Patient transfer is an issue of life and death

The use of ambulances from units based up to 80km from Cork City to transfer patients a short distance across campus at Cork University Hospital is not only bizarre but dangerous.

The purpose-built 50-bed acute mental health unit (AMHU) was opened to much fanfare two years ago, as it replaced a dreary and outdated ward that had been in use within the main hospital building since it was opened in 1979.

There is much that is praiseworthy about it. It cost €15m to build and was completed in 18 months within budget and on time.

Great pains were taken in its design and construction, from the creation of bright and airy corridors to seven beautifully landscaped garden spaces outside, ensuring a pleasant environment for patients, staf,f and visitors.

It seemed at the time that the HSE had done everything right, on this occasion at least. But, as our report today reveals, it didn’t.

An inquest this week into the death of a woman revealed that she had to wait three quarters of an hour for an ambulance to arrive from Fermoy, a distance of 37km, to be transported a two-minute drive or five-minute walk from the AMHU to the hospital’s emergency department in the main building.

Her husband was not allowed by the doctor in charge to put her in his car and drive her to the emergency department; nor was a security guard permitted to take her there because of the hospital’s patient transfer protocol. Marian O’Reilly died the following day, March 6, 2016.

The coroner noted that the death of Ms O’Reilly, who had taken an overdose of prescription drugs, could not be attributed to the length of time it took the ambulance to arrive. Nonetheless, one doesn’t have to be a medical expert to envisage a situation where such an inordinate delay would result in loss of life.

Considering the obvious care and attention to detail that went into the design and construction of the unit, it is inexplicable that no senior management figures within CUH or the HSE gave adequate consideration to the issue of transferring patients to the main hospital building in the event of an emergency.

The HSE and hospital management have a lot of questions to answer. Was the new unit built in the wrong part of the hospital’s grounds? Why was there not a special walkway constructed to transfer patients quickly in the event of an emergency? Why did management at the hospital not address fully concerns voiced by staff even before the unit was opened about how medical emergencies would be transferred?

The inquest into Ms O’Reilly’s death heard that CUH’s patient transfer policy has since been amended to allow transfers using hospital trolleys. Some staff say they were not made aware of the new policy but, in any event, wheeling a desperately ill patient from one part of the hospital campus to another is hardly a suitable or dignified way to treat them.

The issue is not simply about ambulances. It is about the speed of medical response in the event of an emergency. It is, literally, a matter of life and death.