Concern over emergency services policy-making

Many people involved in the health service are not happy with the overall quality of the policy-making process regarding how emergency services are configured and are also dissatisfied with the level of public debate on the issue, a study has found.

The study, ‘Perspectives on the underlying drivers of urgent and emergency care configuration in Ireland’, has been published in the International Journal of Health Planning Management and has also been posted to all Dáil deputies.

Its seven authors are drawn from the Department of Epidemiology and Public Health at University College Cork and the Department of Public Health at St Finbarr’s Hospital in Cork.

Its findings are based around 175 interviews with stakeholders from across the country who are involved in the health system, whether internal stakeholders, such as doctors, nurses, and those working within regional HSE management, or external stakeholders such as local hospital campaigners, politicians, ambulance representatives, and GPs.

Focussing on the reconfiguration of emergency departments (EDs) and acute hospital services, it shows that while Co Dublin has six EDs at a rate of one per 224,233 people, the Mid- Western area has one ED for a population of 385,172 and the South-Eastern region has four EDs at a rate of one per 127,767. According to the report Ireland has “radically different models of provision in different regions” and there has been “little attempt to reconfigure urgent and emergency care in Dublin”.

According to the study, campaigners were often portrayed as “naive” regarding what they thought was best for the patient, with one GP saying: “I think the public wants a hospital next door. They don’t want to travel. They want their hospital right next to them and if you ask the public, that’s what they’ll tell you, but whether that’s good for them or not... I think you need to go with the expert opinion.”

A nursing stakeholder said: “The driver is always money...not patient quality”.