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EMYVALE

Distance to Hospital

NUI Maynooth’s National Institute for Regional and Spatial Analysis has developed a mapping tool by which you can discover the distance you are from services like GPs; Fire Station; dentists; airports; hospitals and a range of other services. The ability to find out how far you are from a 24 hours emergency department has been the one to catch the public’s eye and it is getting fair coverage on radio and papers. Now this is something which we in the HSAG (Health Services Action Group) brought before the Oireachtas Committee on Health back in 2003 and we have passed on detailed information on distances to A & Es to various groups of TDs and senators but it has always been ignored.

This particular system of determining the distances seems to be somewhat inaccurate as places known to be further from an A & E gets a better rating than a place which we know is closer. For example it would claim that Emyvale is 39 minutes whereas Tirnaneil is 41 minutes from Cavan and that is only an example. However the principle is still very important - that the length of time it would take an emergency getting to the A & E is too long for many.

Of course the times which this tool presents do not take many things into consideration – things which will impact heavily on the times. These include volume of traffic, road conditions, weather conditions, or indeed closed roads like the road from Clones to Cavan, which is closed regularly. It also cannot take into account the length of time it takes the ambulance to get to the scene and again our experience of that would not be very heartening. Similarly it does not give consideration to the length of time it will take the ambulance crew to get the patient loaded into the ambulance and again this can be a lengthy process in some cases. We could also add time for the space between the occurrence of the accident or incidence and an emergency call being made and the ambulance called.

Based on all this we would put the times for Main Street, Emyvale, as more likely to be: Call to ambulance 5 minutes +; arrival of ambulance 25 minutes; time at scene 15 minutes +; time to Cavan 41 minutes +; thereby giving us a total of 86 minutes +, which is almost half an hour over the ‘Golden Hour’ and these times are minimum and could stretch another hour. What then for an incident further North in Monaghan or to the West or East, where narrow country roads have to be negotiated. Having to go to Cavan does not give you a great chance of survival as Prof Nicholl, Head of Medical Research Unit in Sheffield University, stated at a lecture in the Royal College of Surgeons in Dublin last Friday – that every 6 miles you have to go in an ambulance your chances of survival reduce by 1%. He also says that closing the local emergency departments (like Monaghan) is wrong and will cost lives.

Modern methods of delivering safe services are being used in other countries to provide rural and isolated communities with emergency care and acute in-patient care. They have found that in-hospital times reduce when the patient is nearer home and in familiar surroundings. As well it is easier for the services to discharge patients, when they are aware of patient background and home conditions. But the big question is – how do we get this message across to the policy makers and how do we get them to look at the bigger picture.