Continuing controversy over Roscommon promises
The Emergency Department at Roscommon County Hospital closed this morning amid continuing controversy.
Yesterday, the Sunday Business Post reported that the Taoiseach, Enda Kenny, had told a rally in Roscommon on February 8 that "We are committed to maintaining the services at Roscommon County Hospital."
Last Tuesday, Mr Kenny had told the Dáil, when asked by Fianna Fáil leader Micheál Martin about specific committments on hospitals: "I am getting a little fed up of the Deputy putting words in my mouth. He should indicate which promises were made in respect of which hospitals and if he can stand over the claims made."
Speaking on RTÉ's This Week, he said he had not "made personal committments regarding local services in advane of the election."
Speaking to journalists last night Mr Martin said: "As well as apologising to the people of Roscommon for both breaking and denying his personal promise to protect all of the hospital’s services, [Mr Kenny] should also apologise to the Dáil."
Mr Kenny now says he regrets any "confusion" on the matter.
Fine Gael councilllors Dominick Connolly and Laurence Fallon of Roscommon County Council have announced they are resigning from the party over the controversy.
Minister for Health Dr James Reilly has defended the decision to close the A&E by arguing that the safety of patients is the prime motivation for the reduction in service.
“Smaller hospitals are not as safe as bigger ones in key areas” he said, citing “a wealth of international research” to back this up. “When it comes to multiple traumas, strokes and heart attacks, it has been proven internationally that one has a 25% better survival rate at a larger hospital which has a higher volume even if one is more than one hour away.”
Dr Reilly told the Dáil that even in an “accident and emergency department with a doctor and X-ray machine” the skill set is simply not available to deal with “multiple traumas, double fractures, heart attacks or profuse bleeding”. In hospitals where there is “no vascular surgeon, orthopaedic surgeon, anaesthetic consultant on-site at night or a person to carry out intubation” any patient in need of these services would be at serious risk. If a patient has to wait “fifteen minutes for someone to come from down the road to intubate him or her, he or she will be dead” he claimed.
The alternative suggested by Dr Reilly is that patients be transported to a larger regional hospital, such as Galway, and that even if a patient is up to an hour away from the hospital this is the safer option.
Speaking on Prime Time last night, Dr Tracey Cooper, Chief Executive of the Health Information and Quality Authority, supported this view, saying that “It is simply unsafe for seriously ill patients or seriously injured patients to be treated in the nearest small hospital.” Instead it is safer for these patients to be “stabilised by good paramedics in the community, to be treated en route, and to be taken to an appropriate centre, which has the appropriate staff and skills to treat those people.”
While Dr Reilly has said that talks are continuing with local GPs about the provision of the out-of-hours service for Roscommon, many GPs have voiced their concern that patient safety is not the prime motivation behind the closure.
“If this was a safety issue, the hospital would have received adequate resources before now,” the GPs’ spokesman, Martin Daly, said on Thursday. “This decision has been taken to save on resources, not ensure safety, and we have genuine fears that lives will be lost”.
The Irish Nurses and Midwives Organisation (INMO) is also highly critical of the move. They say that the decision by the last government to close the emergency department of Louth County Hospital in Dundalk has placed “huge pressure” on Our Lady of Lourdes Hospital in Drogheda. The result has been “patients waiting days and nights for a hospital bed”. They suggested that the closure of the emergency department in Roscommon would have similar results.
Asked on Today with Pat Kenny if the closure of the A&E was about savings or safety, general secretary of the INMO Liam Doran said, "It's about savings in the way it's being handled...What has happened is that all cases will be redirected to the already overcrowded major centre. No-one profits from that. No-one has confidence in that."
According to Monaghan GP Dr Illona Duffy, the resources do not exist in Galway to cope with the increase in patients caused by the downgrading of Roscommon. Speaking on Prime Time on Thursday (7 June) she expressed “serious doubts” that Galway would be able to cope with the increased numbers.
Dr Duffy has also said that “there is no way” the GP out-of-hours service proposed by Dr Reilly “can replace the existing A&E services”. She described the move to bring GPs into Roscommon as a “smokescreen” to hide the real dangers faced by patients, due to the fact that GPs are neither trained nor indemnified for the kind of work that will be required of them.