HSE chief executive questions the future of hospital emergency departments

Conor Ganly


Conor Ganly

Portlaoise hospital

Light for Lives march for Portlaoise hospital in November 2017. Picture: Denis Byrne

Pre-Christmas confidence and assurances that Portlaoise hospital would not be downgraded have not been bolstered by comments by the new boss of the Health Service Executive (HSE).

The Portlaoise Hospital Action Group said at the end of 2019 that they believed that the Department of Health policy is that the Midland Regional Hospital Portlaoise should retain its Emergency Department (ED/A&E).

Their view was based on a pre-Christmas statement and meeting with Laois TD and Minister Charlie Flanagan. In a statement, he said the reconfiguration plan for the hospital is superseded by Sláintecare.

However, in his first significant interviews as HSE Chief Executive Officer, Mr Paul Reid has again raised questions about the number of Emergency Departments and the role of hospitals. Mr Reid said the number of Emergency Departments around Ireland must be assessed.

Mr Reid discussed the issue with Claire Byrne on RTÉ Radio News at One programme.

"Supporting the massive number of 24/7 Emergency Departments we have across the country is a real challenge. So we need to look at the role of our hospitals across the country for the best effect," he said.

Asked if he saw this as a rationalisation of Emergency Departments Mr Reid said the hospital's roles will need to change.

"I would see it quite differently. I would see it as how do we organise our hospitals that we have the right care in Emergency Departments and specialised and elective care in some other hospitals so that we can manage both. We have to do something different so that we can manage daily surges and winter surges and elective procedures," he said.

As to when such real change could be expected, Mr Reid said a 'fundamental change' is contained in the HSE's 2020 service plan with 1,000 extra community staff being recruited.

Speaking to NewsTalk he said there are three major strategic elements that need to be implemented. One is more beds and resources to support those beds in hospitals and the community. He said the second element is changing the way health services are delivered in the hospital and the community. He said the third related to A&Es.

“We do really need to look at the number of Emergency Departments that we’re managing all across the system. So we’re currently managing 29 emergency departments, and that’s the route where primarily people go when they need it.

“There’s a lot we need to do with our current emergency departments, but it has to be part of an assessment we do. Just to give a simple example, in a national trauma strategy where we’re looking at people would be treated in major traumas.

“That does have a vision of having a small number of dedicated, major trauma centres across the country with a number of spines and hubs through the country off that,” he said.

The Chief Executive's explanation is not dissimilar to a big reconfiguration plan for hospitals in Laois, Offaly, Kildare and Dublin which was presented to the Minister for Health in 2017.

It proposed the phased reconfiguration of the Midland Regional Hospital Portlaoise with A&E, maternity, paediatrics, ICU and most surgery transferring to expanded services in other hospitals. Portlaoise's new role would be mainly for diagnostic with a limited minor injury unit.

The plan was drawn up in the wake of the maternity controversy in Portlaoise.

The Minister for Health Simon Harris has promised local consultation on the future of Portlaoise hospital.