HSE presents as 'dysfunctional' organisation, says High Court President

The HSE has presented as a "dysfunctional" organisation in a number of cases before him, the President of the High Court has said.

HSE presents as 'dysfunctional' organisation, says High Court President

The HSE has presented as a "dysfunctional" organisation in a number of cases before him, the President of the High Court has said.

Mr Justice Peter Kelly asked lawyers for the HSE today to inform it of his view about the need for "proper" communications within it after a communications breakdown lead to a young man with severe anorexia nervosa being informed, by mistake, the HSE would not fund specialist treatment for him in the UK.

The HSE letter, addressed to the "profoundly ill" hospitalised man whose life and health remain at serious risk, was opened earlier this month by his mother and one could "only imagine her despair", he said.

This was indicative of communications failures that appeared "endemic" within the HSE and there appeared to be little communication in an organsation that appeared on several occasions in court to be "dysfunctional".

Such a letter should never have been sent to a ward of court and the man's treating doctor was also unaware of it.

The HSE has apologised to the man, his parents and the court over the error.

That arose because its funding branch was not told until this week the man, on the HSE's own application, was made a ward of court last January when orders were also made for him to receive HSE-funded specialist treatment in the UK.

The man has the most acute form of anorexia - treatment resistant - which carries a mortality rate of one in five.

He has suffered from the illness for years and doctors believe it is directly related to having been assaulted as a teenager.

He was made a ward of court arising from findings, due to his illness, he lacks capacity to appreciate the severity of it and to make appropriate decisions in the best interests of his health and welfare.

Because there is no facility in Ireland to treat this most severe form of the illness and his condition has not improved, orders were made last January for his transfer to a specialist unit in the UK where a bed has only now become available.

The judge noted he has dealt with several cases arising from this form of anorexia but all of those, until this case, involved females who, like this man, appeared to be high achievers.

He had made orders for several of those females to receive treatment in the UK, the results were generally good and sometimes "spectacular" and he hoped the man would also fare well.

The man's mother told the judge she was upset when she read the HSE letter but both parents said they had put the matter behind them and wanted to focus on helping their son.

They expressed gratitude to the judge, the general solicitor of wards of court who represents the man's interests, wards of court service, doctors and others dealing with him.

Such involvement made them feel "less alone", the mother said.

The father said they appreciated the judge's understanding of the nature of anorexia and the compassion he had shown them as parents.

The case was re-entered before the judge this week by the general solicitor due to concerns at the delay in a bed becoming available and the seriousness of his condition.

His weight is about 42.5kg and he was found to have hidden away a large number of supplemental drinks he was supposed to consume.

Today, the judge welcomed the man can be moved to the UK within days and made a range of orders to facilitate that, noting there was no opposition to the UK move from either the man or his parents.

The man would retain all his rights as a domiciled Irish citizen while in the UK, he added.

Peter Finlay SC, for the HSE, said it would fund regular visits to him by his parents while David Leahy BL, for the general solicitor, said she will continue to visit him.

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