Groundhog day but management finally hold talks with Portlaoise doctors on the hospital's future

Two to five year time frame set of for reconfiguration but no details of HSE plan discussed with hospital consultants

Portlaoise hospital

Management finally hold talks with doctors on Portlaiose hospital

Senior health service managers and clinicians have finally engaged in discussions with doctors in Portlaoise hospital, but they refused to make a commitment to row back on an extensive downgrade.

While they did not attend the meeting, Laois GPs have already shot down one of the proposals discussed to partly replace A&E. 

A delegation made up of HSE hospital group management and others met today with a body of senior doctors at the Midlands Regional Hospital Group Portlaoise. Management was represented by Dr Susan O'Reilly, Chief Executive of the Dublin Midlands Hospital Group (DMHG) and Trevor O'Callaghan, Chief Operations Officer also of the DMHG.

Also present was Dr Michael Power, National Clinical Lead for Critical Care (ICU) and Dr Colm Henry, National Clinical Advisor and Group Lead for Acute Hospitals in the HSE.

The meeting was called at short notice and doctors believed that it would be used by the HSE's Dublin Midlands Hospital Group to prepare the ground for an extensive downgrade. 

The Leinster Express understands that there was a frank exchange of views between both sides on what the future holds for the hospital. Doctors tried to get some details on what is contained in the plan for the hospital authored by Dr O'Reilly. Management are understood to have staunchly refused to discuss its contents.

A source told the Leinster Express that management declined to engage in meaningful discussion on the future of A&E, paediatrics and maternity services. 

However, there was discussion around other related points. It is understood that a two to five year timeframe was set out for the reconfiguration of the hospital. However, it was accepted that any change would depend on finding capacity for patients in other hospitals that would no longer be treated in Portlaoise.

A possible replacement for an A&E was discussed. It has been suggested that a 24-hour Acute Medical Assessment Unit would operate instead. However, the viability of this was challenged by Portlaoise consultants who said the loss of A&E would mean Portlaoise would not have the services to support such a unit. Management were also forced to admit that no such a unit exists in Ireland.

While there was a feeling of 'groundhog day' among the Portlaoise doctors, they also felt that they were listened to and some of the arguments for the retention of service did get through to some of those on the management delegation. 

The Portlaoise doctors also put forward their alternative plan for the hospital with management. 

In a statement the DMHG said 'investment and development' at the hospital had been discussed. They said it also discussed ongoing operational advancements and longer-term developments.

It said these included: expanded day ward capacity, a new medical assessment facility, and additional consultant staff; challenges in attracting and retaining medical staff; the recent report of the Health Information and Quality Authority; status of a plan for the safe and sustainable provision of services at the hospital.

The statement said the DMHG recently extended a meeting invitation to the local GP community to continue discussions on how best to deliver safe and sustainable provision of services at the hospital. It said this invitation remains open.  

The DMHG confirmed that has developed an Action Plan for hospital services in the midlands and this plan has been submitted to the Department of Health for its review.

In a written statement Dr O'Reilly said: “All of us – management, healthcare professionals and the community as a whole – share a commitment to ensuring that the patients of Portlaoise Hospital receive the highest possible standard of care. The progress of the past 18 months pointed to by HIQA is due in no small part to the commitment of everyone at the hospital.

"HIQA continues to underline outstanding challenges, including the disproportionality high dependency on agency staff at the hospital. We will continue to work on meeting these challenges collectively as we await overall direction from the Department of Health,” she said.

GPs turned down an opportunity to meet Dr O'Reilly and others due to the absence of a plan and other details. They are due to meet Minister for Health Simon Harris this month. They responded to today's meeting.

"GPs look forward to meeting with Dr O'Reilly and colleagues when there is clarity regarding the future of services at the hospital. We have made huge efforts to engage with the DMHG management team over the past number of years, to no avail, in an effort to support and mould a plan that would be acceptable to our patients, our family's, friends and the wider community.

"We have consulted with our hospital colleagues to formulate our own plan which is practical, cost effective and best supports our patients. It also supports the retention of services at the hospital. We are opposed to any downgrade of services at the hospital.

"It is unlikely that we would be able to support a medical assessment unit in the absence of a fully functioning ED. Without an ED there will be no Acute paediatric or maternity services," the said. 

Minister Harris has the final say on Portlaoise. Downgrade is a policy issue and the HSE has no power under law to set policy. This rests with the Minster. The Department issued a statement to the Leinster Express in the wake of Wednesday's meeting. 

"The Department of Health and the HSE are committed to securing and developing the role of Portlaoise Hospital within the Dublin Midlands Hospital Group.

"The most important issue in relation to any changes at Portlaoise Hospital is that patient safety and good quality outcomes must come first. Reports on Portlaoise Hospital in recent years point to the need for reconfiguration of some services to ensure that patients are treated in the most appropriate setting by specialist staff that can safely meet their needs. The HSE has submitted the draft plan to the Department and it is currently being reviewed in detail.

The statement said that once there is an agreed position on the draft plan, it is intended that the Hospital Group will engage further with all interested parties, to ensure that the needs of patients, staff, the local and wider community are addressed.

"Any changes to services at Portlaoise, once approved, will be undertaken in a planned and orderly manner and will take account of existing patient flows and demands in other hospitals and the need to develop particular services at Portlaoise in the context of overall service configuration in the Dublin Midlands Hospital Group," he said.

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