HSE emails show 'grave concerns' about closure of SouthDoc branches in Cork and Kerry

SouthDoc says it still plans to reopen the shuttered centres in Blackpool, Cork, and Listowel, Kerry, but that consolidating services was safer for both patients and staff due to the highly transmissible new strain of Covid-19. Picture: Eddie O'Hare

Emails expressing the HSE’s “grave concern” about the continued closure of SouthDoc centres in Cork and Kerry were sent at least three times this year but the private company still refused to reopen them, Freedom of Information documents reveal.

The continued closure of the services despite the HSE’s pleas to reopen them has been described as “scandalous”.

SouthDoc says it still plans to reopen the shuttered centres in Blackpool, Cork, and Listowel, Kerry, but that consolidating services was safer for both patients and staff due to the highly transmissible new strain of Covid-19.

The pandemic has led to “a huge change in the dynamic of patient engagement”, SouthDoc said in a statement, with 83% of patients in Cork City and 87% of patients in Listowel now being seen remotely, with the remainder attending treatment centres or being visited by a doctor at home.

Pre-pandemic, just 15% of SouthDoc’s patients were treated remotely.

Out of 180,000 patient contacts last year, SouthDoc received no complaints around clinical care, a spokesperson said.

Sinn Féin TD Thomas Gould said people on the northside of Cork were suffering due to the closed centre in Blackpool.

'Affront to the people of the northside'

“The continued closure to SouthDoc Blackpool is an affront to the people of the northside and to the HSE,” he said.

Their refusal to prioritise healthcare needs of all under their care is scandalous. 

"It has been made clear that there needs to be a consideration to the provision of services by private operators and if these are in the best interests of communities.

“We have seen time and time again that this Government puts private companies, banks and organisations above ordinary people and it is time for that to end.

“I think it is clear from the correspondence that the HSE has put pressure on SouthDoc to reopen the facilities but that SouthDoc has blatantly ignored this. It is now time for the Government to intervene. 

"When the HSE are clearly struggling, it is up to the Taoiseach and the Minister for Health to intervene and give them support. They are failing the people of Cork North Central by not doing this.” 

SouthDoc is paid about €7m annually by the HSE to provide GP care out-of-hours for public patients.

But Mr Gould said the company’s failure to reopen the Blackpool and Listowel centres left the company in breach of its service level agreement with the HSE and he has referred the matter to the Public Accounts Committee.

FOI documents accessed by Mr Gould show repeated requests by the HSE to reopen the centres.

Although SouthDoc had agreed to reopen the clinics in mid-January it reversed that decision just days before the centres were scheduled to reopen.

In one letter, the HSE, expressed “deep concern” that the private company was unilaterally making decisions on whether or not to reopen clinics without first consulting its funder, the HSE.

'A breach of our trust'

SouthDoc’s lack of consultation with the HSE was described as “at the very least a breach of our trust and working arrangements”. 

“Of course there is a pandemic and all health services must protect its patients and staff alike,” Michael Fitzgerald, chief officer for Cork Kerry Community Health, wrote on January 15 to Dr Joanne Montgomery, SouthDoc chairperson.

“This is the reason that at this stage of the pandemic we use our best advice and public health knowledge as to how to protect ourselves and also use PPE as a support to this protection. This is how we are maintaining service across our system, such as Community Nursing, Home Support, residential services, etc.

“This is my expectation of your organisation.

“As it stands at present, I do not accept this decision by SouthDoc and call on you to reinstate the service as agreed,” Mr Fitzgerald said.

Primary care service manager of Cork Kerry Community Healthcare Majella Daly threatened to issue SouthDoc with a performance notice if the company did not meet with the HSE to discuss the matter by a certain date.

'Quality of clinical care is unaffected'

But a spokesperson for SouthDoc told the Irish Examiner that the company is “fully satisfied” that the quality of clinical care is unaffected by the closures.

Providing remote care via telephone or video consultations was compliant with current public health guidelines and more convenient for patients, they said, while in-person care at a centre or at home if a patient cannot get to a centre was still happening “if clinically indicated". 

Latest SouthDoc statistics, from October 1, 2020, to March 22, show 8,585 patient telephone calls were made to Cork’s Kinsale Road centre from the traditional Blackpool treatment centre catchment area.

1,216 of these resulted in visits to the treatment centre, which was an average of seven appointments per night from the Blackpool area.  7,221 of the calls were dealt with by video or phone by the GP, averaging out as 42 per day. 

There were 148 SouthDoc GP visits to homes in the Blackpool area, an average of just over one per night.  30% of almost 28,000 calls made to SouthDoc in Cork city were from the Blackpool area.

Listowel

In Listowel, during the same period, 2,080 patient telephone calls were made to SouthDoc’s Tralee treatment centre from the traditional Listowel treatment centre catchment. 

Of these, 216 resulted in visits to the Tralee treatment centre, which was an average of 1.25 per night, and 49 doctor visits to homes in the Listowel area, an average of one every three nights. This included the October bank holiday weekend, Christmas/January holiday period and St Patrick’s weekend.

A meeting of SouthDoc’s board of directors and medical directors is scheduled for March 30 at which the company will review the possibility of re-opening the two centres.

Cork Kerry Community Healthcare confirmed  the HSE has been in contact on a number of occasions with SouthDoc, in relation to a proposed timeframe for the reopening of services in both Blackpool and Listowel.