Room for compromise on CUH cystic fibrosis row
As a result the CF charity funding the ward, Build4Life, is refusing to hand the money over.
National charity Cystic Fibrosis Ireland is calling for an independent expert to help mediate a resolution.
Cystic Fibrosis Ireland is calling for an independent expert with knowledge of CF to help resolve the row that has led to a delay in a new inpatient facility for adults with cystic fibrosis and other lung conditions in Cork University Hospital.
The row that has led to the delay has added to the anxiety of patients with CF and their families throughout the South-West.
Through fantastic fundraising efforts, involving many, a total of €2.3m has been raised by Build4Life towards the €3m cost of the new unit that will benefit up to 20 patients, including those with life-threatening conditions such as cystic fibrosis and other lung diseases such as chronic obstructive pulmonary disease. A further two in-patient rooms will also be made available by the hospital for CF patients in a nearby ward if necessary, making a total of 10 rooms that can be used for CF care.
The local charity Build4Life contends that eight of the rooms in the new unit should be ring-fenced for CF patients. On the other hand, CUH contends that, if these eight rooms are ring-fenced, other sick patients will never be allowed to use them, even when they are empty and not needed for CF care.
The hospital also points out that the need for a full ward is a factor in determining staffing levels. If the new ward in CUH is only partially full most of the time, the number of staff on duty will be reduced by the same amount because of existing HSE rules.
It is our experience at CFI that, with sufficient goodwill, it is possible to find middle ground and for an agreement to be drawn up that will both ensure the availability of rooms for people with CF and will allow access to rooms, when they are not needed, for other,non-CF patients.
This might involve ring-fencing a lesser number of rooms and/or having good operational procedures in place. For example, in St Vincent’s University Hospital in Dublin, 34 rooms were identified as the in-patient need.
In an agreement between the hospital, CFI, clinicians, and the HSE, 20 of these rooms were ring-fenced and 14 are to be made available when they are needed. This is because the number of CF inpatients in St Vincent’s fluctuates between 22 and 34, with higher demand for beds in the winter months. This policy was put in place when the new unit in St Vincent’s opened.
After an initial glitch that was highlighted by CFI in the media, the new policy has since worked satisfactorily. A hotline between CFI and the hospital has also helped smooth this process.
In the new policy, two rooms are always kept free for emergency CF admissions. A committee has been established to monitor the agreement on a regular basis that includes CFI, and statistics on admissions and bed use are presented in a quarterly report.
In another, smaller, example in University Hospital Galway, three in-patient beds for CF have been provided through charitable fundraising. After an agreement with the Galway branch of CFI, the hospital allows other patients to use the rooms when they are not needed for CF care. This policy has also worked well.
In the on-going row, it must be noted that CUH is in some ways different from other hospitals in respect of CF care. For example, the CF in-patient unit in CUH will be part of a larger respiratory unit (total of 22 beds) rather than a stand-alone CF unit, such as that which exists in Dublin. In addition, more treatment for adults is carried out at home in the Cork region than in Dublin through a targeted and supported home-delivered antibiotics programme.
This latter factor is likely to reduce the in-patient demand in Cork compared with Dublin and will need to be taken into account if an agreement is discussed.
THERE has been much progress in CF care in Ireland. Despite all the problems, that should not be lost, and the general public through their generous support have played a key role. There are innovative and effective new drugs; the introduction of new-born screening in 2011 has meant care can begin immediately and the increase in double lung transplants last year is a further beacon of hope.
CUH is increasingly recognised internationally for both its care teams and its research work, thanks to Dr Barry Plant, the lead adult CF consultant. The southern branch of CFI continues to play a vital role in helping to improve CF services in CUH and has done so over many years. There is no doubt, however, that better in-patient facilities for both adults and children with CF are badly needed in CUH and other hospitals around the country.
CFI is playing its role by funding many of the units outside of Cork, including in Waterford, Castlebar, Limerick and Drogheda hospitals. Local charities such as Build4Life are also playing an important role.
CFI takes this opportunity to thank the Irish Examiner for continuing to highlight the needs of people with CF in the South West. We call on Minister for Health James Reilly to appoint an independent expert to help mediate the process and for all sides to come together to discuss a possible middle way forward.
* Philip Watt is the chief executive officer of CFI
