Downgrade to cost public dearly

Health GPs warn public to face the reality of a big loss of hospital services despite pre General Election assurances

Downgrade to cost public dearly
By Conor Ganly

Laois GPs have warned the public that assurances over the future of services at the Midlands Regional Hospital, Portlaoise cannot be believed.

In a lenghty statement warning that the loss of many key services is now on the cards, the GPs say the public will pay a heavy price if they continue to believe commitments given.

“Despite assurances from HSE Management and Public Representatives that the future of MRH Portlaoise would be secure, the evolving reality is not so,” said the latest statement issued by the GPs.

They said the HSE promised consultation with themselves and their hospital colleagues but this commitment 'fell by the wayside'.

“There has been no meaningful consultation with us. Indeed we believe that the Clinical Leads for each specialty & HSE DML Management have been unable to reach consensus on how to safely secure the future of services at MRH Portlaoise,” said the statement.

The doctors outline the multiple consequences of downgrading the hospital to a Model 2 hospital with no Emergency Department (ED/A&E), Paediatric or Maternity services.

The say trolley numbers remain at staggering levels despite approaching Summer and there is no capacity to facilitate patients at any other centre in the group without huge capital investment, but they say this is not possible in a timely fashion.

The GPs say the current system cannot cope with effectively removing an entire hospital from the acute accident and emergency system.

The doctors say they are told on almost a fortnightly basis to avoid referring patients to the EDs in Portlaoise and Tullamore because they are full.

The GPs point to the ambulance service and its “ gross understaffing” and an inability to reach target times.

“A lack of joined up thinking by management is clear, if they plan to transfer Portlaoise’s quota of emergency patients to hospitals with no available beds.

“This plan is reckless in the extreme and shows no regard for patient safety. Considering these issues alone raises questions as to the competency of management in suggesting such a plan,” say the doctors.

Th GPs say the paediatric service at Portlaoise is excellent but the HSE continues to “starve” disability and early intervention services in Laois, Offaly of resources and now suggests that removing inpatient care for children, including those with complex health needs and disabilities, is a patient safety improvement.

In relation to maternity, the doctors say that having made significant gains in terms of patient safety and resources, the maternity services management now plan to dismantle this and remove access to local maternity care for mothers.

However, they say that the Coombe Women’s Hospital is at capacity and will not cope with Portlaoise's cases.

In relation to mental health the GPs say the ED is a vital support for Mental Health and Psychiatry services locally, especially for those who are suicidal.

The GPs say waiting lists in the midlands are unacceptably high with some patients waiting up to two years for surgery in Tullamore.

The doctors argue that by increasing ED attendances and raising levels of acute admissions here, without appropriate investment and planning, will further exacerbate delays and reduce elective surgery admissions.

On Primary Care the doctors say there has been difficulty attracting and retaining GPs.

Without a functioning service at MRH Portlaoise, this will get worse they say.

“Patients already have difficulty in accessing GPs. Midoc is overburdened and faces difficulty filling shifts on a regular basis.

“Removing services will result in collapse of primary care services in the area,” warn the GPs.

It is also argued that the recruitment and retention of high quality staff is a major problem and reports of further frontline recruitment embargoes in recent days will do nothing to alleviate this issue.

The doctors say that downgrade will remove more training posts from the services including psychiatry, paediatrics, obstetrics and medicine.

They say at least seven posts will be removed from the Midlands GP training scheme.

“Many GP trainees tend to remain in the area where they completed their training, however, downgrading the hospital will make Laois undesirable to work in Primary Care,” say the doctors.

“Laois GPs will continue to advocate on behalf of our patients, community, families and friends who rely so dearly on a safe, well resourced fully functioning hospital, including ED, Maternity and Paediatric Departments.

“We call on HSE Management, the Department of Health, Ministers with Health Responsibilities and our local elected representatives to deliver on previous commitments and ensure that services are retained and enhanced for the benefit of all in the region,” they say.

The statement is signed by Drs Michelle Byrne, Simon Honan, John Madden, Sean Montauge, Mary Sheehan and Gerry White on behalf of the Laois Faculty of the Irish College of General Practioners and the MIDOC out of hours GP service members.