A WELL KNOWN colorectal surgeon has called on An Taoiseach Leo Varadkar and Health Minister Stephen Donnelly to engage in continuing dialogue to increase acute hospitals services and personnel throughout the Mid-West.
Professor Calvin Coffey recalled reconfiguration of acute hospital services was supposed to be followed by the introduction of a co-located hospital, additional funding and extra health infrastructure across the region.
This didn’t happen due to the economic crash and have not been implemented in recent years by the present government.
This has resulted in doctors, nurses, consultants and health care professionals all providing health care above and beyond what they should be providing.
Professor Coffey, who is one of the signatories of an open letter signed by 87 consultants and doctors, agreed that chronic overcrowding increases the risk of an adverse outcome for patients on trolleys due to the sheer volume of number and the lack of adequate staff.
Stressing the need for investment in hospitals throughout the region, Professor Coffey said this includes Ennis Hospital, Nenagh Hospital and University Hospital Limerick.
“We know from medical literature and research done by medical and clinical personnel the longer the wait in an ED beyond a certain length of time, the greater the risk to the life of people in that environment.
“We know that for a fact. Prolonged excessive waiting times are harmful. In the Mid-West on the ground, you have a daily reverse of reconfiguration.
“Patients are being brought into UHL from remote areas in West Clare, are triaged, it is recognised their condition can be managed in Ennis Hospital so they are sent back out to the day ward.
“When they are sent to the day ward, they are occupying out of necessity beds that are required for scheduled surgical care. As a result we can no longer provide scheduled care.
“There must be greater infrastructure across all of the region. The government must honour all of the commitments that were given before reconfiguration was started,” he said.
He explained a lot of procedures involving the bowel, bladder and different organs in Ennis, Nenagh and St John’s are critically important to prevent patients from getting into trouble.
“If you cancel those procedures, they become emergencies the following day. Now you have what was a scheduled procedure becoming an emergency procedure and you have a patient coming into an Emergency Department that is already overwhelmed in terms of the volume. It doesn’t make sense and is dangerous.”
Professor Coffey called for continuing dialogue with Mr Varadkar and Mr Stephen Donnelly.
Commenting on recent statements made by the Taoiseach in the Dáil, Professor Coffey noted he didn’t know when the first 96-bed block at UHL would be completed, he didn’t know when the second 96-bed block would be commenced and he didn’t know when the elective scheduled hub was due to start.
Professor Coffey also expressed concern about the Taoiseach’s comments that construction is to begin on the new Bon Secours Hospital in Limerick quite soon and he encouraged the UL Hospitals Group to “begin early discussions with them”.
He said the Taoiseach and Health Minister have been informed by the UL Hospitals Group that the Mid-West has the lowest number of hospital consultants, nurses and health care professionals and the highest number of emergency presentations and admissions per head of population in the country.
Despite irrefutable facts that the Mid-West is in dire need of a new elective hospital and improvements in health infrastructure to cater for the volume of patients, Professor Coffey said a decision was taken to provide an elective hospital in places like Cork and Galway.
While the ED in UHL has to cater for about 388,000 people, he pointed out there are six emergency departments serving a population of 1.2 million in Dublin.
“We need action imminently really. The 96-bed block that is being built at the moment is five years too late. When it is up and running, it will help but will not change the demographic we have tomorrow.
“We are very much on the back foot because of promises of new infrastructure that should have been delivered five years ago.
“The whole movement to concentrate services into the one hospital seems to have forgotten what we learned in the past,” he said.
In the open letter, doctors outlined the extreme crowding and relentless demands on health services for more than 10 years.
“Regarding University Hospital Limerick (UHL), the ability to provide care to our patients is stretched beyond its current capacity.
“All staff, who are endeavouring to provide the best possible care to patients in these conditions, are becoming increasingly demoralised and, as a result, the hospital is facing ongoing problems with recruitment and retention.
“UL Hospitals Group is not adequately resourced to deal with the volume of emergency presentations. UHL emergency department sees over 240 patients each day. Built in 2017 for maximum attendances of 190 patients, it is now overwhelmed with unacceptable pressure on all staff to endeavour to provide an appropriate standard of care.
“The recent Deloitte report clearly outlines the disparity in support and resourcing. We welcome the recent engagement of the Taoiseach and Minister for Health and their acknowledgement that UL Hospitals Group require specific support to build additional bed capacity to serve the demographic demands.”
“The origins of this ongoing crisis date back to the poorly resourced reconfiguration of hospital services in the Mid-West in 2009. The 640 beds to support this were never delivered.
“The withdrawal of direct emergency hospital care at Ennis, Nenagh and St John’s Hospitals was detrimental without the required capacity at UHL.
“We propose that additional resources are urgently required to maximise the use of our model two hospitals in a safe and clinically effective manner.
“We are calling on the Minister for Health to bring this about through engagement with the clinical stakeholders and allocation of adequate resources.
“Currently, patients from remote parts of West Clare, for example, must present to the emergency department at UHL and regularly spend two to three days on a trolley before ultimately transferring, by ambulance, to their local hospital where they could have presented and been effectively treated in the first place.
“The consultants of UHL commit to engage with all parties concerned public, primary care, management and politicians to seek urgent and sustainable solutions to this unacceptable situation.
“We call on the politicians of Limerick, Tipperary, and Clare to honour their commitments to the people of the Mid-West and address the chronic under resourcing of the region, in both primary and hospital care, as a matter of absolute urgency. Furthermore, we suggest that the Mid-West be the first hospital group to open a scheduled care surgical hub.”