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Concern over axing of Navan surgery
[Posted: Wed 01/09/2010 by Niall Hunter, Editor www.irishhealth.com]
The HSE has announced that all acute and emergency general surgery is to cease at Our Lady's Hospital in Navan.
In a statement today, it said the decision had been taken "in the interest of providing the highest quality service to patients and following expert clinical advice."
The HSE move has been condemned by the Irish Nurses and Midwives Organisation (INMO), while one local GP described the decision as "disastrous" and claimed it would lead to the eventual complete closure of Navan's A&E.
The HSE said the A&E at Navan will continue to function on a 24-hour basis with triage by emergency department, medical and nursing staff.
However, patients arriving at Navan's A&E needing acute or emergency surgery will be transferred to another hospital in the HSE Dublin-north-east region, namely Cavan, Drogheda, Beaumont or Connolly hospitals, which will provide this service on a rota basis.
A standard protocol has been developed between Navan, the ambulance service and these hospitals to ensure the safe transfer of patients, the HSE said.
However, this is an interim arrangement until appropriate capacity for these patients is made available at Our Lady of Lourdes Hospital in Drogheda. When this capacity becomes available, all acute and emergency non-major surgery from Navan will be redirected to Drogheda.
The HSE said patients requiring non-urgent (as opposed to acute/emergency) surgical procedures at Navan will be referred to outpatient, day case or inpatient surgical services as appropriate. It said the majority of minor non-urgent surgery cases in future would be referred to Drogheda or Dundalk hospitals.
The HSE said Navan currently dealt with four emergency surgical admissions per day, with one of these requiring a surgical intervention within a 24-hour period.
It said patients needing medical care for conditions such as stroke, cardiac arrest and diabetes will continue to be admitted to Navan Hospital.
Orthopaedic surgery will continue as normal at Navan, which houses the regional orthopaedic unit.
The HSE said patients requiring rapid access to outpatients or day surgery will be facilitated at Drogheda or Dundalk hospitals.
Last month, the HSE ordered that all laparoscopic (keyhole) surgery should cease at the Co. Meath hospital. It said it took this decision following concerns regarding the hospital meeting standards needed for this surgery.
Since 2006, no major surgery has been carried out at Navan Hospital. In February of this year, the practice whereby patients requiring major surgical intervention were taken by ambulance to Navan to be stabilised and then sent to another hospital also ceased.
The latest HSE move will mean the end of minor and intermediate surgery at Navan Hospital.
The HSE told irishhealth.com that the advice that led to the decision about Navan emanated from a HSE review carried out by a group comprising Dr Doiminic O'Brannagain, Clinical Director, Louth/Meath Hospitals; Dr Colm Quigley, adviser to the north-east transformation programme and physician at Wexford Hospital; Mr Ken Mealy, consultant surgeon at Wexford Hospital, and Mr Arnold Hill, consultant surgeon at Beaumont Hospital in Dublin and Professor of Surgery at the College of Surgeons.
Prof Hill is also an adviser to the National Cancer Control Progamme, which over the past two years has reorganised cancer services into eight major hospital centres.
The HSE said last month the ceasing of keyhole surgery at Navan followed an ongoing clinical governance review of hospitals.
In April of this year, the HSE proposed that all surgeons at Navan sign a document stating that only certain types of surgery would be performed there.
The Irish Hospital Consultants Association expressed concern about this proposal and it was not implemented at the time. It is understood that one of the general surgeons at the hospital was placed on administrative leave but was subsequently reinstated.
Local Fine Gael TD Damien English said with general surgery now being removed completely from Navan, the hospital was being downgraded by stealth.
He claimed this downgrading would not end with the loss of acute and emergency surgery.
The INMO said there was no clinical basis for the decision to remove all surgery except orthopaedics from Navan, and claimed the decision was solely based on financial reasons.
The nurses body said a management consultants' report last year stated that Navan Hospital was a safe and appropriate setting for minor and intermediate level surgery and for emergency appendectomies and hernia operations.
Navan GP Dr Niall Maguire told irishhealth.com the decision to remove surgery from Navan would prove "disastrous."
He said the decision to remove basic and intermediate surgery from the hospital effectively left three highly-skilled surgeons there surplus to requirements, and the HSE had undermined them.
Dr Maguire said the hospital was being downgraded and would effectively be left to deal with "lumps and bumps and endoscopies."
He warned to that remaining A&E services at the hospital may also have to cease, despite what the HSE said, as emergency and acute medical care often required surgery or anaesthetic consultation, which would no longer be available on the hospital site.
Dr Maguire said the latest HSE decision was likely to mark "the end of Navan Hospital."
He added that Co. Meath had a very low ratio of GPs per population and this would make it difficult for them to pick up the slack following the further downgrading of local hospital services.
Labour Party health spokesperson Jan O'Sullivan said the decision in particular by the HSE to divert people to Our Lady of Lourdes Hospital in Drogheda was inexplicable as this hospital was already under severe pressure and the move would only add to its problems.
|anony Posted: 02/09/2010 10:43|
Typical HSE/Department strategy - their 'experts' are so omnipotent and infalible that no one else can contradict their pronouncements. During the year prior to the closure of Monaghan Hospital a medical audit of the medical services at the hospital was carried out. The results were published and accepted by top medics as being as good as and in some cases better than similar services in other larger hospitals - so what do you do with that??? - you close it down of course. Monaghan Hospital had an excellent reputation for surgery and outcomes but there were problems identified in Cavan Hospital. What do you do ???? - Close Monaghan and transfer the patients to Cavan. Who will say 'STOP' and will they say it before our entire health services have been driven into oblivion?
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