2026-01-22

6. Deputy Michael Murphy asked the Minister for Health the alternative arrangements being developed by the HSE to ensure continuity of coronial post mortem services for the south-east region from January 2026, given that consultant pathologists at UHW will no longer provide this service; and if she will make a statement on the matter. [5311/26]

I ask the Minister for an update on the provision of post mortem services at Waterford University Hospital following the decision by HSE pathologists operating as independent contractors for the Department of justice to withdraw from the service from 1 January.

As the Deputy will be aware, the Department of Justice, Home Affairs and Migration has responsibility for coroners’ legislation and policy and is actively engaging with all relevant stakeholders, including my Department and the HSE. Since 2 January 2026, coronial post mortems have been provided by locum consultants recruited by the Department of justice, and the facilities and auxiliary staff of University Hospital Waterford have been provided to support that. The Department of justice has advised my Department that the service will be provided three days per week; that is, Mondays, Tuesdays and Fridays. Historically, the health service has assisted in the provision of coronial post mortem services on a sort of grace-and-favour basis. While consultant pathologists are employed by the HSE, coronial post mortems are carried out independently for the Department of justice. Obviously, that grace-and-favour model is not working. Hospitals are withdrawing from the provision of coronial post mortem examinations for a range of diverse and complex reasons, including a shortage of consultant pathologists willing to undertake that work, and increasing diagnostic workloads for an increasing population. My Department and the HSE will continue to engage constructively with the Department of justice to support a long-term resolution of the issue. All stakeholders remain committed to ensuring the continuity, quality and efficiency of coroner-directed post mortem services.

As the Minister says, this is ultimately the responsibility of the Department of justice under the Coroners Act. I thank the Minister for her engagement with me over the last six months. As she knows, behind every post mortem is a family in deep distress and shock. Often, these post mortems are the result of a sudden, accidental or tragic death. I welcome these interim arrangements. It is not ideal. It is my understanding that these locum pathologists are coming in from the UK three days a week. I know that members of the clergy have spoken publicly on behalf of families. Delays are already occurring. There is a panel of three locum pathologists, but could we look at increasing that number to four or five? Flights can be delayed or cancelled, somebody can have a bereavement or somebody can be sick. I ask the Minister to continue to engage with the Minister for justice. Let us keep this arrangement under review so that families can have post mortems in the timely manner they deserve.

It is important to separate out the arrangements we are talking about. This arrangement is not for all post mortems; it is for coronial-directed post mortems in instances, as the Deputy correctly identifies, of sudden or unexpected death that require and are directed to have this type of post mortem carried out. That is very much an issue for the Department of justice. Clearly, pathologists are continuing to do the work they have always been doing. Where a family has experienced a sudden tragedy - a sudden bereavement of some kind - and the coroner has directed this form of post mortem, that is obviously the responsibility of the Department of justice. I will speak with my colleague, the Minister, Deputy O'Callaghan, and ask him to increase his efforts to try to ensure there are more locum pathologists coming. However, University Hospital Waterford remains there to provide support in that ancillary way for this specific type of post mortem, which is, of course, a subset of all post mortems.

I agree and I acknowledge that our HSE pathologists have been doing this work as independent contractors. However, these pathologists are primarily concerned and occupied by diagnostic, surgical pathology work, for example, in cancer diagnosis. Therefore, for obvious reasons, they are withdrawing as independent contractors. Between 3,000 to 4,000 coronial post mortems are carried out annually in the country at various locations, namely, Dublin, Limerick, Cork, Galway and Waterford. Is there merit in looking at this more closely in terms of some kind of a strategic plan and a national strategy for the next ten years? The real concern, certainly across the south east, is that we will become like the UK whereby there are delays of weeks and weeks. Will the Minister keep that under consideration?

Again, I will direct that to my colleague, the Minister for justice, because coronial post mortems are a different thing. There is a difficulty recruiting pathologists across the country. For example, our friends in Belfast are having real difficulty on the paediatric and perinatal pathology side, which is very distressing for families with the loss of a child or a baby. There is a shortage generally but we have to create a distinction between the justice system and the health system, which continues to do its work. We need pathologists to continue to do their work, both in terms of diagnostics and research and also in terms of something that is separate and ancillary and arises as a consequence of the coronial court process. The latter is very much a matter for the Department of justice. Nobody cares about that when it is their loved one whose funeral is being delayed. In that space of real tragedy, real hurt and real pain, nobody cares who is responsible for it; they just want the issue resolved. I will discuss it with my colleague, the Minister for justice.