In the Sunday Business Post of November 12th 2017 I read an article by journalist,
Susan Mitchell, regarding a secret Action Plan to reduce Portlaoise Hospital to one
similar to Roscommon - a report that seems to have been kept secret because they
were afraid of local objections to the plan. Top medical men, all I'm sure living
and working in Dublin were recommending the plan and more and more or less saying
that all the acute patients from the catchment area of Portlaoise should be taken
to a Dublin hospital in order to get 'better services' -(now where did we hear those
two words before??). I wrote a reply and sent it to the SBP but heard nothing. However
I never expected it as Monaghan never did count on the richter scale for the Dublin
medics or politicians. Much of the reporting on the problem in Monaghan and the protests
being held always seemed biased in favour of Dublin. Anyhow I have decided to publish
me response here so that some one can read it.
Portlaoise Action Plan It was with sadness, a heavy heart and a feeling of déjà vu
that I read the article by Susan Mitchell entitled ‘The Report the Government doesn’t
want you to see’ in relation to Portlaoise Hospital. The people of Monaghan read
similar reports and similar reporting regarding services in Monaghan General Hospital
when the authorities were in the process of downgrading Monaghan to a similar level
as that proposed for Portlaoise and if the people in the catchment area of the Portlaoise
Hospital want to know what life will be like when these services are removed from
their hospital, all the have to do is ask the people of Monaghan.
Oh yes, the people of Monaghan marched the streets of the capital and marched the
streets of Monaghan and the party in power, Fianna Fail, were not for turning. The
opposition was on our side and Fine Gael would not do that if they were in power.
James Reilly, who was to become the Minister for Health in the Fine Gael Government
stood on the Courthouse steps in Monaghan before the election and promised to fight
for the services to be retained in Monaghan. You can listen to his words of encouragement
to us to ‘fight, fight, fight and Fine Gael will fight with you’ by using this Youtube
link - https://www.youtube.com/watch?v=CDY9dG89iBU . Then, as Minister, he completed
the downgrading begun by Fianna Fail. What a let-down that was.
The Action Plan is proposed and being pushed forward by medics and the reason given
is that certain acute and emergency services in Portlaoise are unsafe for patients.
So they want these services provided for the people in the catchment area of Portlaoise
in some of the four major hospitals within 50 minutes of Portlaoise. So they want
a few extra thousand patients taken to hospitals that are already overcrowded, lacking
in beds and staff and unable to provide timely services for their existing patients.
This overcrowding and delays in treatment has been flagged by senior medics as very
dangerous for patients and that it causes needless deaths but yet this is where they
want to put the Portlaoise patients. Surgical patients in need of emergency surgery
will add to the waiting lists in those hospitals and also add to the numbers languishing
on trolleys somewhere in the hospital. We also ask what distance the patients on
the other side of Portlaoise will have to travel to get to those hospitals?
It is interesting that €20m is being promised for Portlaoise Hospital and they promise
that it will be busier than ever. Monaghan got a similar promise to appease the people
into believing that Monaghan Hospital will remain a hospital. It is used from 9am
to 5pm Monday to Friday and a small Step-down unit and a similar Rehabilitation Unit
but no emergencies are taken there by ambulance and there are no acute surgical or
medical services. Some day-surgery, some diagnostics and clinics but no emergencies
Regarding promises: Monaghan was promised 'better services' but they never materialised.
Indeed they have deteriorated. Monaghan was promised an Advanced Paramedic as a First
Responder but that lasted a few months. Then we are lucky if there is one on duty
at all or we may have to share one with Cavan/Louth/Meath/. We were to get another
ambulance but that did not work out either and ambulance times are unacceptable.
The nearest A & E is Cavan which is 50 minutes from Monaghan. However for people
North of Monaghan Town you can add another 20 minutes. It can take the ambulance
20 minutes to get to the location but sometimes we have to wait for an ambulance
from Cavan, Dundalk, Ardee, Longford or even Northern Ireland. They spend 20 minutes
stabilising and loading the patient, then 70 minutes to hospital – which is a total
of 1 hour 50 minutes before the patient can access Hospital treatment. The Air Ambulance
then came on stream. We can give a time line of a call out. A 999 call goes in and
an ambulance is dispatched to scene. It takes 20 minutes to get there. 15 minutes
after arrival and review of patient they decide to call the Air Ambulance which takes
30 minutes to arrive and find a suitable landing area. The ambulance then takes the
patient to that point and transfers the patient to helicopter which takes 15 minutes
before the helicopter is ready to depart scene. It takes 10 minutes to reach Cavan
landing area and another 10 minutes before patient is handed over to hospital staff.
That is a total of 1 hour 40 minutes – outside the Golden Hour and a big delay in
getting hospital treatment. (These times are minimum and in many cases will be exceeded).
This type of delay can result in death, not perhaps immediately but later because
treatment was not begun in time. When we claim this we are asked to prove that the
patient would have survived by reaching hospital sooner, which is impossible to prove
but we take the word of certain consultants.
Now also if you have to go to hospital for tests or for treatment you make your own
travel arrangements. For cancer patients, e.g., volunteers and voluntary donations
provide transport for those who cannot afford it. Indeed so many health services
depend solely on the goodwill and generosity of people to fund services in areas
around the country. It is once again rural Ireland inhabitants who suffer most as
there are no or few public transport systems running in rural areas.
We in Monaghan are convinced that the downgrading of services in Monaghan General
Hospital has put more lives at risk than when the hospital was offering full services
and that needless deaths have happened. Those services could be provided if the system
was properly resourced and managed. But there lies the crux - the real problem is
the lack of investment in beds, nurses and doctors and the inability to manage the
system. The Government needs to develop an attractive career path for nurses and
doctors and offer them acceptable remuneration so that they will be willing to stay
in Ireland and work in our health services. This will also save the huge expenses
paid for agency staff and locums which is causing hospitals to cut and/or delay services
in order to keep within budget. It might also be a plan to rotate staff between a
large and small hospital to maintain skills as it is much safer to make the healthy
do the travelling instead of very ill patients and those in need of emergency intervention.
We wonder if the numbers are too small for staff in the hospital to maintain skills
how do the ambulance personnel maintain their skill attending the same numbers?
If this Action Plan for Portlaoise is proceeded with then it is incumbent on all
concerned to ensure that the receiving hospitals will be able to deal with the extra
workload and have enough beds and staff. This must be done before any effort is made
to remove any service from Portlaoise and the people being served by the receiving
hospitals should be shouting loud and clear that their lives will be put in severe
danger if this is not done. The people from the Portlaoise catchment area will not
have a hospital when they need it most – in an emergency but the major hospitals
will also offer a poorer service through overcrowding.
The question is – have we the people in power to solve this problem properly or will
the people of Portlaoise be left with the same unacceptable situation as Monaghan.
Peadar McMahon, Chairman Monaghan Community Alliance.
The Alliance has not gone away and may have to become active again as the situation
is totally unacceptable and this Government does not seem to be in a position to
change things other than to talk about what they are going to do with their ten year
plan. As in the past, only more so, we get spin and more spin which is meant as a
Valium tablet for us so that we will be calm and forget about what could happen in