HSE defends systems for referring children for specialist care 

A spokeswoman said the HSE tries to deliver treatment for children and young people 'at the right time, by the right person, and in the right place'. Picture: iStock

The HSE has defended systems for referring children to specialist care saying that, for most, treatment “should be provided as close to home as possible”.

It was responding to concerns expressed by Tánaiste Micheál Martin, published in the Irish Examiner on Monday, around the pace of referrals from regional hospitals to larger specialist sites.

Regarding treatments for seriously ill children, Mr Martin said referrals are “key” to the best possible outcomes by ensuring children are moved to centres of excellence from secondary hospitals.

“We shouldn’t be slow to refer children to the centres where it matters,” he said.

“I know where secondary hospitals are sometimes slow to refer children to Crumlin and that’s a mistake.” 

Asked why this is the case, Mr Martin, speaking in New York, said: “It’s a clinical view. Maybe the ‘I can handle it’ approach, ‘I don’t need to’.

Need for regional centres

Taoiseach Leo Varadkar told the Irish Examiner it "may well be the case" that consultants are slow to refer seriously ill children to the specialist care. However, also speaking in New York, Mr Varadkar said he hasn't had any briefings on this.

"I think it is also important to have special services and regional centres as well,” he said.

"It shouldn't be the case that everyone has to be referred to the national centres and Dublin or Cork for that matter. But where those referrals are warranted, then of course they should take place."

Treatment 'as close to home as possible'

Reacting to Mr Martin’s comments on Monday night, a HSE spokeswoman said health services for children and young people try to give treatment delivered “at the right time, by the right person, and in the right place”.

She said: “For most children, this care should be provided as close to home as possible in line with Sláintecare principles”. This refers to reforms moving some treatments out of hospitals.

“A small number of children and young people require tertiary care from a specialist hospital such as CHI,” she said referring to the hospital group which includes Crumlin.

'Timely expert care'

“The clinical programmes, including the national clinical programme for paediatrics and neonatology, work with clinical teams in the specialist and regional centres to develop models of care so that these children receive timely expert care.” 

Varying potential reasons for lower-than-expected referral rates for specialist children’s care were raised by staff at Cappagh Orthopaedic Hospital in Dublin during a previous interview with the Irish Examiner.

This hospital, among other care facilities, offers children orthopaedic surgery including some types of spinal procedures which do not require access to an intensive care unit.

Cappagh not affected by ED surges 

As a national centre, they can receive patients from other hospitals and GPs outside of Dublin including in Cork.

Unlike Crumlin or Temple St hospitals this site does not have an emergency department. Orthopaedic consultant at Cappagh James Cashman said this means their waiting lists are not affected by cancellations linked to surges in emergency care.

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However, getting referrals from other hospitals is "a challenge", he said, pointing to bureaucratic obstacles.

"Doctors want their patients taken care of — they are happy to come — but it tends to be an administrative difficulty to get them sent over," he said.