HSE Audit Reveals Post-Mortem Training Gaps, Consent Issues in 12 Hospitals
A 2023 HSE audit of 12 hospitals revealed critical gaps in post-mortem training, inconsistent record-keeping, and non-compliance with consent guidelines for organ retention and disposal. Issues included verbal consent acceptance and refusal by pathologists to share report dates. The HSE is developing a training program and review group to address these systemic problems by late 2026.
An internal HSE audit of 12 hospitals in 2023 found that «essential post-mortem training» was not fully designed or delivered, risking inconsistent approaches and errors in informing bereaved families about organ disposal. The 2025 audit, released under the Freedom of Information Act, reviewed compliance with the 2023 HSE National Guidelines for Post-Mortem Examination Services.
The audit identified inconsistencies in record-keeping for post-mortem examinations and organ retention, with some registers missing data like time of death and Coroner authorisation. It also noted an «undefined and undocumented relationship between the HSE and the Coroner Service.» Four hospitals—Sligo University Hospital, Our Lady of Lourdes Drogheda, University Hospital Limerick, and University Hospital Waterford—accepted verbal consent from coroners for post-mortems, despite guidelines requiring signed written consent, except in exceptional cases. Some coroners also used SMS instead of required written authorisation.
Management of temporarily retained organs also deviated from guidelines; six of the 12 hospitals offered only one disposal option (burial or cremation) instead of both, potentially causing distress. Cork University Hospital (CUH) did not record final post-mortem report dates because the Assistant State Pathologist and Cork Coroner refused to provide this information, citing independence. The Coombe Hospital had eight discrepancies in its organ retention register, which it claims are resolved but require independent verification.
Cork University Hospital performed the highest number of post-mortems reviewed in 2023 (980) and 2024 (456), while Children's Health Ireland at Crumlin performed the fewest (15 in mid-2023, 41 in 2024). This audit follows previous controversies, including a 2022 HSE audit finding that several hospitals incinerated organs without family knowledge. The HSE is developing a comprehensive training program, expected by late 2026, and has formed a review group to address these issues.