Hospital chief says Portlaoise is safe now but not sustainable in the long run

The hospital in Portlaoise.

Midlands Regional Hospital, Portlaoise

The chief executive of the Dublin Midlands Hospital Group has insisted that Portlaoise hospital is 'safe' and gave a ringing endorsement to staff but is not backing down on the plan to downgrade the hospital.

Hospital consultants at the Midland Regional Hospital, Portlaoise wrote to Dr Susan O'Reilly in the past fortnight demanding that she move to publicly address what was termed as concerted spin against the hospital.

The doctors told her that claims made about the hospital were a risk to patients. The doctors met with Dr O'Reilly in Portlaoise last week. Speaking after a meeting with the Leinster Express, Dr O'Reilly said services are safe.

“They were expressing their hurt and concern about being perceived as perhaps not being seen as safe.

“Now, I want to state unequivocally that you have a hospital where you have a very committed excellent staff.

“They are very dedicated to patient care. The services are safe,” she said.


However, she stood over the four-year plan to remove maternity, emergency, paediatrics, ICU and most surgery from the hospital.

Dr Sean Fleming, a consultant cardiologist in Portlaoise, called for a statement in a letter written on behalf of the Medical Board at Midland Regional Hospital, Portlaoise to Dr Susan O'Reilly.

The letter is also written in response to Dr Fergal Hickey spokesperson for the Irish Association of Emergency Medicine, who they say has given interviews and comment to Midlands 103, Newstalk, Morning Ireland and to the Sunday Business Post.

"We wish to register our dismay at your failure to correct inaccuracies concerning this hospital in the media. These inaccuracies have been placed in the public domain in what amounts to a concerted campaign of spin and misinformation," says the letter.

The doctors say that Dr Hickey has never visited MRH Portlaoise and has had no role in any report concerning this hospital.

The doctors say these media reports contain a series of inaccurate statements.

They highlighted three of particular concern:

1. Dr Hickey has implied on two occasions that the paediatric unit in the hospital is unsustainable. (Newstalk 16.11.17 & Midlands 103 15.11.17). He has referenced the unpublished Carter Report from 2014. The Carter Report contains no such statement and indeed, no statement that could be interpreted to cast doubt on the sustainability of paediatrics.

2. In a piece in the Sunday Business Post, based on interviews with Dr Hickey (1.10.17) it was stated that the A&E here functions as a Minor Injury Unit. This claim is false.

3. He has engaged in a concerted effort to push figures that misrepresent attendances at Portlaoise and to present the erroneous impression that the quality and complexity of treatment provided here at MRH Portlaoise is less than that provided at similar units throughout the country.

They said he had in addition, attempted to erase from consideration the 17,000 women and children that present to MRH Portlaoise for emergency care.

The letter says that these and other similar statements should not go unchallenged in the public domain. The Portlaoise doctors say they are of real concern from a safety perspective. They risk confusing people as to how and where to seek care at a time of crisis.

"Additionally, such spin and inaccuracy risks misleading decision makers and the general public as to the nature and the extent of the challenges inherent in any plan that would seek to downgrade services at MRH Portlaoise.

"You, in your position as CEO of the DMHG, have a duty to patients and to staff to counter this misinformation. Your failure in this duty comes on top of your failure to consult with local people and stakeholders, and your failure to produce a plan that properly reflects and adequately provides for the health care needs of people in the Midlands.

"It has further eroded our confidence in you as CEO of DMLHG . We call on you to urgently make a clear statement refuting these inaccuracies," concludes the letter.

In his reply, Dr Hickey refuted much of the content of the letter.

Dr Hickey is a President of and currently the Communications Officer for the Irish Association for Emergency Medicine, the representative body for Emergency Medicine in Ireland - the advisory group for the national Emergency Medicine Programme.

“Its 2012 report which I co-authored is the model of care for Emergency Medicine for Ireland.

“I have simply responded to specific media requests for comment on various matters to do with the situation in Portlaoise and the MRHP Action Plan; I have not sought media interviews or coverage,” he said.

On point one he said that the National Clinical Leads for the various National Clinical programmes including the Paediatric lead, Prof Alf Nicholson, were “unanimously of the view” that ‘paediatric services in Portlaoise were “unsustainable”.

“I have simply stated their professional view which I have no reason to disagree with,” he said.

On point two he said the 2015 HIQA report specifically states (p97) that 'Clinical staff at the hospital reported that most patients attending the Portlaoise ED are walk-in patients with minor clinical complaints and injuries.'

He said HIQA also points to patients who are specifically brought to hospitals other than Portlaoise as a result of bypass protocols affecting Portlaoise.

“When the correct numbers and complexity of patients are taken together, it is clear that the acuity and numbers of patients attending Portlaoise ED are small by the standards of Model 3 hospitals,” he said.
Responding to point 3 he said the HIQA report (p97) raises concerns about the accuracy of the ED returns from Portlaoise.

“Hospitals are expected to adhere to rules as to what should and should not be counted in a hospital's ED returns and many of those groups of patients who are included in the Portlaoise figures should not be included.

“This has the effect of artificially elevating the numbers apparently attending Portlaoise ED although they should not have been included in the returns in the first place.

“I have simply explained this issue to the public and disagreed with the view that Portlaoise is a particularly busy ED which it isn't,” he said.

Dr Hickey referred to Appendix 17 pp 497-99 of the EMP Report

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