Doctor hits back at critical report

A senior doctor at Cavan General Hospital today denied that the surgical unit was in a dysfunctional state.

A hard-hitting report from the Royal College of Surgeons in Ireland (RCSI) was highly critical of a lack of surgical leadership at the hospital.

The conditions at the North West hospital were highlighted almost a year ago after nine-year-old Frances Sheridan from Co Cavan died three weeks after an appendix operation.

Dr Alan Finan, a consultant paediatrician and secretary of the Medical Board of the hospital, said the report on the hospital from the RCSI was wrong to use the term “dysfunctional”.

“We feel it is probably inappropriate. The surgical department in the hospital, we don’t believe it is dysfunctional at the moment,” Dr Finan said.

“From the point of view of the relationship between clinicians in the hospital, nursing staff in the hospital and hospital management there is not a significant level of dysfunction currently.”

The senior consultant said the Medical Board had broadly welcomed the RCSI report carried out by a high-level delegation last November.

“We welcome the RCSI’s involvement and we welcome 90% of the reports review and recommendations,” he said.

Sinn Féin’s TD for Cavan, Caoimhghin O’Caolain said it was now up to Health Minister Mary Harney to intervene to ensure that the recommended changes were urgently implemented in the surgical unit.

RCSI Prof Niall O’Higgins led the inspection after 15 adverse clinical incidents were reported at the hospital’s surgical unit over a short time period in 2003.

“Those 15 incidences were highlighted and have been addressed within the hospital and health boards,” he said.

Dr Finan admitted that these problems had been highlighted repeatedly in several reports.

However, he stressed that a hospital multi-disciplinary steering group had been working over the past six-months to report on and tackle its problems.

Dr Finan warned the recommendations and resources needed to be implemented immediately.

“It is important that in the changes from health board to Health Service Executive that these issues don’t get lost in that transition.”

The RCSI report, which was sent to the North Eastern Health Board that runs the hospital, also points to a lack of communication between management and consultant staff at the facility.

“We would see historically that there has been a problem in that area but it is being addressed.

“There is Medical Board representation on the hospital management team,” he said.

The report also highlighted resource deficiencies in the surgical department at the hospital which is currently being run by three locums and one permanent consulting surgeon staff.

“No medical department or surgical department in the country can function appropriately staffed with 75% locum staff it needs permanent staff who have residency in the department,” the senior doctor stressed.

Two of the unit’s permanent consultant surgeons were suspended in 2003 over “interpersonal difficulties”.

The unit was then embroiled in controversy after a post mortem revealed nine-year-old Frances died from complications of her recent surgery.

Dr Finan said there were many positive aspects to the report. He was confident the surgical department would get back on track but it would require the significant resources outlined in the RCSI report.

“I feel the resources need to be released centrally that the health board do not have the necessary resources to make this happen it needs to be moved from central resources, from the Department of Health.”