Resumption of surgery a victory for people power

The resumption of general surgery at Our Lady's Hospital, Navan, is very good news for those campaigning for retention of services at Our Lady's, who have been fighting a difficult battle over the last year, in particular, to see services reinstated. The HSE has confirmed that minor and intermediate general elective surgery resumed at the hospital from Monday of this week. Surgery was halted at the Navan hospital in September 2010, leading to major questions about the long-term viability of the hospital. The return of surgery to Navan will come as a boost to patients, staff and the local community in Navan who have fought a high-profile battle to retain services at the facility. The news comes just over 12 months on from a huge protest march which brought an unprecedented 10,000 people onto the streets of Navan in a show of strength to demand that the continuing cutbacks in services at the hospital, which has served the people of Meath well for generations, be halted and surgery be returned. Surgery was stopped at the hospital some 14 months ago amid HSE concerns about outcomes for some patients. The HSE said at the time that six cases had resulted in poor clinical outcomes and it was also concerned that there were low volumes of certain types of surgery at the hospital. The hospital was suddenly ordered to halt surgery last year and the review was commissioned by the HSE to investigate patient safety concerns. A review into four cases of keyhole gall bladder surgery, at Our Lady's found no negligent errors in surgical technique identified in relation to the practice of laparoscopic surgery by any of the surgeons involved. The Peyton Report, published last July, recommended the return of some surgical services and vindicated the surgical team at Our Lady's, who had been under a cloud after their work was called into question. One of the other findings of the review by Northern Ireland-based surgeon, Dr JW Rodney Peyton, is that a small, standalone surgical department at Our Lady's Hospital is not viable in terms of expertise or clinical governance, and needs to be part of a larger surgical department. The HSE said an implementation group had been established by the Louth-Meath Hospital Group to oversee and ensure all recommendations are acted upon and addressed in a timely manner. According to Fine Gael TD Regina Doherty, there have been other positive developments at the hospital, with a chronic pain service expected to commence in January. She said this will save patients in the Louth/Meath area from having to travel to Dublin for the service. She added that there was further good news in relation to the regional rheumatology service at Our Lady's, launched in September. As well as a rheumatologist already dedicated to this service, a second consultant post is to be provided, together with a musculoskeletal physiotherapist. However, the manner in which elective surgery was suddenly removed from the hospital in September 2010 still raises many questions. According to one of the most ardent critics of the HSE in this area, GP Dr Ruairi Hanley, the health authorities have waged an "unrelenting campaign to downgrade and ultimately destroy rural hospitals throughout Ireland". He said the reality is that the vast majority of sick people requiring inpatient care are not victims of complex trauma, nor do they need expert specialist care. They typically have illnesses that can easily be treated as inpatients in well-resourced, small local hospitals, many of which have successfully been providing this service for decades. In a strongly worded letter published recently, he claimed the HSE's agenda was clear - to force sick and vulnerable of County Meath onto trolleys in one of "the worst and most overcrowded hospitals in Ireland, Our Lady of Lourdes in Drogheda". He added he believed if the HSE was allowed to close or downgrade Navan A&E, patients would die tragic, painful and unnecessary deaths in a facility that is already barely capable of dealing with current levels of demand. Despite the very positive news that certain surgery has resumed at the hospital this week, there remain concerns that the Navan hospital could be downgraded from a category three to a category two hospital if there is any threat to acute medicine services. The people of Navan and the wider county have made it very clear that local services should not be downgraded until a better service, with adequate capacity, is provided. For that reason, hospital campaigners and public representatives alike will need to remain vigilant over the coming weeks and months.