According to the answers received from the HSE by Cllr. Seamus Coyle in relation
to Hospital Waiting Lists for in-patient and Out-patient services Monaghan General
Hospital, or even Monaghan Hospital, no longer exists as waiting list figures are
given for The Mater, Beaumont, Connolly, Drogheda, Navan, Cavan, Rotunda, Cappagh
and Dundalk hospitals are all accounted for but there is no mention whatsoever of
Looking at the figures for Cavan and Drogheda and considering the services needed
by the majority of those on the Waiting Lists it is our opinion that many of them
could access those services in Monaghan General Hospital, if the authorities were
managing their resources efficiently. However every time the return of a service
to Monaghan is mentioned the old mantra is trotted out – there are not sufficient
numbers for staff to maintain their skills. The media quote certain medics who insist
on informing the public that research shows that there has to be big numbers of patients
for doctors and nurses to maintain skills. They fail to point out that research shows
this applies only to a small number of specialist services whereas 85% of presentations
by patients can be dealt with safely in smaller hospitals. Indeed in other countries,
where hospitals were downgraded like Monaghan, the authorities are returning services
to those small hospitals. We in Ireland never learn from others – we must find out
the hard way.
Some in the Medical profession tell us that small hospitals are unsafe. They told
us that Monaghan General Hospital was unsafe. They had no proof but the Government
believed them as it suited them. There were other eminent medical professional who
disagreed with them and said that 85% of patients could be treated safely in hospitals
like Monaghan General but they were not listened to. The Medical profession also
tells us, and it seems this is agreed by all, that it is very unsafe for patients
and staff to have big numbers in the A & E. They tell us that overcrowding delays
treatment, which can be fatal for some, and that infection is spread which can be
fatal for patients who are already fighting a different complaint. They claim that
there are many needless deaths each year as a result. Now the Medical Profession
wants to stuff thousands more patients into A & E’s and hospital Wards that are already
overcrowded causing delays in treatment, mistaken diagnosis, and infection spread.
They cannot have it both ways. I would contend that patients would be far safer in
the small hospital if it is managed properly and resourced appropriately. But perhaps
that is where the problem lies.
Research also tells us that it is safer for a patient to be taken to hospital directly,
even to a small hospital, than to be treated at the scene and the ‘Golden Hour’ is
still very much the guiding time. Again some medics would try to convince us that
the ‘Golden Hour’ is not important any more. The problem is that it is almost impossible
to prove that a patient would have survived had they arrive at a hospital sooner
and so needless deaths might happen but no one can prove it would have been otherwise
with earlier hospital treatment. Some ambulance personnel have told us that they
are under severe pressure at times trying to maintain life in an ambulance while
they by-pass a hospital.
The big problem of course is the lack of nurses, doctors and beds. Our nurses and
doctors are emigrating to other countries where there is good management, appropriate
salary scales and excellent career paths. Could the HSE reform its ways of working
and design attractive career paths with proper corresponding salary scales in order
to keep our staff and so be able to open more beds. Until that happens our public
services will sink lower and lower until all patients will have to be treated in
Private Hospitals, paid for by the tax-payer, or sent abroad at the tax-payers expense.
Perhaps that is what the authorities want, as it will ease the burden of having to
manage so many hospitals.
Speaking about abroad – a couple of years ago at a cross-border meeting on health
there seemed to be a plan on the table, which now seems to be closer to implementation.
The main articles of the plan seemed to be – Letterkenny Hospital would be downgraded
to a Day Hospital and Altnagevlin in Derry would serve the people of North Donegal;
Enniskillen would serve South Donegal, Sligo, Leitrim, West Cavan and North Monaghan
while Sligo and Cavan Hospitals would be downgraded; South Monaghan, East Cavan and
North Louth would get services in Daisy Hill, Newry (Dublin would contribute to upgrade
Newry) and South Louth would go to Dublin with Drogheda downgraded. Did I hear that
our Taoiseach recently told people along the border that we should be going to Enniskillen
and the North to get hospital services? Is the plan advancing? When a Regional Hospital
for the North East was proposed a few years ago Monaghan Community Alliance submitted
a proposal for that hospital to be built somewhere between Ballygawley and Monaghan
to serve both communities but it was thrown in the bin. It was and still is a very
good idea. Until something positive is done we are all living in unsafe conditions
and being deprived of proper hospital services and unless we begin making huge noises
we will be ignored.
Once again the Minor Injuries Unit in Monaghan seems to be under threat as it is
claimed the numbers using the services there are not sufficient to make it sustainable.
First of all we have a problem with figures quoted as our experience of statistics
used to downgrade the services in Monaghan were never accurate. Secondly the figures
given and cost of providing each presentation does not seem to have included the
€100 fee paid by many using the service when not referred there by a GP. Thirdly
the opening hours for the Unit do not include the times that it would be most needed
– evenings and weekends. Finally if Monaghan General Hospital were allowed to take
more of the 85% of patients going to Cavan and Drogheda and if ambulance personnel
could get a decision to take some of the less serious cases to Monaghan instead of
driving to Cavan or Drogheda it would make Monaghan more sustainable, make the ambulance
more available for emergencies, reduce the overcrowding in Cavan and Drogheda A &
Es, and be more economical and most important of all – be safer for patients.