HSE chief says UHL emergency department 'much more safe now' than when Aoife Johnston died

Aoife Johnston.

HSE CHIEF EXECUTIVE Bernard Gloster has said that the health service “failed” Aoife Johnston and that failure “led to her death”, but the hospital where she died is “much more safe now”.

Gloster apologised to the family of the 16-year-old, who died of bacterial meningitis on 19 December 2022 after a 12-hour wait in the overcrowded emergency department of University Hospital Limerick.

Aoife had initially presented to the hospital on 17 December, and was eventually admitted to intensive care, but passed away shortly after.

On Friday, a verdict of medical misadventure was returned at the inquest into the death of the teenager.

Speaking on RTÉ’s This Week programme this afternoon, Gloster said he had met with Aoife’s parents James and Carol.

“To them today, on behalf of the health service, there’s only one thing we can say to them and that is that we apologise,” he said.

We are sorry. We failed Aoife. Our failure led to her death, and we failed them as a family.

Gloster said that while the question of accountability “remains very much alive to me”, it was not one he could preempt or determine until he had finishing studying the transcripts of the inquest and the independent report by Chief Justice Frank Clarke.

He said there are no findings against any individuals, but that the question of accountability “will be addressed by me alone and without fear or favour”.

Gloster was asked about comments made by Dr James Gray, who was the only ED consultant on call the weekend Aoife died. Gray told the inquest that not only was the ED a “death trap”  on the night, “it is still a death trap”, five years after Aoife’s death.

In response, Gloster said the department is “much more safe now” despite the fact that there is still overcrowding.

He said the number of junior doctors in the department since Aoife died has risen from 26 to 47, while the number of emergency consultants has gone from 10 to 15. He said nurse staffing levels have also increased.

“Many other steps have been taken to improve safety, so I would take issue with the description of it today.”

He said he’s “satisfied” that if people need emergency care, they “should and could” attend UHL’s emergency department.

“But I do understand the concern that people have against the backdrop of the very traumatic week that the public experienced. Our job is to work to build people’s confidence and safety assurance in the hospital.”

Gloster said everyone working in UHL and the health service “has a role to play in rebuilding the public confidence and in ensuring that we are honest with people about the pressures we have, and we have pressures”.

“Since Aoife’s death alone, the very significant safety indicators that were obvious then, a substantial amount of those have been addressed in a way that does make the department more safe.”

He said there is “no question” of the HSE not recognising bed capacity as a challenge, but that is comes with a requirement for “multiple changes at multiple levels”.

“Otherwise all of the capacity in the world will make no difference.”

When asked about the possibility of opening minor injury clinics at Nenagh, Ennis and St John’s on a 24-hour basis to take pressure off the UHL emergency department, Gloster said:

“If the evidence is there, and if the staffing capability is there to extend the local injury units, there’s no question but that any proposal from the hospital to me would be considered.”

However, he added that if you staff one option, you have to consider what other option you can’t staff.