THERE are no State-owned fixed-wing aircraft on standby to fly a transplant patient to a British hospital -- the fastest means of getting there.
The glaring gap in arrangements for transplant patients is not addressed in a report into the failure to transport Leitrim girl Meadhbh McGivern by the Health Information and Quality Authority (Hiqa), meaning that the litany of errors in the case could easily happen again.
Incredibly the "perfect storm" of events surrounding the transfer of Meadhbh for liver transplant surgery to London in July saw those involved in the process using the slowest aircraft possible -- a helicopter.
Even then they got it wrong -- believing it would take an old Coast Guard helicopter just an hour-and-a-half instead of four hours to reach London from Sligo.
The Air Corps, the only government agency with fixed-wing aircraft able to take patients to Britain, is not required to have them on standby or to have pilots on call.
An agreement with the HSE specifically says fixed-wing aircraft are not on standby for transporting patients to Britain "and may well be unavailable due to prior taking or unavailability of aircraft or crews".
The service is on an "as available basis", the agreement said.
On the night, frantic arrangements were being made to fly Meadhbh to the UK, three of the four fixed-wing aircraft available to the Air Corps were grounded or out of service for maintenance.
These were two Casa maritime patrol planes, and a Learjet executive jet, which is the only plane with a specific 'Lifeport' air ambulance system that can be integrated into the power system.
The only other fixed-wing aircraft, the Gulfstream G4 jet, was flying the President back from a royal wedding in Monaco, which was estimated to land in Baldonnel at 22.30.
The Air Corps was told this option would not be required, while London was beyond the night-time flight range of an AW139 helicopter. The devastating report found there was no one person or agency in charge of her care or transportation.
Hiqa chief executive Dr Treacy Cooper said the overriding finding that contributed to Meadhbh's failed transportation was that no one person or agency was in charge or accountable for the overall process of care and transportation.
The most crucial piece of information not passed on was what type of liver was being offered, from a donor who was dead, meaning the deadline for surgery was shorter then usual.
Several agencies were involved in a "desperate and frantic" attempt to get transport for the young girl, including the HSE, the Air Corps, the Coast Guard, the Department of Transport, and the Emergency Medical Support Service.
The teenager was minutes from boarding a Coast Guard helicopter when she was told she would not make it to London before a 2am deadline.
Meadhbh's father Joe said that the findings of the report were frightening and damning, and that it confirmed what he and his wife had suspected, all along: that there was "never a plan in place".
He said the government Gulfstream jet was used for presidential, ministerial and military transport. "But what about transport for sick children trying to get to King's College Hospital for a liver transplant? Should that not rate up there among its intended uses?" he asked.
Along with a wide range of recommendations affecting all the agencies involved in the transfer, the report said that a national aeromedical co-ordination centre group should be set up to co-ordinate the transfer of patients by air.
In the North, a private contractor co-ordinates and provides all aeromedical transfers to the UK using fixed-wing aircraft.
- DON LAVERY
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