Plans to close A&Es being considered by HSE

PLANS to close or limit accident and emergency departments across the country are being considered by the Health Service Executive.

Two months ago the Irish Association for Emergency Medicine (IAEM) highlighted the severe difficulties in recruiting junior doctors to staff A&Es, now known as emergency departments (EDs).

Since then the situation has deteriorated, with some EDs consistently unable to fill shifts with doctors of the necessary experience to safely manage patients, according to the IAEM.

The HSE’s national director of human resources, Sean McGrath, said it was no longer sustainable to have so many EDs open 24 hours a day.

He confirmed in an interview published yesterday in a Sunday newspaper that the HSE was preparing a contingency plan for Health Minister Mary Harney that also included the rationalisation of other services.

A spokesperson for the HSE said a series of proposals and options were being worked on by the health authority.

The spokesperson said she understood that decisions have not yet been taken as to what aspects of the plans might have to be implemented.

“We are preparing a range of plans for consideration by the management team and by the minister,” she pointed out yesterday.

The spokesperson said the HSE was aware there had been a reduction in non-consultant hospital doctors and that was likely to reduce further in July.

Other specialities that are expected to be affected by the shortage of junior doctors include anaesthesia and obstetrics. Around 140 NCHD posts were unfilled in January and the HSE is preparing for a further drop in numbers in July, when doctors begin their new rotations.

The HSE’s reconfiguration plans will also heighten fears about the downgrading of smaller hospitals in some parts of the country.

Around 10,000 people protested against moves to end emergency services at South Tipperary General Hospital at the end of March.

IAEM president Fergal Hickey said the association had warned the HSE there would not be enough doctors to maintain existing services but the HSE was only now beginning to understand the scale of the issue.

According to the IAEM, EDs unable to provide a safe service should be closed or have their opening times restricted to periods when they can offer a safe service.

The association said the steps needed to be taken might seem to be a disproportionate response but the reality was that some EDs could not be guaranteed to provide safe care for patients.

However, the association is insisting that those EDs that receive an increased workload following the reconfiguration are given the infrastructural and staffing facilities needed to provide a safe round- the-clock service.

Meanwhile, the Irish Hospital Consultants Association has said the planned closure of two wards and an operating theatre in Dublin’s Beaumont Hospital was an example of how to mismanage resources in these difficult times.

IHCA assistant secretary general Donal Duffy said the closure was a false economy, with up to 1,400 patients having their treatment delayed this year.