What future now for Navan Hospital?

The erosion of surgical services at Our Lady's Hospital in Navan has continued to accelerate over the past number of months. Following the discontinuation of keyhole surgery announced by the HSE in early August, the HSE is scheduled to make a significant announcement later this week concerning acute surgical procedures in Navan. The health authorities want to brief staff and local GPs on its plans initially before making any public announcement but it is believed it will concern the removal of all acute surgery from Our Lady's to Our Lady of Lourdes Hospital in Drogheda. All this comes as a bitter blow to those who have fought to retain services at the Navan hospital over many decades as it now appears inevitable Our Lady's, which serves a county with a population in excess of 160,000 people, will soon have lost so many of its services as to render it nothing more than a community hospital and day care facility. Since the Teamwork report of 2006, no major surgery has taken place at Our Lady's Hospital and, earlier this year, the practice of patients needing major surgical intervention being stabilised initially in Navan and then being transferred to a major hospital in Drogheda or Dublin ended. Angry local GPs in Navan who are at the forefront of a campaign to stop the further downgrading of the hospital have been voicing their frustrations over the past couple of weeks at the HSE's decision to end laparoscopic (keyhole) surgery, branding the decision as hasty and inappropriate. They are particularly angry about the lack of consultation by the HSE on the move and have openly questioned its motives for ending this service. They have called on the authorities to make available the evidence they used to determine that the quality of surgical care in Navan has deteriorated - the reason given by the HSE for the removal of this particular type of surgery. Coming just a week after it was revealed that the North-East Doctor on Call (NEDoC) service is facing a cut of up to 75 per cent in its funding, which it claims will decimate its services for out-of-hours GP care, it is difficult not to come to the conclusion that - in the words of Meath East Fine Gael TD Shane McEntee - the whole health system is breaking down. It is also difficult not to arrive at the view that Our Lady's is suffering a slow, painful death by a thousand cuts and will end up as nothing more than a glorified nursing home unless the haemorrhaging of medical services is staunched. Now, there are fears that the HSE will announce later this week the winding down of all acute surgical services in Navan, with doctors warning that the loss of this day and five-day surgery will have a knock-on effect on all general surgical and medical services in the hospital, reducing its role to that of a community hospital with no acute services and perhaps just a minor injuries unit. The loss of the surgical services would inevitably mean the closure of the hospital's A&E and medical assessment unit, GPs further predicted. Clearly, the GPs in Navan have had enough and say they will overwhelmingly oppose any further cutbacks in service provision at Our Lady's. Four years ago, in the wake of the publication of the Teamwork report, it was accepted that major acute surgery would be henceforth carried out in Drogheda but that Navan would retain routine minor and intermediate surgical procedures which are typically referred there from local GPs. Now, this service looks like it will also cease and patients in both emergency and non-emergency cases will be forced to go outside the county for treatment. In the county with the largest population in the region, this makes no sense. Ill patients will now have to endure longer journeys to get to hospitals outside Meath and, in the case of Our Lady of Lourdes in Drogheda, will no doubt be forced to endure the misery of lying on a trolley there while waiting for a bed to become available or while being treated. Even with its new emergency department, the anecdotal evidence from some patients treated there so far is that Our Lady of Lourdes remains a hospital under pressure and that while staff are doing their best to cope with a significantly increased workload, this facility is already stretched beyond its capacity. The downgrading of Navan Hospital to a step-down facility might be acceptable if the original promise to construct the new regional hospital for the north-east was still a realistic possibility. However, this is clearly not going to be on the horizon for many years and, in the meantime, the existing facility in Navan will continue to be stripped of the type of services that GPs and patients want retained. Should the fears of the Navan area GPs come to pass this week, then the people of the Meath who want to see a proper functioning hospital retained in the county town need to make their voices heard in opposing further cuts to services that have saved many lives at Our Lady's. It is time to make a stand.