Halappanavar in June of this year over his wife’s death.
An earlier HSE review found in June of this year that inadequate care and monitoring were factors in Savita Halappanavar’s death.
Originally posted 3.45pm
To embed this post, copy the code below on your site
So has anyone been found to be at fault for the failures?
Don’t be ridiculous, of course not. It was ‘the system’ that failed. Not people.
Always systems failure. Sickening.
Her husband will get a fortune
If Savita had walked down the street and someone hit her and killed her then someone would be looking at a lengthy prison sentence but because these were paid medical professionals that killed here then we get reports and excuses, it is a disgrace that anyone should suffer in this manner.
@claire God help the families and the medical staff in the hospital who so royally messed up – it was not intentional and it could happen to any relative of ours… a tragedy for all involved and of course for Ms Halapanavar and her husband… hopefully with this report it will never happen again.
It was a medical f***k up from start to finish.
will the ‘Irish Times’ be printing the full details of this report?
– or will it just be the ‘catholic country’ bit?
I am disappointed, saddened, disgusted & shocked at the level that treatment this women received or lack off! Her death resulted in highlighting the failures of said hospital & hugely worrying for any mum to be entering this hospital now, then or anytime in the near future. I’m sure Savita is not the only patient that has been effected by lack of basic care giving, it is just astonishing how many other women have been put at risk for there ignorance. HIQA should have come down on them harshly & have issued recommendations this is just a complete cope out.
They’ll print the report Zoe. But then they’ll have 3 columnists a week telling us it’s all about abortion. The IT is a joke these days. I wouldn’t wipe my arse with it anymore. I was a loyal reader for years. The Savita story destroyed the IT comments section.
The woman was septic! Any nurse/midwife worthy of their registration should have recognized the signs. The words carelessness and sloppy spring to mind………..
Did no one use their nose?
No, all box ticking instead.
This report, once again, proves that it was not Ireland’s abortion law which caused Mrs Halappanavar’s death; rather it was the abysmal monitoring of the patient, whilst in a public-sector hospital, and the failure to diagnose sepsis in time which resulted in the death of Savita Halappanavar.
Really then why is one of the recommendations for a change in polices and clinical guidelines for the management of inevitable miscarriage and changing the law to allow this to happen?
@J Ní Shuilleabháin,
Your misquoting the report. The report asks for consideration of the law in these cases clinical professional judgement can be exercised in the best medical welfare interests of patients. It also asks for clear and precise national clinical guidelines to meaningfully assist doctors in the area.
It does not ask for abortion. It does not ask for change of the law. It does not implicate Irish law in her death. Don’t warp this to match your constitutional change agenda.
Come on, Janet! Can’t you follow Fergal’s hair splitting? It doesn’t ask for abortion or a law change (which has already been implemented so now irrelevant), it asks for abortion procedures. Totally different!
It proves nothing of the sort. Both the abortion law and the abysmal monitoring are implicated. Once her condition had been understood what would the next step have been, according to you? Would it have been the same one they ultimately refused, because of the “law”?
That was the position Nick argued during the abortion law debate, censored.
And – the report agreed, Paul, as they advocated clarifying procedures in cases of inevitable miscarriage.
Funny how it seems like you’re more concerned at pointing fingers than taking action to move forward and improve the situation for women.
Nick,
This report points a lot more clearly to negligence. Very little confusion with the law here.
@censored,
if they were implicated I would expected that to have been made clear in the report but it does not! If her infection was understood anti infection treatment could have started. If needs be inducing beyond viability could have been done entirely legally imho. Those who say the law is to blame forget to see that there is no evidence her consultant considered inducing/abortion as a solution but didn’t due to the law. Abortion was suggested by the family who does not suggest her doc saw it as the solution.
The Sword of Damocles argument is utterly fanciful and dishonest.
You mean this report, which was released after the change in the law and did not have it as part of the purview? The law has been changed, I’m not sure why you’re so focused on something that has been fixed, rather than the aspects which have not.
As someone without an axe to grind in all this – I beginning to believe the issues here are about an awareness of sepsis. That is what we should be angry about.
Fair play Niall, just beware of the pro-choice side who are using this tragedy as an excuse to railroad in lax abortion legislation – they have done this since the day the tragedy hit the national headlines.
Our hospitals should be the safest for both mother and baby – sadly this report highlights serious shortcomings in this.
On the other hand, if this is the standard afforded to some maternity patients, I would hate to see how much of an issue sepsis would be – as I suspect – if this country allowed abortion (sepsis can set in after abortion also).
If there is one thing that this report makes very, very clear, it is that we all owe a debt to Praveen Halappanavar, whose determination to find answers exposed the shortcomings in our care of pregnant women and will in all likelihood lead to a significant improvement in standards for all women who give birth in our hospitals.
He is the only person who emerges from this sorry mess as a hero.
It’s just disgusting. I can’t even bare to think about it.
What a dreadful and deadly failure of the most basic provision of care at this hospital. The evidence is now there for action to be taken against those directly responsible for the death of Savita Halappanavar. The PEOPLE responsible for this shambles must be held to account for their gross negligence it’s not good enough just saying sorry, this paragraph says it all “It said that the consultant, NCHDs and midwifery staff “were responsible and accountable for ensuring that Savita Halappanavar received the right care at the right time” – but this “did not happen”. The records must show WHO failed to do what and where at the ward level, the further up the command chain you go the buck has to stop with those who failed to manage the system, those who failed to implement a proper system and those at the top who should have ensured that such a system was in place, that’s what they get paid to do. Also “When it came to patient healthcare records, there was evidence of a number of retrospective entries of information in the case of Savita Halappanavar. Notes were found to have been entered two weeks following her death.” This shows that somebody was trying to cover their arses and it stinks that they thought they could get away with that, that in itself is surely grounds to ensure that those responsible face some sort of criminal sanction. The whole episode reads like a bunch of clueless idiots were in charge who didn’t know what they were doing and/or how to provide the most basic medical care, how can that be? how can that hospital be safe? This highlights the most serious of failures which calls into question the way other Irish hospitals are staffed and run and makes you wonder how safe they are too. It’s a frightening thought that this is only the tip of the iceberg and there are other equally incompetent hospitals out there, who is checking on this?
Shocking. Its really wrong that people were so quick to blame Irish law as it left those responsible off scot free. I hope Irish hospitals become safer places after this. If they do I will know its no way related to No. 35/2013 — Protection of Life During Pregnancy Act 2013.
Fergal, one of the recommendations of the HIQA report is to allow for abortion in cases of inevitable miscarriage. I don’t think anyone is saying that abortion is the only issue here – there was clearly negligence, but you also haven’t read the report if your argument is that the legislation was unnecessary.
No. Your missing the detail. The report does not once mention abortion or termination. It actually asks for guidelines and consideration of the law concerning this.
Yes, it uses lots and lots of euphemisms, funnily enough. I don’t think you understand what the X legislation was – it set out clearer guidelines. This is a good, important thing, but it doesn’t mean that no other negligence should be addressed.
Are you still associating this with the X case, Nick?
the question is why
Sounds like a lot of negligence! There should be a lot of people worried about being struck off the doctor and nursing register!
From what I read in the news at the time this happened,the lady was admitted to hospital suffering the early signs of miscarriage. There was still a foetal heartbeat but the medical staff knew that the pregnancy was self terminating. She requested a termination but the staff, unsure of the legal standing under the law as it was, decided to deny her request. They probably crossed their collective fingers and hoped that nature would take its course, the foetus would self terminate and they could give after care for the miscarriage. She contracted sepsis from the foetus which still a magnet to retain a heartbeat somehow while slowly positioning her blood stream. This is what I got form the reporting of the case at the time, as I said. So why is it that the life of the mother is not of more importance than the right of the foetus? All this talk about “right to life” but what about those already living?
And at what stage are we going to come to grips with the fact that other cultures live here and not all of them are Chatolic. She was I believe Hindu and from what I know abortion, on demand or otherwise, isn’t a “sin” in her culture. So, in a plural society, she had a right to request one. She certainly had a right to request one if she was having a miscarriage when she was told there was no hope of saving the child.
@mary,
Many Hindus do consider abortion sinful but actually that is irreverent. What is relevant is that there was no reason to believe that any kind if termination would have improved her prognosis because of their incompetence. In fact due their incompetence there was no reason to believe her condition was risky at all. That is the scandal. That is what is shocking. Ireland’s restrictions on abortion stem from our commitments to human rights. Not ‘Chatolics’
@Fergal I remember the first abortion referendum in the 80′s where the pro choice movement posited the notion of a young abuse victim becoming pregnant at the hands of her abuser. And the Catholic Church screaming that such a thing would never happen. How they were fear mon fearing and trying to scare people into legalising abortion. And nine years later there was the X Case. And I remember bishop Eamon Casey on the Late, Late Show pontificating about how she should have the child while he was fleecing the dioceses of Galway to support his own illegitimate son. I remember a lot of talk about where life begins and all the rest but no.. I can’t say that I remember anything about human rights. I’m no advocate for abortion on demand but if we are going to bring phrases like “human rights” and ” right to life” into a debate like, this I just want to know why priority isn’t given to the person ALREADY LIVING?
Where in this report, or the other published reports has it said an abortion would have saved Savita? I’m genuinely asking. In any reports into Ms Halapannavar’s death that I’ve read, they say there were a “litany of failures”, “medical negligence”, bloods not followed up on etc etc ??
From my reading of it, it’s one of those where they can’t know for sure. Best practice would have been to give her an abortion, but it also would have been to do a lot of other things differently. It’s just impossible to know what would have made the difference.
It isn’t a matter of ‘best practise’ at all. There are many examples where waters have broken way to early like here and where both parties come out safely. To induce or not would be a matter for debate and would not be an automatic reaction to these circumstances in the UK. Best practise would have been to monitor a women with an open cervix for infection! Don’t simply this.
No, in most places, the woman would have been advised of the risk and given the choice. She was nowhere near viability and did not wish to continue the pregnancy. Best practice is not to force her to remain with an open cervix (which is the equivalent of an open womb) against her will indefinitely.
The report has also recommended that guidelines be clarified for inevitable miscarriage, which says everything, really.
Yet the report doesn’t suggest legal uncertainty contributed to her death. which says everything, really.
As noted, it’s impossible to know whether or not an abortion would have made the crucial difference, all other factors considered. We can’t change what happened, but we can ensure it doesn’t happen to any other woman, by changing all of the variables.
So no new law was required, Nick?
Exactly Paul, but Nick still advocates “choice for all” and that includes healthy mothers with healthy babies too…
The legislation was inevitable. It was already in he headlines before Savita even got pregnant.
And there was no “new law”, they merely legislated for a 21 year old Supreme Court decision.. Despite being asked to consider the position of TFMR by the expert group.
There’s still no provision in Irish law for a woman to request her diagnosed miscarriage be completed at diagnosis if it is failing to do so naturally.
Shanti,
Substantial risk to the life of the mother.
That’s the law. This report would appear to refute what you have argued.
Paul, I know you love to wax weird theoretical rather than actually consider realistic, practical scenarios, but common sense is that in these situations, the right to life cannot be balanced. How can we best look after a woman? As the report notes, better monitoring, clearer procedures for inevitable miscarriage and more awareness of sepsis would all be very helpful.
Yes. Substantial risk to the life of the mother, which in Savitas case for some bizarre reason was not acted upon.
Nick,
I referred directly to the law and the contents of this report.
Shanti,
Thank you for pointing out that deficiency in the recent legislation. It’s not really good for medical practice is it?
The report was commissioned to look at failures in the medical service (including the lack of guidelines for inevitable miscarriage) rather than the law.
Nick,
The report is specific to the death as a result of the Galway tragedy. It is related but its commission does not have the general scope you attribute to it.
It’s my understanding that doctors have to swear some modern version of Hypocratic oath. Some UN something or other but it’s similar to the Hypocratic oath which has the primary directive of first you preserve life. So, were her doctors more afraid of being sued because the law didn’t technically allow them to terminate the pregnancy? Or were they ethically against terminating the pregnancy? In either case, what happened to “preserve life” the oath they swore? And if there is a shade of grey area that I haven’t conceived of, please fill me in. I’d be interested as this is my local hospital.
The treatment for savita in the timeframe leading to her death would have been basic systemic infection management. There would have been absolutely no need for an abortion.
That’s the fact. Like it or not. The HIQA report clearly shows the number of missed opportunities where the provision of this treatment would have treated savita but were overlooked due to inadequate protocols. That’s the truth, now please stop using Saiyas death as some sort of campaign for some ulterior motive.
Apart from the fact Savita’s request for a termination was ignored. She was miscarrying. Instead of providing her with her requested termination of an unviable pregnancy, her request was ignored and sadly now neither her or her baby are alive. HIQUA recommend a review of hospital policy for ‘patient choice’ or would you prefer we ignore that too?
I suspect your comments are little more than ideology – based on your religious beliefs.
The source of the infection that ultimately led to the patient’s circulatory shock and ultimate death was the non-viable fetus in the womb, following the breaking of the waters. Had the pregnancy been terminated then the source of the infection would have been removed and the patient would have survived.
@mary jones,
some doctors swear the Hippocratic oath but most don’t. The question of termination was not relevant as they completely overlooked how serious her case was. Even if they did induce early she could have still have died due to infection. A lack of basic care killed her.
Wouldn’t that depend on when and where she contracted sepsis Connaughtabu?
Indeed, Niall – there’s no guarantee that an abortion would have saved her or that it would not. No one can know for sure. What is clear is that there will be cases where it’s helpful to have a clear decision making process and accountability to woman involved. This has been improved by the law, now it’s time to hold the hospital accountable for any negligence.
Sorry but the report clearly stated that a contributing factor in Mrs Halappanavar’s death was the refusal of an abortion. I don’t understand your point.
Aactuallly Hippocrateeth an abortion was exactly what Mrs Halappanavar was having – a spontaneous abortion, which if it had been speeded up medically would probably have saved her life.
At the end of the day inducing could/would have occurred elsewhere in Ireland. There was no legal impediment. Just incompetence.
Indeed – it would have occured elsewhere in Ireland. I’m not sure why you’re so opposed to ensuring that this care is uniform as well as taking action on the other forms of negligence?
No Mary, Sorry, they do not swear that oath anymore.
Niamh Byrne: The ‘patient choice’ you refer to relates to the following:
The “Oath” as such, has no standing legally. It’s just a philosophy that doctors pledge to adhere to. It was originially written in either Latin or Greek – possibly both – they were a strange bunch in those ancient times, but it’s best and most often summed up in four short words .. “First, do no harm”
Hardly any doctors formally swear an oath. It’s a basic notional code of practice (first do no harm).
Daniel, ‘choice(s) is mentioned 9 times int he report but you chose the one that was least relevant to the findings, I wonder why. I didn’t imply anything of the sort, I stated that Savita, made an informed choice and her request was ignored, that is my issue. in what other area of medicine would a patient request be ignored? Nowhere. Savita, sadly, was having an inevitable miscarriage, the baby was not going to survive. Surely you can see that her choice, a termination should have gone ahead.
The oath PJ was Greek in origin. Hippocrates. Yet, Irish Doctors don’t take it, and though as you say it has no legal standing, nor does it actually contain the term “First, do no harm” in its original form. {Not even the loosest translation}
And it’s highly doubtful that Hippocrates had any hand in writing it in the first place – though he is known as the father of medicine.
The standard treatment when a woman presents with a diagnosed miscarriage with ruptured membranes / dilation (according to best medical practice) is abortion (unless the woman requests otherwise – and even so, checks for sepsis have to be really rigorous).
This is because even if there’s no sepsis present – the ruptured membranes and dilated cervix are high risk factors for infection.
In Ireland best medical practice (which is based upon medical evidence) cannot be followed as the law of the land does not allow for it, if it did – there would likely never have been a problem. But we cannot say for sure because there was only one outcome.
That’s interesting. I’ve heard it quoted countless times – even by medics.
Check it out here PJ – the Irish IMT – Irish Medical Times site. Make sure you tick yes at the beginning when it asks you are you a medical professional, otherwise it’ll lock you out.
http://www.imt.ie/opinion/guests/2009/04/what-does-the-hippocratic-oath-mean.html
@Shanti.
This conversation should be about best medical practice, or lack thereof where pregnant women in trouble are concerned. I think we’ve had enough debate hijacking by vested interests {not suggesting you’re hijacking} but there comes a time to recognise there are serious deficiencies nationally in maternal health care and that don’t revolve around abortion. Let it rest.
Dr. Hema Divakar, President-elect of the Federation of Obstetric and Gynaecological Societies of India speaking to the Hindu Times said:
“Delay or refusal to terminate the pregnancy does not in itself seem to be the cause of death. Even if the law permitted it, it is not as if her life would have been saved because of termination. Severe septicaemia with disseminated intravascular coagulation (DIC), a life-threatening bleeding disorder which is a complication of sepsis, major organ damage and loss of the mother’s blood due to severe infection, is the cause of death in Savita’s case. This is what seems to have happened and this is a sequence which cannot be reversed just by terminating the pregnancy.”
Let’s get back to discussing the real problems around this report – and btw Shanti, I always find you a very competent poster and rarely pass a post of yours. If I do pass your posts it comes down to two things. Either I’m rushing or on a work break, or I need a quick fix or distraction. Your posts tend to be lengthy, and those are the posts I normally seek out.
Thanks for posting this. It is more or less what I also read at the time but I’m not in the medical profession and would ne’er have been able to summarise it so well.
This was meant to be @ Shanti
Again, Niall, it’s disappointing that you ignore that even within that article, it was debated whether an abortion would have helped. It’s definitely unclear and unknowable – so the logical solution would be to legislate (which they did) and work on improving standards in hospitals.
Cheers Niall.
And my apologies.. I realise I am a waffler – I’m just trying to be clear, something I do not always succeed at..
I agree, so many failures to follow best medical practice. Sadly to talk about what may have happened is all conjecture – we know what happened. A litany of negligence, an “undue focus on the foetal heartbeat”, well meaning explanations lost in translation, and a failure to follow best medical practice where a miscarriage is in process and the cervix is dilated / amniotic sac ruptured.
The report – conducted by those actually investigating and not just commenting from afar identified problems everywhere – from the hospital to the legislature.
We should heed it all. Best medical practice is called that because it’s based upon evidence, not morals or politics – just what works.
She should have been monitored better, she was at high risk for infection – they should have identified that and been extra vigilant about following up test results, the foetal heartbeat was not as important as this – purely because the miscarriage was deemed inevitable.
The priorities seemed muddled, but it is easy to see why. There’s no excuse for the failure to monitor and follow up when the patient is at such a high risk and best medical practice is not being followed. It’s literally asking for trouble.
It’s heartbreaking to think like this, “should have” won’t do much now.
I agree it’s unclear Nick. I’ve been saying that for a long time. I do however have a tendency to respond to agenda driven pro and anti side comments on this topic these days. I too would prefer to focus on the systematic – and it is systematic – deficiencies in hospitals around the country. In fact on the radio today it was said that 5 maternity wards nationally {I stand open to correction on that as I was in and out of the room when the radio was on, but it was drivetime) are not up to scratch on the grounds given in the report.
That is worrying.
No you’re not a waffler, competent. Exceptional on mental health issues in particular.. And I love your pic too. What is it off btw? Very eye catching. That’s how I spot your posts.
The thing is that, at this point, X legislation has been passed. A lot of people on here seem to want to focus on accusing others of “political agendas” regarding X legislation, but it’s done now and hopefully will make a difference to some women.
Now should be the time where people could come together to say “actually, these hygiene standards are not ok. How are women being monitored? How much attention is being paid to foetal heartbeat during inevitable miscarriage as opposed to sepsis risk?” But that just doesn’t seem to be happening, sadly.
Thank you Mary :)
Niall, I’ll go follow you on twitter rather than derail the thread!
I’m not on twitter or social media Shanti|! I only signed up to because media sites require it now. I don’t know how to use twitter of facebook etc – nor do I want to. I get the occasional email from both but I don’t open them. I don’t like social media, and I want nothing to do with it. It killed me to have to open an account to comment on the IT. When the IT died I moved over here and a few other places. All of them required Twitter or Facebook. Don’t follow me because I don’t know what that means!!
I was waiting for you to turn uo on this article http://www.thejournal.ie/readme/world-mental-health-day-suicide-depression-1119862-Oct2013/
But I didn’t see you. You must have been tied up.
Ah – I did think it odd you had no followers / following.. I didn’t get a chance to see that one.
I had tweeted you, but I’ll tell you here so :) It’s Vision Crystal by Alex Grey. His work is indeed eye catching..
Nice one Shanti. Checked him out last few mins.
I really like this one
I think the medics in RCSI do. In the US swearing the oath is the norm. Its a regional thing.
The oath used in modern day doesn’t mention abortion, so rather irrelevant.
I’m impressed by the honesty of the report. Hope this will lead to changes. Such a tragedy for Savita Halappanavar and her family.
So a healthy, educated woman, who was contributing to our society with her knowledge and taxes died, because in the twenty odd years since the X case nobody bothered to put in place safeguards to protect a woman from some one in ten million chance that something like this would happen.
And before everyone jumps down my neck here, I would never advocate abortion on demand. I don’t believe it’s a form of birth control. As it stands we export our problem to Britain. Any woman who wants an abortion goes to the UK for a few days and comes home with problem solved. God bless the Brits for that at least.
Our government arrived promising radical changes in health care and health management. Over half way through its term, it has, at best, achieved nothing in terms of improvement. Many would claim it has made things worse.
In any other country, heads would have rolled – voluntarily or enforced – long before this report was published. Not here, though.
Now that it has been published, however, it is clear that the Ministry and HSE are worse than unfit for purpose. Minister Reilly, Junior Ministers White and Lynch and the entire board of the HSE should resign or be dismissed with immediate effect.
Brian, in the real world, nothing changes in Ireland.
The public service unions are the real power.
Always will be.
Time for Angela to cut the money supply.?
Unions are a power, agreed. But secondary to a government that is unaccountable for its duration to anyone except itself.
Even outside its duration, its likely successor comes from its incestious gene-pool.
It shouldn’t take Fuehrerin Merkel to change it. Maybe a few thousand taking to streets.
In the meantime, Reilly, Lynch, White and Board of HSE have to go.
I’m always suspicious of reports and their findings in the sense that, is the shock and awe factor going to blind us from pointing the finger at who is directly to blame. Because there are a lot of professional people here with blame and it is not the Irish way to expose and fire these people.
Furthermore I believe this is a wake up call across all services our hospitals provide, not just maternal. The bloated a and e rooms and sick and dying people on trollies is the system screaming at us to re manage it. It’s a terrible and shameful thing to do to our people.
Smash up the hse
You cannot possibly blame any particular individuals in this case. Due to a lack of available staff the system broke down. This problem will not be fixed any time soon as the HSE refuse to provide the money to do so. Thousands of graduate midwives and nurses are emigrating due to the incompetence of the HSE and systems failure will continue due to the severe lack of staff.
What’s the Point that she was admitted to hospital ? Die at home,no difference .Horrible.
That´s a great picture.!
HIQA bosses look properly pissed off.
A taxpayer sponsored Quango paying high salaries to bureaucrats who are empowered to criticise other deficient colleagues, who work in the Health sector.!
To what effect.?
Lawsuit pending.
Charge it up to the state!
If we only knew how many other similar lawsuits were in train..
Making nobody accountable for this tragedy will allow it to happen again to some other poor family.
Use precise geolocation data. Actively scan device characteristics for identification. Store and/or access information on a device. Personalised advertising and content, advertising and content measurement, audience research and services development.
These cookies are necessary for the website to function and cannot be switched off in our systems. They are usually only set in response to actions made by you which amount to a request for services, such as setting your privacy preferences, logging in or filling in forms. You can set your browser to block or alert you about these cookies, but some parts of the site will not then work.
These cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.
These cookies enable the website to provide enhanced functionality and personalisation. They may be set by us or by third party providers whose services we have added to our pages. If you do not allow these cookies then these services may not function properly.
These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site. All information these cookies collect is aggregated and therefore anonymous. If you do not allow these cookies we will not be able to monitor our performance.
Cookies, device or similar online identifiers (e.g. login-based identifiers, randomly assigned identifiers, network based identifiers) together with other information (e.g. browser type and information, language, screen size, supported technologies etc.) can be stored or read on your device to recognise it each time it connects to an app or to a website, for one or several of the purposes presented here.
Advertising presented to you on this service can be based on limited data, such as the website or app you are using, your non-precise location, your device type or which content you are (or have been) interacting with (for example, to limit the number of times an ad is presented to you).
Information about your activity on this service (such as forms you submit, content you look at) can be stored and combined with other information about you (for example, information from your previous activity on this service and other websites or apps) or similar users. This is then used to build or improve a profile about you (that might include possible interests and personal aspects). Your profile can be used (also later) to present advertising that appears more relevant based on your possible interests by this and other entities.
Advertising presented to you on this service can be based on your advertising profiles, which can reflect your activity on this service or other websites or apps (like the forms you submit, content you look at), possible interests and personal aspects.
Information about your activity on this service (for instance, forms you submit, non-advertising content you look at) can be stored and combined with other information about you (such as your previous activity on this service or other websites or apps) or similar users. This is then used to build or improve a profile about you (which might for example include possible interests and personal aspects). Your profile can be used (also later) to present content that appears more relevant based on your possible interests, such as by adapting the order in which content is shown to you, so that it is even easier for you to find content that matches your interests.
Content presented to you on this service can be based on your content personalisation profiles, which can reflect your activity on this or other services (for instance, the forms you submit, content you look at), possible interests and personal aspects. This can for example be used to adapt the order in which content is shown to you, so that it is even easier for you to find (non-advertising) content that matches your interests.
Information regarding which advertising is presented to you and how you interact with it can be used to determine how well an advert has worked for you or other users and whether the goals of the advertising were reached. For instance, whether you saw an ad, whether you clicked on it, whether it led you to buy a product or visit a website, etc. This is very helpful to understand the relevance of advertising campaigns.
Information regarding which content is presented to you and how you interact with it can be used to determine whether the (non-advertising) content e.g. reached its intended audience and matched your interests. For instance, whether you read an article, watch a video, listen to a podcast or look at a product description, how long you spent on this service and the web pages you visit etc. This is very helpful to understand the relevance of (non-advertising) content that is shown to you.
Reports can be generated based on the combination of data sets (like user profiles, statistics, market research, analytics data) regarding your interactions and those of other users with advertising or (non-advertising) content to identify common characteristics (for instance, to determine which target audiences are more receptive to an ad campaign or to certain contents).
Information about your activity on this service, such as your interaction with ads or content, can be very helpful to improve products and services and to build new products and services based on user interactions, the type of audience, etc. This specific purpose does not include the development or improvement of user profiles and identifiers.
Content presented to you on this service can be based on limited data, such as the website or app you are using, your non-precise location, your device type, or which content you are (or have been) interacting with (for example, to limit the number of times a video or an article is presented to you).
With your acceptance, your precise location (within a radius of less than 500 metres) may be used in support of the purposes explained in this notice.
With your acceptance, certain characteristics specific to your device might be requested and used to distinguish it from other devices (such as the installed fonts or plugins, the resolution of your screen) in support of the purposes explained in this notice.
Your data can be used to monitor for and prevent unusual and possibly fraudulent activity (for example, regarding advertising, ad clicks by bots), and ensure systems and processes work properly and securely. It can also be used to correct any problems you, the publisher or the advertiser may encounter in the delivery of content and ads and in your interaction with them.
Certain information (like an IP address or device capabilities) is used to ensure the technical compatibility of the content or advertising, and to facilitate the transmission of the content or ad to your device.
Information about your activity on this service may be matched and combined with other information relating to you and originating from various sources (for instance your activity on a separate online service, your use of a loyalty card in-store, or your answers to a survey), in support of the purposes explained in this notice.
In support of the purposes explained in this notice, your device might be considered as likely linked to other devices that belong to you or your household (for instance because you are logged in to the same service on both your phone and your computer, or because you may use the same Internet connection on both devices).
Your device might be distinguished from other devices based on information it automatically sends when accessing the Internet (for instance, the IP address of your Internet connection or the type of browser you are using) in support of the purposes exposed in this notice.
The choices you make regarding the purposes and entities listed in this notice are saved and made available to those entities in the form of digital signals (such as a string of characters). This is necessary in order to enable both this service and those entities to respect such choices.
have your say