Managers ‘knew of fears over surgery ban’

THREE weeks before Patrick Joseph Walsh died, management at Monaghan Hospital received three letters from consultants and GPs warning it was unsafe to ban surgeons from performing emergency surgery in the evening.

One of the letters was sent by surgical teams in Monaghan and Cavan General Hospitals, according to Dr Illona Duffy, a Monaghan GP.

A similar letter was sent by the medical board in Monaghan, while more than 30 Co Monaghan GPs also wrote to management expressing their concerns.

Dr Duffy said there was concern that the hospital was off-call for emergency surgery in the evening, even though all the necessary services and resources could have been made available.

“They [hospital management] ignored the concerns expressed and that is why Mr Walsh died,” she said.

“There have been repeated episodes where patients in Monaghan have run into serious difficulties and needed surgical care but it was not allowed,” she said.

Monaghan had its surgical ward closed with the loss of 26 beds, but the extra beds were not provided in either Cavan or Drogheda hospitals, which were meant to take up the additional workload.

“With the threat of the closure of medicine at Monaghan, there will be a loss of 56 beds, and there is no way they can be provided at the other hospitals,” added Dr Duffy, “You are left wondering where are the sick people meant to go.”

Dr Duffy was one of a number of doctors who was interviewed by the independent investigators who compiled the report into the death of the 76-year-old retired farmer.

The investigators found that Mr Walsh’s death, last October from a bleeding ulcer, while it may have been inevitable, was avoidable in the circumstances in which it occurred.

They found that the refusal of surgeons in both Drogheda and Cavan to accept Mr Walsh’s transfer was unacceptable and fell short of good clinical practice.

Dr Duffy said there was a full surgical and anaesthetic team both on-call and in the hospital on the night Mr Walsh died. They could not operate on Mr Walsh because there were no theatre staff available.

The doctor said she was disappointed that the inquiry did not find out who decided that Monaghan should not be on call.

There was no mention of who on the management side should be held responsible.