New rules may close A&E units

THE CLOSURE of half the country’s accident and emergency units can only be averted if the number of consultants is doubled urgently, doctors warned last night.

A&E units in more than 20 smaller hospitals without a full-time emergency consultant face the threat of closure because they fail to meet new training rules.

This means units in hospitals which include Bantry, Mallow, Ennis, Clonmel, Nenagh, Kilkenny and Dundalk face either closure or a severe restriction in services.

The developments are certain to spark anger, such as that seen over the loss of Monaghan Hospital’s A&E unit, in locations right across the country.

The Irish Medical Organisation (IMO) last night said the Government had to speedily recruit an extra 50 emergency consultants to ensure services were not hit.

Fintan Hourihan of the IMO said: “Unless there is a significant increase in the number of consultants in the coming months, it’s inevitable that for reasons of standards and medical litigation that services will be curtailed.”

The crisis has been sparked by changes to training rules which mean junior doctors in the affected A&E units will have their relevant accreditation withdrawn by the Royal College of Surgeons because they haven’t been trained by a consultant.

Once this accreditation is removed, hospitals can no longer employ junior doctors in these posts.

It is three years since the rules were introduced but only now are the real consequences about to be felt.

Professor Arthur Tanner said the Royal College of Surgeons had to ensure standards were maintained in A&E units across the country.

The organisation had already started a system of rolling checks to identify junior doctors who do not meet the new training rules.

Patients’ groups, however, have appealed for common sense and talks to prevent any sudden action which could spark a crisis in the health service. Irish Patients’ Association president Stephen McMahon said a solution had to be worked out and the needs of patients should remain paramount. Major reports on staffing and health service structures are to be sent to the minister next week which will indicate what direction the health service will head in the coming years.

One of the reports into how the health service operates, carried out by Prospectus management consultants, is expected to recommend that regional centres of excellence be developed instead of spreading resources too thinly across the country. It is also understood to contain recommendations for sweeping changes to the health boards system, such as a reduction in their size and a more national approach to services delivered by hospitals.

Mr Hourihan, meanwhile, says the 50 emergency consultants will be needed within the next 18 months to avert a serious crisis. While the Government has a freeze on public sector recruitment, it says it is willing to recruit frontline health staff depending on the resources available.