Hyponatraemia inquiry: Trust 'not responsible' for patient safety
A former chief executive of Belfast Health Trust has said it was "shameful" that the trust did not have responsibility for the clinical safety of patients before 2003.
William McKee was giving evidence to the hyponatraemia inquiry in Banbridge, County Down.
It is examining the deaths of five children in hospitals between 1995 and 2003.
Mr McKee was head of the Royal Group of Hospitals between 1993 and 2006.
He then became chief executive of the newly formed Belfast Health Trust.
Mr McKee was giving evidence to the inquiry as the five children involved all died in the Royal Belfast Hospital for Sick Children (RBHSC)- although some of the children had initially been treated elsewhere.
After several hours in the stand, the inquiry's team asked Mr McKee who he held responsible for the deaths of the children, but specifically four-year-old Adam Strain and Claire Roberts, who was nine.
In response, Mr McKee said he accepted the trust had failed.
"We failed Adam Strain and his family in the care management of his fluids. It's clear we failed Claire Roberts in her treatment and in the communication with her family both before and after her death," he said.
"However, having thought long and hard about it and while it's a judgement that should be left to others, I feel I should not as chief executive, be held responsible for the children's deaths.
"Not withstanding the need for a scapegoat I think any responsibility that would fall to the chief executive would depend on whether this was an isolated incident with clear clinical components or whether it was indicative of systematic failure."
In response, the chairman of the inquiry, John O'Hara QC, said it was not a "scapegoating exercise" and said his role was to establish the facts around what happened.
Earlier on Thursday, Mr McKee told the inquiry that it had to be accepted that up until 2003 there was no "guidance, responsibility or authority" given to the trust board to take responsibility for the clinical safety and quality of care given to patients.
That practice has since changed, but Mr O'Hara said directly to Mr McKee: "In essence, this means there's no barrier, no protection for the public."
In reply, Mr McKee answered: "By today's standards, it's shameful, but by the standards of 1995, that's the way it was."
He also said that among some consultants and doctors there was a pre dominance of independence of self-regulation and a dominant culture.
The inquiry is investigating the deaths of Claire Roberts, Adam Strain, Raychel Ferguson and examining the events following the deaths of Lucy Crawford and Conor Mitchell.
In the case of four of the children, the inquest stated that hyponatraemia was a factor that contributed to their deaths.
Hyponatraemia describes an abnormally low level of sodium in the blood that can occurs when fluid is not administered correctly.