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Navan surgeons defended their record
[Posted: Wed 01/09/2010 by Niall Hunter, Editor www.irishhealth.com]
Surgeons at Our Lady's Hospital in Navan told the HSE last week that their results for procedures compared favourably with all published figures.
In a letter to local hospital management, they said there had been one death recently at Navan following keyhole gallbladder surgery, which was in an elderly patient and was not directly related to the surgery.
The HSE today ordered a halt to all types of general surgery at Navan, "following expert clinical advice" and in what it said were the interests of high quality services. The decision has led to much local anger.
The three consultant surgeons were responding to the HSE's decision earlier in August to cease keyhole surgery at the hospital, following what the health executive said were concerns about meeting the standards required for this type of surgery.
On August 25, the surgeons told the HSE the decision to halt keyhole procedures was not justified and no properly conducted audit of surgical activity at the hospital would provide support to this decision.
The surgeons said they had requested further details from the HSE of the clinical review which led to its decision to stop keyhole surgery in Navan, including how its results compared to those of similar hospitals. The consultants said they were not notified or consulted about this review.
The surgeons said all operations were discussed at a weekly audit at the hospital but no concerns in relation to keyhole surgery had been raised at these meetings over the past four years during which they have been held.
They said a total of 826 keyhole gall bladder and 706 keyhole hernia operations had been carried out at Navan since 2003. "Our figures and data for this considerable experience compare favourably with all published figures."
The letter also states that a consultancy report from last year included a review of keyhole surgery at Navan from 2003-2005 and when the results were examined by the reviewers they were found to be satisfactory and comparable with the Royal College of Surgeons of England Laparasopic (keyhole) Audit of 1994.
The surgeons said since this report, the rate and range of complications following laparascopic gall bladder removal had not significantly changed and remained within the norms of similar units.
They said a total of two deaths and two common bile duct injuries had occurred at the unit since 2003 following keyhole gall bladder surgery.
"One of the mortalities occurred recently in an elderly patient. At post mortem, the cause of death was directly related to a mesenteric thrombosis (abdominal blood clot)."
The surgeons said they were convinced the surgical unit at Navan "has been subjected to very unfair criticism and comment for quite some time."
They said a decision to cease keyhole surgery at the unit should only have been taken following a full independent examination of all laparoscopic activity at the hospital.
The surgeons added that the consultancy report from last year concluded that Navan would function very well as a treatment centre for hernias, elective gall bladder surgery and ambulatory surgery.
The Navan consultants- Frank Cunningham, Joseph McGrath and Ibrahim Ahmed, called on the HSE to reverse its deicison to stop keyhole surgery at Navan.
In a letter last month to a Navan GP, Finbarr Lennon, consultant general surgeon at Our Lady of Lourdes Hospital in Drogheda, said the decision to cease keyhole surgery in Navan, following on from a series of HSE directives relating to surgery at the hospital, was a very serious development
He said it had the effect of undermining the general surgical services and all the consultant surgeons therein who were endeavouring in very difficult circumstances to deliver emergency and elective services to the community.
'It inevitably will reduce the confidence the family doctors and the community have in the surgical unit and indeed the hospital itself."
Mr Lennon said such a decision to cease surgery should only occur after "the most rigorous independent external investigation."
He pointed out that there is no acute hospital in the country that can ensure zero risk to patients. "Surgery is an invasive area of medical practice and complications do occur."
Mr Lennon said where concerns arose in surgical units, internal procedures are in place for assessment and responses to adverse incidents.
"The clinical audit mechanism is the normal means utilised to change or modify surgical practice in individual units."
Mr Lennon said the recent decision to cease keyhole surgery at the hospital was a "totally disproportionate response to any clinical or operational shortfalls that may exist in the delivery of laparoscopic surgery in Navan."
Read more on the axeing of surgery at Navan here
|gosh Posted: 16/09/2010 10:56|
As a longstanding patient of Mr. Mc Grath I am alarmed at the removal of surgical services in Navan. I have lived in Meath for over 30 years and in all that time our emergency unit has been in a portakabin. It has been rumoured , for all that time, that Navan was set to close. I wonder if,like the British,this is a case of "do not let a good crisis go to waste". I do not want to go to Drogheda. The HSE tells me it is in the interest of patient safety. How safe will it be to travel unknown roads on a bad weather night.
Mr Dempsey said ,on local radio, this morning that we patients could not be told all because of legal restraints. Why would you close a functioning hospital because of legal cases. Suspend the staff if there is a question as to their competence. But close a whole hospital because you might be sued!!!! Come on ??
About two months ago my GP requested an Orthtopaedic consult. When the appointment was not coming I rang the Hospital. Medical records who told me I would be waiting 14/18 months. As I am in constant pain I asked my GP to refer me somewhere else .As an urgent case I got an appointment In Blanchardstown for 2011 Feb. The Ortho. in Navan is the regional Ortho. for the North East. Yet it is closed until the end of the year. The were so efficient that they had spent all their allocated funds by August. So the bookeepers say I have to wait in pain!!!!!
Mary Harney's figures are a sham as we do not feature on her waiting lists until after the first consultation with a Surgeon. Please keep Navan open. get rid of Ms. Harney instead.
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