Reconfiguration doubles costs in a year

The day-to-day running cost of centralising acute services in the Mid-West doubled from €6.2 million in 2009 to €12.3m in 2010, The Clare Champion can exclusively reveal.

The 24-hour emergency services were removed from Ennis hospital in April 2009 and transferred to the Mid-Western Regional Hospital, Limerick, despite opposition from Ennis hospital campaigners and public representatives.
Surgical services that were previously provided in Ennis were also transferred to Limerick in October 2009 following recommendations contained in the Teamwork Report.
The HSE has also confirmed in response to a Freedom of Information request that this expenditure is separate from the capital costs of reconfiguration, which are “partially” related to the centralisation of services such as the €2.5m endoscopy projects in Ennis and Nenagh hospitals.
The regional health authority also stated €4.1m has been spent on the Critical Care Block up to the end of last year out of a total approved budget of €39m.
Former Medical Council president and General Election candidate, Dr John Hillery, said he was alarmed to learn the cost of reconfiguration had doubled in the region given that the current model isn’t working as it should in terms of best international practice.
Dr Hillery said the release of these figures reinforced the need for a total review of acute hospital services in the Mid-West by HIQA.
“The consultant acute services could be provided at Ennis hospital for much less than the huge sums being spent in Limerick hospital,” he said. He proposed that an independent cost-benefit analysis be undertaken on the whole reconfiguration process to ensure patients are getting value for money.
He suggested advanced nurse practitioners could be recruited to assess and stabilise emergency cases in Ennis hospital on a 24-hour basis. He has also written to the chief medical officer Dr Tony Holohan asking him to commission an independent review.
“The release of these figures further undermines public confidence in the whole reconfiguration process. If Ennis and Nenagh hospital each received €2.5m they would be able to provide safe services. Having spoken to doctors in Clare, they are not happy with how the whole reconfiguration is working. I can’t understand how HIQA only reviewed one hospital that was operating in the old system and didn’t review the care in Nenagh and Limerick hospitals.
“We should not have any more removal of services and in fact services should be developed in Ennis. Beds should be re-opened in Ennis to relieve the pressure and overcrowding in Limerick. I would also like to see more responsibility be given to local hospitals like Ennis to allow run their own affairs,” he said.
In April 2005, consultants in Ennis hospital costed the provision of extra staff in Ennis to make it compliant with the European Working Time Directive, as highlighted in the Hanly Report, and found it would cost an extra €1.4m to make Ennis EWTD compliant, including the full complement of anaesthetists, medical consultants and surgeons. This was submitted to Mary Harney in April 2005.
Dr Tom Nolan said it was bad enough to lose services, but to lose money as well is “unforgivable”.
Deputy Timmy Dooley expressed surprise with the dramatic increase in the cost of reconfiguration stating he understood there wouldn’t be a significant difference in terms of the cost of providing the new service.
The Fianna Fáil deputy also supported the call for a review of the reconfiguration costs to get a breakdown of where the money is being spent.
The Mid-West HSE had not responded at the time of going to press.