GPs say HSE axe to fall on surgery at Navan hospital

Fears that the HSE is planning to axe all acute surgical services in Our Lady's Hospital in Navan have been expressed by local doctors and public representatives. The HSE confirmed this week that it would be making an announcement about hospital services later this week after it had briefed consultants, hospital staff and local doctors, but would not indicate any details of the changes. However, GPs in the area believe that all acute surgery at the hospital will cease. This follows the decision earlier this month to halt all laparoscopic procedures at the Navan hospital. The HSE has confirmed that the Louth-Meath Hospital Group is €13 million over budget for 2010, and while it is due additional funding, measures have already been taken to reduce expenditure and it says it is working to further reduce expenditure and to increase income, while ensuring all efforts are made to protect services. Local doctors have warned that removing acute surgical services from Navan would have a knock-on effect on all general surgical and medical services in the hospital and have warned that Our Lady's Hospital was being reduced to a community hospital with no acute services. Navan GP representative, Dr Niall Maguire, warned this week that the move would have serious consequences for patients and the referral practices of GPs. He said impact of the upcoming decision would totally undermine the surgical unit in Navan and risk the loss of all surgery on-site. He pointed out that Meath has the lowest provision of GPs in the country, that the North-East Doctor on Call (NEDoC) service is under threat and not a single one of the 12 primary care teams promised for Meath in 2007 had been established to pick up the slack when hospital services are reformed. "There is no prospect of a regional hospital and Drogheda Hospital is already stretched beyond capacity," he said. Dr Maguire said that the removal of acute surgery from Navan along with the ending of laparoscopic procedures would mean less anaesthetists and nurses and would leave any surgery unviable. He added that acute medical services would find it impossible to operate without the back-up of a surgical unit. "To our minds, as GPs, if this is allowed to happen, it will mean the end of Our Lady's as an acute hospital in the very near future. Basically, Navan will be left with something along the lines of Longford Hospital - an outpatient clinic with a minor injury unit. The A&E and medical assessment units will close," he warned. "All sick patients in Meath will have to travel to Drogheda, Cavan or Dublin in an emergency or even for the routine treatment of surgical problems, pneumonias, asthma, bronchitis, bad urinary infections, diabetes and so on," Dr Maguire predicted. The GPs' representative described the choreography and sequencing of the HSE plan was a travesty and a gross abuse of process. "We all accepted, following the Teamwork report in 2006, that acute surgery would transfer to Drogheda, but that Navan would retain day and five-day surgery which would allow the delivery of all minor and intermediate surgical procedures and simple major surgery such as elective laparoscopic cholecystecomy. This would cover 70 per cent of the normal routine general surgical procedures that are referred from GPs to local and regional hospitals," he said. Dr Maguire said that all clinicians would welcome properly funded changes to medical services in the north-east but, in the absence of any concrete developments in terms of community care or a new regional hospital, GPs would overwhelmingly oppose cutbacks to service provision at Navan. He said local doctors felt that the recent attack on surgical provision in Navan was a cutback under the guise of a baseless concern about quality. "There is no reasonable basis for the competence of the surgeons or the capacity of their unit to be called into question as it has been," he said. Fianna Fail Cllr Tommy Reilly said he was very disappointed at the news that Our Lady's Hospital was going to lose its general surgery service. "It seems that the downgrading of Navan's hospital is taking place bit my bit yet, at the same time, we have not had the slightest move on the planning of a new regional hospital to be located in the town," he said. "Navan was chosen as the site for the hospital but, after that, there was nothing but dead silence. Why can't we take money from the pension fund to pay for a regional hospital? It seems that we have no problem taking money out to prop up that sick Anglo Irish Bank but not a euro towards a regional hospital. It is disgusting, to say the least", he said. Meath West Fine Gael TD Damien English said that the reported removal of surgery from Our Lady's Hospital was "an absolute disgrace" and one that would have serious future consequences for the hospital "under this FF-led Government". He said there was no doubt in his mind that this move by the HSE was a direct consequence of the Government's piecemeal health policy and by decisions taken at the Cabinet table. "It is unfortunate for the people of Meath that our voice at Cabinet has been weak on vital health decisions over the past few years. The result has been a continuous slow drip removal of services from Our Lady's Hospital to hospitals in Dublin and Louth, especially. Health services at Our Lady's are being allowed to be taken out of Navan and put into hospitals that are already over capacity," he added. He went on: "Navan Hospital is a great facility for the people of Meath but we are told that it is now best to withdraw more services before the new regional general hospital is provided. This is hard for the people of Meath, the patients and staff in Navan Hospital to accept, especially as it would make more sense to improve the services here as our population continues to grow." Sinn Fein Cllr Joe Reilly, a member of the Dublin North-East Regional Health Forum, described the recent reports of the removal of surgical services as "death of Our Lady's by a thousands HSE cuts". "The statement by HSE management appears more akin to the utterings of a multinational corporation CEO than those of people responsible for the provision of a public health system," added Cllr Reilly. Meath County Council chairperson, Cllr Ann Dillon Gallagher, said the biggest concern for patients and members of the public was the fact that the HSE transferred and altered services before they had an alternative service in place. "Once again, we are left reacting to a decision without that decision being debated and examined in public. As far as I can see, the patient is the last consideration on the list of HSE priorities," she said.