No guarantees on A&E service

Health Minister for Health Harris does not rule out downgrade and remarks similar to the managment's message

No guarantees on A&E service
By Conor Ganly conor.ganly@leinsterexpress.ie @laoisnews

The Minister for Health did not rule out Portlaoise hospital's downgrade and closure of its A&E in the Dáil last week and much of what he said is in line with management's view.

Less than a month in office Minister Simon Harris faced questions in the Dáil on the hospital from Laois TDs amid dowgrade fears.

While he refused to commit to what will happen, his Dáil statement closely resembles the longstanding stance taken by the HSE.

Sean Fleming, Fianna Fáil, and Brian Stanley, Sinn Féin, raised the matter seperately with Minister Harris.

However, while they pushed for a commitment to prevent the HSE downgrading, Minister Harris kicked for touch .

“I am committed to securing and further developing the role of the Midland Regional Hospital in Portlaoise as a constituent hospital within the Dublin midlands hospital group. Patient safety and outcomes must come first,” he said.

However, the minister said reports on the hospital ”pointed to the need for reconfiguration of some services to ensure patients are treated in the most appropriate setting by specialist staff who can safely meet their needs”.

He said that since 2014, the focus has been on supporting the hospital to “develop and enhance management capability, on implementing the changes needed to address clinical service deficiencies and on incorporating the hospital into the governance structures of the Dublin midlands hospital group”.

He said governance and management arrangements in Portlaoise have been strengthened and additional clinical staff have been appointed and staff training, hospital culture and communications have improved.

He confirmed that Dublin Midlands Hospital Group (DMHG) recently produced a draft plan for clinical service delivery in Portlaoise but stressed that it is the subject of further work.

“Any change to services at the hospital, including any plans for service reconfiguration, will be undertaken in a planned and orderly manner and will take account of current use of services, demands in other hospitals and the need to develop particular services at Portlaoise in the context of overall service reconfiguration in the Dublin midlands hospital group.

“It is important to note that this work is being done to strengthen services in Portlaoise from a patient safety and quality perspective and to ensure the services currently provided by the hospital that are not viable are discontinued and the services that are viable are safe, adequately resourced and developed on the basis of health needs. I am confident that any changes will improve services for patients at the Midland Regional Hospital in Portlaoise. I have to emphasise at this stage that no decisions have been made. There is quite a body of work to be done,” he said.

Much of what he said resembles the stance of the DMHG. A November 2015 statement is very similar to what the Minister said.

“Any change will be undertaken in a planned and orderly manner with a view to maximising patient safety, sustainable service and improving patient outcomes. This will take account of existing patient numbers, demands in other hospitals and the need to develop services at Portlaoise in the context of overall service reorganisation within the Hospital Group,” said the statement issued on behalf of Dr Susan O’Reilly, CEO who wrote the draft plan for the hospital.

“Patient safety and outcome must come first. In this regard the DMHG is comprehensively planning how services will be delivered at the Midland Regional Hospital Portlaoise into the future. It has been made clear on a number of occasions previously that any decisions taken will only follow extensive consultation and engagement with all parties concerned.

The important point to note here is that this work is being done to strengthen services in Portlaoise Hospital from a patient safety and quality perspective and to ensure that services currently provided by the hospital that are not viable are discontinued and that services that are viable, are safe and adequately resourced. This is also in keeping with the recommendations of the HIQA Report into services at the hospital”, she concluded.

Substantial investment and enhancement measures have been put in place to ensure a safe level of services at the hospital. Maternity Services have been strengthened following the agreement of a Memo of Understanding between the HSE and the Coombe Hospital to provide a managed clinical maternity network within the Dublin Midlands Hospital Group. This will provide a single maternity service over two sites (Portlaoise and the Coombe) with clinical governance led by the Coombe.

Improvements in the Midland Regional Hospital at Portlaoise include a number of additional consultants posts (anaesthetics, surgery, emergency medicine, paediatrics, obstetrics, physicians) and 16 midwifery posts. Furthermore, investment in patient quality and safety, complaints management and patient engagement have also occurred over the last year.

As a consequence of these measures taken, the Dublin Midlands Hospital Group and the HSE is confident that the Midland Regional Hospital at Portlaoise provides a safe level of service to its patients in the midlands area today.