Times Debate: ‘Centralizing acute Hospitals in the best Interest’.( Mid-West Region)

[cakeordeath]

Motion:
‘This house believes that centralizing acute hospital services is in the best interest of public safety.’

Speakers:
*Dr Maurice Neligan Consultant cardiac surgeon
*Cathal O'Donnell Senior accident and emergency consultant Mid-West Regional Hosp, Dooradoyle Limerick
*Paul Burke Senior accident and emergency consultant Mid-West Regional Hosp, Dooradoyle Limerick
*Dr Michael Harty, The chair of the Clare branch of the Irish College of General Practitioners

Limerick Institute of Technology. 26 May 2009 6.30.(free)

I am expecting a heated debate and input from the floor!
Dr Maurice Neligan Says that experience has shown him that the large hospital model will not work. He believes that the morale, business and social factor of having a properly equipped hospital in the community cannot be underestimated. The chair of the Clare branch of the Irish College of General Practitioners, Dr Michael Harty, has little or no faith that promise made by the HSE will be followed through. And finally,Cathal O'Donnell and Paul Burke currently working at the coalface in the Mid-West, say that the current system operating in small hospitals is costing lives.

You add to the mix,the Irish Nurses' Organisation and a group of 80 GPs from the Mid-West who have said that the plan won't work unless Limerick Regional Hospital gets major investment as outlined in the Teamwork report commissioned by the HSE. Highly unlikely now! While Dr Christine O’Malley a Nenagh Hospital Consultant says doctors trying to transfer patients still have to ring the main switchboard in Limerick to locate the on-call consultant. As it stands it’s a shambles.

And Finally TD Peter Power "I welcome the fact that this reform has been led by clinicians who are the experts on this. It is not necessarily led by politicians, although it is assisted by them.” ( just for fun)

[SIZE="1"](I have no link to the above.)[/SIZE]

[cakeordeath]

The reconfiguration of acute health services in Clare Limerick and Tipperary was debated last night. The motion was "this house believes that centralising acute hospital services is in the interest of patient safety.”

Paul Burke and Cathal O Donnell debated FOR the motion. (The consultants charged with heading up the changes in the Mid West Region). Maurice Neligan ,(renowned cardiac surgeon) and Dr Michael Harty (Co Chairman of the Clare/North Tipperary GP Action Committee) spoke against it.

Centralisation of acute hospital services 'scandalous', says GP


Centralisation of acute hospital services 'scandalous', says GP - The Irish Times - Wed, May 27, 2009


The debate on the motion, was opposed by a small majority of the more than 200 attendees.

One of the most controversial aspects of the centralisation programme locally was the loss of 24-hour AE services at Nenagh and Ennis general hospitals.

“This a scandalous and simplistic way to deliver acute care especially in peripheral areas like Clare and north Tipperary,” argued Dr Harty. “It places patients at unacceptable distances from acute life-saving medical care and forces people to travel unnecessarily to an already overworked and overwhelmed central hospital in Limerick.”

He described centralisation as a “national policy” and said Bantry, Mallow and Tralee hospitals were next in line for “downgrading and eventual closure”.

Paul Burke said in favour of the motion that centralisation of services did “not mean closing local hospitals or taking away services, but merely changing the way” these services were delivered. “We should think of our acute service throughout the [midwest] region as one large hospital and three smaller ones feeding into it,”

“not mean closing local hospitals or taking away services, but merely changing the way these services were delivered.” ?

Of course it means taking away services. Of course it does. The taking away of services has already begun. The services are already being taken away with nothing to replace them. To me it's like giving a child a brand new state of the art trampoline, but without the safety net - great if the child can get on and stay on.

A & E in the mid west Regional was a disgrace on Sat night last. During the week, there was an 18 hour wait.

[He3]

The HSE is not meeting its promises about the Primary Care teams that are supposed to make all this work.

Only 50% of primary care teams in place by year end | Irish Examiner

THE number of primary care teams (PCTs) in the Health Service Executive (HSE) South is less than half the figure required to support the reconfiguration of hospital services, according to a leaked report.

A Review of Acute Services in the HSE South estimates 139 PCTs are needed, but according to the HSE, 63 will be operational by the end of 2009. These 63 teams were in development between 2006 and 2007, but just 34 have had their first clinical team meeting, according to a HSE performance report.

[cakeordeath]

According to Dr Burke, since April 6th last, when centralisation of services was introduced in the midwest, there had been an increase of four patients attending the Limerick AE department.

Is that per night? Is that 28 per week? How many admissions?

Is that 28 beds (or trolleys taken per week) without out a single extra bed added?

I know for a fact that there is talk of reducing the number of nurses in there.

Shame on them. The opposition wont be heard until reconfiguration arrives on their own doorstep.

[cakeordeath]

The HSE is not meeting its promises about the Primary Care teams that are supposed to make all this work.

Only 50% of primary care teams in place by year end | Irish Examiner

THE number of primary care teams (PCTs) in the Health Service Executive (HSE) South is less than half the figure required to support the reconfiguration of hospital services, according to a leaked report.

A Review of Acute Services in the HSE South estimates 139 PCTs are needed, but according to the HSE, 63 will be operational by the end of 2009. These 63 teams were in development between 2006 and 2007, but just 34 have had their first clinical team meeting, according to a HSE performance report.

Yes. And the advance paramedics? One car in Clare, One in North Tipperary.

Something else, the average stay in the mid west is 5.7 nights but this is to be reduced to 3 nights. I cannot as of yet give a link.

The pediatric unit, ( not hospital - we don't have one south of Dublin) is to reduce staffing from 4 nurses to 3. That means that if two nurses are on Special - one to one care for a very sick child - which has been the case for the last two weeks, that leaves 2 nurses for an entire ward of 30+ sick children. Last week a child waited 2 hours for a spoon of calpol.

Adults? Every drunk from Kilkee to Nenagh in the A & E department. They cant be treated locally so every available ambulance is driving the 100 KM + journey to bring them to the reconfigured centre of excellence that has not one extra bed and if anything, stands to have even less resources than it did last year.

And how on earth are GP's supposed to decide with certainty whether patients are surgical emergencies ( Go to the mid west Regional) or medical emergiencies ( go to Ennis or Nenagh if referred by a GP)?

Do they have labs in their medical bags? Can they test the bloods, send the urine to the lab in order to rule out an acute abdominal?

[cakeordeath]

Midwest first, then Cork/Kerry , then the hospitals in Wexford, Carlow, Kilkenny and Clonmel with services to be concentrated at Waterford Regional Hospital.

Lets not forget the centralisation of pediatric services too

[He3]

There is an unhappy symmetry between the mess they are making of centralisation, and the mess the government has made of de-centralisation.

[drzhivago]

There is an unhappy symmetry between the mess they are making of centralisation, and the mess the government has made of de-centralisation.

Fantastic comment

[sarahj]

The govt are taking away necessary publicly provided emergency and other services and allowing them to be replaced with private fee-paying health centres.

Not only is it a waste of tax payers money but it is extremely inefficient.

On top of that - there is some clear evidence now on what services should be provided locally and what should be provided centrally, Obviously Mary Harney hasn't heard any of that either.

[Schuhart]

there is some clear evidence now on what services should be provided locally and what should be provided centrally, Obviously Mary Harney hasn't heard any of that either.

What clear evidence are you referring to?

(I'm not necessarily disagreeing - I actually take evidence seriously. I just want to know what you have in mind here.)