Programme not about closing rural hospitals, insists reconfiguration chief

THE Health Service Executive’s reconfiguration programme is all about patient safety and is not a process for closing down rural hospitals, the man charged with the task has insisted.

HSE national director of reconfiguration, Brian Gilroy, said the process was about improving quality of care, access to care and patient throughput.

He said there was no agreement on how major acute work should be carried out and what should be examined now was how and where the rest of patient care should be delivered.

Mr Gilroy said the regions would build from the ground up.

All of the proposals are subject to review and approval by the health authority’s national director of quality and clinical care, Dr Barry White.

Mr Gilroy said the acute medicine programme would be completed in the coming weeks and would be followed by the chronic disease management programme.

The health authority points out that the country’s 50 acute hospitals had developed in a largely ad-hoc manner over the years, with much of the acute secondary care duplicated across hospitals in the same health authority region.

In the last few years the HSE has been concentrating on reconfiguring services, initially in the mid-west and north-east and is now looking at the other regions.

The HSE has stated that the challenge is to reconfigure in order to build a sustainable health service: one that has patient safety and quality care at its core, can flex to meet changing demands and provide increasing value in terms of both cost and health outcomes. And, it says, central to this is providing patients with the services they need when they need it.

Dr Ilona Duffy, who was one of a number of people who protested at the downgrading of Monaghan General Hospital has insisted money, not safety, was the reason small acute hospitals were being closed or downgraded. “I would not have backed Monaghan Hospital if I felt there were safety concerns,” said Dr Duffy.

“What is happening is the removal of an entire layer of the hospital system with hospitals intended for more specialist work being overloaded,” she said.

Former clinical director of Medicine at South Tipperary General Hospital in Clonmel, Dr Paud O’Regan, claimed acute hospital services were under threat from the Acute Medical Working Group.

“This group was about to propose at a meeting last Friday that acute medicine, major surgery, obstetrics, paediatrics and a proper emergency department would be removed from this hospital and transferred, not to a regional centre of excellence but to St Luke’s Hospital in Kilkenny,” said Dr O’Regan.

Mr Gilroy said the claim made by the retired doctor was simply not true. “That did not happen,” he insisted. The Acute Medical Working group had defined safe settings for carrying medical activity but no decision had been made in relation to any individual hospital.

Newly elected president of the Royal College of Surgeons in Ireland, Prof Eilis McGovern, who was appointed by the HSE as project director of the initiative to reconfigure acute hospital services in the north-east firmly believes that the public barrier to realigning hospitals had now been lowered.


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