What is to happen with the Accident and Emergency Services at Mullingar Regional Hospital? Are they going to be scaled down, no longer dealing with any serious trauma cases, with reduced services like the hospitals in Nenagh, Ennis, Roscommon and elsewhere, or is the Trauma Steering Group Report which suggests taking trauma cases from nine existing hospital A & E departments an unworkable and unrealistic plan?
To judge by the INMO response to The Sunday Business Post “leaked” story (pictured below), and the stance of local Deputies Peter Burke (FG), Willie Penrose (Lab) and Robert Troy (FF), it appears the “proposals” are not “real” – but will cause a huge level of controversy if attempts are made to implement them.
The report suggests that nine hospitals including also Portlaoise, Cavan, Naas and Ballinasloe (Portiuncula) have been earmarked to lose emergency trauma services, with serious trauma cases going instead to the nearest major hospital with more specialist doctors. However, the question is, does this plan add up or not?
The story brought strong reactions this week from the INMO and local Dáil members, Peter Burke (FG), Willie Penrose (Lab) and Robert Troy (FF) – with all rejecting the reported plan, which has yet to be delivered to the Department of Health. A Department spokesperson said on Monday that no plans are currently in place to close the units, saying that a report from the Trauma Steering Group has yet to be delivered.
Separately, the Irish Association for Emergency Medicine has previously called for far fewer than the current 29 A & E departments, claiming that centralising trauma units would mean more specialised care for patients in the bigger hospitals. However, this would also mean patients having to travel far greater distances to such emergency departments, and “centralising” efforts have not worked for other areas in recent years.
The country’s nurses said this week they are fed up with such “piecemeal change” – making things worse rather than better. It was not the first time this was proposed and attempted, but didn’t work, they say.
INMO’s Deputy General Secretary, David Hughes, said on Monday, that up to now, after the scaling back of services in Nenagh, Ennis, Roscommon and Tipperary, the so-called Centres of Excellence selected were “reduced to chaos”. The major hospitals, with few additional resources, were expected to take trauma cases into already overcrowded and overworked departments. They were all since perpetually overcrowded. A ten-year all party agreed health plan is needed with real Centres of Excellence developed, but these were neither funded or developed.
“We must learn from the errors of the past and there is no realistic prospect of the type of thinking behind these proposals being implemented in the short or medium term, even if they are valid,” Mr. Hughes said. “We call on the Government to make a clear statement that the existing Emergency Departments are not threatened by this report and there will be no repeat of the disastrous consequences already evident in Limerick, Galway, Drogheda, South Dublin and South Tipperary hospitals,” he concluded.
CALLED MINISTER
Deputy Peter Burke (FG) said he had called the Minister for Health on Sunday after reading the newspaper report and Minister Harris confirmed the Mullingar Hospital A & E is not closing, the Department had never considered closing it, and there are no existing plans which considered its closure.
Peter Burke said the opposite in actually the case. A sum of €5m was granted by the Government to upgrade the A & E with work in progress and the new A &E due to open this winter. Fine Gael had approved a €40m spend on Mullingar Regional Hospital, now in the final stages of cost benefit analysis, and approval was recently received for a new MRI scanner, giving it the necessary tools to assess patients. “It will include four new theatres, a new ICU unit, new Rehab unit and new Endoscopy unit,” he said.
Trauma cases accounted for less than 1% of all cases presenting at Mullingar Hospital. There was no evidence this unfinished report will hold any weight, or have an impact on Mullingar. Tullamore Hospital was already an orthopaedic centre caring for broken limb cases, and some patients were brought directly there, he said.
The new A & E will make things safer and better, when open.
‘DANGEROUS’ PROPOSALS
Deputy Willie Penrose described the expert group proposals as “dangerous” and could put lives at risk. It was stymied by the last government, but was still being pursued, and was a grave assault on the public health service in the midlands and mid-Leinster. It would leave an “entire swathe of the most heavily populated part of the country with inadequate 24 hour emergency care. Over 300,000 will be put at unnecessary risk due to this flawed policy, which needs to be halted at once,” he said, calling for the intervention of the Minister for Health and his Fianna Fail counterpart, as part of the government agreement.
“This assault on the public health system cannot be allowed stand, and if it occurs on their watch, it will never be forgotten or forgiven,” he said.
“The dogs on the street know that existing A & E units are overcrowded, stretched to the limit and in dire need of additional resources, not cutbacks,” he said. This draconian text-book exercise in book balancing and theory, with no basis in reality of service provision on the ground, would put patient safety at serious risk.
Deputy Penrose said that patients on trolleys and day long queues at the A & Es knew all this, as do nurses, ambulance drivers and other full-time staff, and had constantly expressed their well-founded concerns. If this “ill-judged plan” went ahead, it would only compound existing problems, he said.
“This is not about patient safety. Children don’t get sick 9 to 5, or elderly people during the day, and accidents happen mostly at night. Not everyone can go to the Beacon or Blackrock private during the night,” he said.
“This must be stopped in its tracks by the government,” he said. “The answer is not to close A& Es, but to staff them, and make them safe.”
“A DANGEROUS PLAN”
Deputy Robert Troy described the proposal being examined as a “dangerous plan” that would put lives at risk and must be resisted. Any efforts to downgrade services at Mullingar Hospital must be opposed. In the past hospital services were downgraded and relocated elsewhere with promises of better care being provided, but implementation left a lot to be desired, with patchy and inadequate emergency healthcare in some communities. “We don’t want this situation in Mullingar” he said, calling on Health Minister Simon Harris to make a statement, and saying he was requesting a Dáil debate in the coming week. Clarity was needed.
