12 hospitals risk losing 24-hour A&E units

UP TO 12 acute hospitals around the country could lose their 24-hour A&E service, following a review of activity levels by the Health Service Executive (HSE).

Included on the list of potential casualties is the Mercy University Hospital (MUH) in Cork, which re-opened its A&E just last December following a €5 million upgrade.

Following a review of emergency departments and out-of-hours surgery at each of the hospitals, the HSE is recommending that A&Es be replaced “by a combination of minor injury clinics and medical assessment units (MAUs)” in the majority of the hospitals studied. The minor injury clinics would operate from 8am-8pm.

The HSE also says that the findings of its review “support plans to limit the provision of acute surgery in smaller hospitals”.

It says acute surgery services, after 8pm and at weekends, should also be withdrawn from the majority of hospitals studied.

In addition to MUH, the hospitals included in the review are: the South Infirmary Victoria University Hospital (SIVUH) as well as Mallow and Bantry hospitals in Cork; Kerry General; Cavan, Louth, and Monaghan hospitals; Our Lady’s Hospital, Navan; the Midwest Regional Hospital in Ennis, the Midwest Regional Hospital Nenagh and St John’s Hospital, Limerick. Around-the-clock emergency services have already been withdraw from Ennis and St John’s.

A spokesperson for the HSE said no decision had been made yet on the report’s recommendations.

In relation to the new A&E at MUH in Cork, he said its future would be decided by a second separate review of emergency departments currently under way in the HSE South, as part of hospital reconfiguration plans in the region.

The A&E element of the review, which looked at annual attendance, for 2007, found it ranged from 6,242 in the smallest (Bantry General Hospital) to 34,580 in the largest (Kerry General Hospital).

Those carrying out the review said some hospitals “experienced difficulty” in locating patients’ medical records. “The inability to locate medical records in a seamless and timely manner, of itself, represents a risk in the acute hospital setting,” the report said. It also found minor injuries accounted for 43% of all attendances, with more than two thirds of patients attending Bantry A&E in this category.

The number of acute surgical procedures occurring out-of-hours in hospitals studied ranged from 59 in Louth County Hospital and MWRH Ennis to 589 in Bantry.

The report concluded that the findings “support HSE plans to reconfigure acute hospital services in the networks studied”.