Minister Simon Harris finally driven to act on CUMH crisis

Health Minister Simon Harris. Picture:

Minister Simon Harris received letters in May and October about the state of gynaecology services at CUMH but did nothing, writes Health Correspondent Catherine Shanahan

Catherine Byrne, minister of state for communities and the drugs strategy, knows what it’s like to have a gynaecological problem. She told the Seanad as much when she deputised yesterday for Health Minister Simon Harris.

She’s a mother of five, and has, on occasion, had to present at the emergency department (ED) for that very reason. Her own experience means she can empathise with the thousands of women stuck on an interminable waiting list for the gynaecology service at Cork University Maternity Hospital (CUMH). Like Deputy Byrne, many of these women also end up, in crisis, in the ED.

Unfortunately, empathy was about the limit of what Deputy Byrne had to offer when she stood in for Mr Harris to take questions on why, up to yesterday evening, he appeared reluctant to involve himself in resolving what is an outrageous situation for women in the southern region: almost 4,200 on a waiting list for outpatient appointments to attend the gynaecology service at CUMH, of whom almost 800 are waiting 18 months plus.

To add to this crisis, up to 20 consultants at the maternity hospital took the improbable step of writing to their chief executive, Tony McNamara, warning that they will no longer take responsibility for women whose health deteriorates as a result of excessively long waits for treatment.

Against this backdrop — and with strong odds of the hospital being sued at some point for delayed diagnosis of a gynaecological cancer — the health minister’s response to the crisis had been lukewarm.

When this newspaper asked his department during the week what his position was in relation to consultants warning they could no longer stand over the safety of their gynaecology service, the response was: “The minister has asked the HSE to report to him on the recent media reports in relation to maternity and gynaecology services at Cork University Hospital.”

However, the minister had been aware of the problems besetting the service for a number of months, as evidenced by statements made in the Dáil yesterday when Fianna Fáil’s Aindrias Moynihan pointed out that he had raised the matter as far back as last summer. Indeed consultants at the hospital wrote to the minister last May outlining the requirements for the service in light of the overall waiting list, which outstrips any other gynaecology unit in the country.

Independent Senator Colette Kelleher, who raised the matter in the Seanad yesterday, wrote to Mr Harris on October 5 last, having raised the matter at a joint health committee meeting on September 29.

In her letter of October 5, Senator Kelleher thanked the minister for “agreeing to follow up on the completely unacceptable situation in relation to the gynaecology service for women in Cork, as raised with you at last week’s joint health committee meeting”.

Sentor Kelleher detailed the requests consultant gynaecologists felt were necessary to tackle the situation. These include staffing to allow the provision of a five-day theatre service in Theatre One, the only gynaecology theatre currently functioning in CUMH, which exists as a four-day service, and sometimes three, when staff shortages occur. The gynaecologists are also looking for the staffing of a second fully-commissioned theatre which has never been used for gynaecology lists since the hospital opened almost a decade ago.

Also sought are four additional consultant gynaecologist posts; a gynaecology day unit, in the offing since 2013, and a gynaecology one-stop shop, part of the 2014 Reconfiguration of Gynaecological Services Plan, which has not been activated to date.

All of this was outlined in a letter to the minister last May, and again at the start of October. The response delivered on his behalf by Catherine Byrne yesterday, did not address any of these resource issues, even though he was “of course aware” of the difficulties besetting the CUMH service.

Instead, Mr Harris said the HSE had advised that CUH was undertaking a number of initiatives to address waiting times, including “additional evening outpatient review clinics”.

In fact, consultants would say the clinic sees no more than five to eight patients a week, with no hope of making any impact on waiting lists. The patients seen are also not necessarily those waiting longest, some of whom have very specific conditions that cannot be dealt with at this clinic.

To top it all, the clinic in question is temporarily unavailable and will remain so until the new year. This newspaper understands that there are no additional outpatient clinics planned before the end of the year. Nor are there any additional theatre lists planned for long waiters before the end of 2016.

The HSE also advised the minister that a gynaecology sonographer had been recently appointed to lead an ultrasound service, but again consultants say this will not have an impact on outpatient or inpatient lists.

Up to yesterday evening, it appeared all of the minister’s responses were guided by what the HSE was telling him. Even Deputy Byrne acknowledged in the Seanad that the response she delivered on his behalf did not address the concerns raised by either Senator Kelleher or Fine Gael Senator Colm Burke.

Senator Burke said the “truth was not being given by the HSE” and he was “extremely disappointed” with the minister’s response.

“What is set out here will not do one thing for the waiting lists,” he said.

However, events took a turn yesterday evening. Under sustained pressure from Fianna Fáil deputies Aindrias Moynihan and Billy Kelleher, Mr Harris announced he would visit CUMH to talk with consultants directly.

“I’m not just visiting the hospital for the sake of visiting, I’m visiting it because I want to meet with the clinicians who I have read have a number of views in relation to measures which should be undertaken.

“And I want to hear directly from those clinicians so I will make arrangements to do so as quickly as possible.”

This begs the question — what took him so long to reach this decision? He was repeatedly advised during the year that waiting list figures were out of control. He was advised on a couple of occasions of the actions that needed to be taken. He was warned women’s health and lives were being jeopardised.

Chair of the Institute of Obstetricians and Gynaecologists, Dr Peter Boylan wrote in this newspaper of the need for CUMH to have its own separate governance. Yet up to yesterday afternoon, there was no mention of actually meeting the consultants who are dealing on a daily basis with the problems besetting the gynaecology service.

It took sustained pressure in the Dáil to finally get the minister to commit to a site visit, an announcement that caught even his press office off guard.


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