Needless hospital deaths are the direct result of Government policy
The fact is that Patrick Walsh was the victim of a decision taken in July 2002 by the (then) North-Eastern Health Board to take the hospital off call for emergency medical and surgical services.
A number of potentially avoidable deaths have resulted from the decision to terminate 24/7 emergency services at the hospital.
But this decision was not an aberration: it stemmed directly from the policies expressly adopted by and being implemented countrywide by the Government, the Department of Health and national medical bodies.
Deaths, such as that of Mr Walsh, were a clearly foreseeable consequence of such policies.
The current state of paralysis at MGH is both understandable and inevitable: staffing levels have been reduced, equipment has been removed and wards have been shut.
Since the ban on emergency surgery was put in place, surgeons at the hospital who carried out surgery beyond that recommended found themselves cautioned by management.
By Health Service Executive diktat, theatre nurses are not rostered in MGH after 5pm, making out-of-hours surgery impossible. Against this background, seeking to blame hospital staff for this death is both hypocritical and devious.
We hope that the Carey inquiry will deal with all of the issues highlighted by this tragic death, and that it will follow the recommendations of medical colleagues at St Mary's Hospital, London, in analysing tragic events such as that in MGH last week.
These include insufficient priority given to safety issues, inadequate staffing levels and lack of clear protocols and guidelines, all of which may have been at play in MGH.
Unless commonsense prevails, the experiences of MGH are likely to be repeated at Hanly pilot sites in Ennis and Nenagh, and, in due course, in hospitals such as Roscommon, Bantry, Clonmel and Mallow.
The Hanly report still remains Government policy and its full implementation will result in the closure of 24/7 emergency and maternity services in smaller hospitals nationwide.
A&E staff at Ennis general hospital estimate that 20 lives will be lost annually in the county if Hanly is enforced as planned. A change of heart on the negative aspects of Hanly, as manifested by the experiences in Monaghan, is now imperative.
The Government's policy, as highlighted by the crisis in Monaghan, will result in the removal of 'secondary care' hospitals providing appropriate levels of emergency care to non-urban populations in particular.
What these communities need are locally accessible, quality, urgent care hospital services so that people will not die needlessly from ruptured appendices, acute asthma, strokes, heart attacks and bleeding ulcers.
If that requires five hospitals to be on call 24 hours a day for 330,000 people, then so be it. It is our firm belief that country people should have similar access to high quality urgent care services as city dwellers.
We are not unrealistic in our aspirations to maintain such services for all: smaller hospitals can only provide certain levels of care.
But efficient use of resources should not fall on the backs of the health care needs of non-urban communities living in town or country.
It appears that Prof Drumm has the same objectives for our health care service as we do, but recent comments by him suggest that we may differ on how this should be achieved.
We believe that the only way the goals that we share for our health service will be achieved is by involving those interested in our healthcare, including local politicians, in the resolution of its future.
The Health Services Action Group's conference in Liberty Hall, Dublin, on November 26, will offer an initial opportunity to all.
Dr John Barton
Chair, Health Services Action Group
Senator Kathleen O'Meara
Vice-Chair
Dr Tom Nolan
Joint Secretary
Peadar McMahon
Chair, Monaghan Community Alliance
Anne Breen
Dr Jerry Cowley TD
Mayo General Hospital Action Committee
Dr Illona Duffy
Seamus Healy TD
MichaeI McCullagh
Chair, Portiuncula Hospital Action Group
Peadar McNamara Chair,
Ennis Hospital Development Committee
Uni Ní Chuinn PRO,
Roscommon Hospital Action Group
Cllr Kathleen O'Brien Chair,
Laois General Hospital Action Committee
Noel O'Connor
Treasurer, Friends of Mallow Hospital
Cllr Bernie O'Halloran
Loughlinstown / St Colmcille's Hospital Action Group
Paul Malone Chair,
Nenagh Hospital Action Group
Pat Whelan Chair,
Mullingar Hospital Action Group.
