'Very significant patient safety risks' forced decision to close Navan emergency department

HSE chief executive Paul Reid said the chief clinical officer and staff at various levels had raised concerns with him about patient safety at the hospital, highlighting issues with ICU capacity. File picture:Arthur Carron/Collins

The identification of “very significant and serious patient safety risks” prompted the decision to close the emergency department at Our Lady’s Hospital in Navan, Co Meath, Paul Reid has said.

The HSE chief executive told the Oireachtas health committee that a number of serious issues had been personally brought to his attention, and to the attention of the HSE, regarding the situation in Navan.

The decision to replace the emergency department with a 24-hour medical assessment unit has been criticised at Government level, with the Tánaiste saying on Tuesday that the closure of the ED had not been sanctioned, while Health Minister Stephen Donnelly said “no decision” had been taken on the matter.

Leo Varadkar also said ministers were “not satisfied” with the HSE’s responses to questions regarding the situation at Navan.

Mr Reid said the chief clinical officer and staff at various levels had raised concerns with him about patient safety at the hospital, highlighting issues with ICU capacity.

“I have to take those risks very seriously,” he said. 

“I can’t ignore that. I have to address it.” 

Under questioning by Sinn Féin’s health spokesperson David Cullinane, the HSE boss said he “lived in the real world” and takes full cognisance of Government concerns on the matter.

He added: “We will address all those concerns over the coming weeks.” 

Update on Sláintecare

At the committee, officials from the HSE and the Department of Health provided updates on areas of the Sláintecare health reform programme, including the regionalisation of services and efforts to reduce waiting times.

Fine Gael TD for Cork North-Central Colm Burke raised the issue of an elective hospital for Cork, saying that the likes of CUH and Mercy University Hospital were under “serious pressure”.

Department of Health secretary-general Robert Watt said sign-off for the project would come to the Government before the summer break, after which design and procurement would be finalised and a tender document would be issues "as quick as it can".

Social Democrat co-leader Róisín Shortall asked officials about accountability within the health service, at a corporate and clinical level.

Mr Reid said some disciplinary processes in the HSE date back to the 1970s and weren’t fit for purpose.

“We need to create a culture where it’s safe to come forward where things have gone wrong,” he said. 

Mr Watt said legislation may be required to underpin such changes but a body of work was required before this could happen.

Solidarity-PBP TD Gino Kenny raised the issue of junior doctors, or non-consultant hospital doctors, who voted in favour of industrial action earlier this week.

“I think it was extraordinary in the statement by the Irish Medical Organisation that the European Time Directive is consistently breached,” Mr Kenny said. 

“This is unacceptable in public health that junior doctors are being subjected to this pretty awful situation. What happens then is that when they get into the health system, they become so burnt out they leave the country.” 

Mr Reid said the HSE was anxious to work with trade unions on mitigating some of the issues.