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  • Closure of Roscommon Hospital A&E

    TAOISEACH Enda Kenny might have missed the show but hundreds of smuggled crosses dotted the Connacht football final yesterday in a macabre protest at the closure of Roscommon Hospital's A&E.

    As driving rain and wind whipped around Dr Hyde Park, Roscommon, the symbols were held aloft as a silent message of defiance, supported by more elaborate signs and the protesting voices of hundreds outside
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  • #2
    how many local regional hospitals is this now bangers? i heard the hospital i was in in ennis had their emergency closed down....now mind you id personally debate the usefulness of it but what the heck is the region going to do without it....and these other hospitals...

    disgraceful..

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    • #3
      Originally posted by Mykidsmom View Post
      how many local regional hospitals is this now bangers? i heard the hospital i was in in ennis had their emergency closed down....now mind you id personally debate the usefulness of it but what the heck is the region going to do without it....and these other hospitals...

      disgraceful..
      I am in the process of doing business with one of Dublin's major hospitals for some much needed equipment, I have to wade through 5 levels of managers to get to a decision maker, none of these people are performing a useful function. Wasteful paper pushers, this is where the problems lie........I could go on about the Manager that ripped the hospital off...........The frustration of it all....
      Yesterday is history, Tomorrow is mystery, Today is a gift.

      Comment


      • #4
        Originally posted by Mykidsmom View Post
        how many local regional hospitals is this now bangers? i heard the hospital i was in in ennis had their emergency closed down....now mind you id personally debate the usefulness of it but what the heck is the region going to do without it....and these other hospitals...

        disgraceful..

        Hi, Helen, as you may have seen some time ago, I showed a photograph taken at the Admissions Department of Tallaght Hospital. The cost,(which must be paid before you are seen) is currently €100.

        I was rushed by ambulance to the A&E and spent 60 hours lying on a trolly in a coridoor.



        Hospital safety - the same (very) old story

        [ by Niall Hunter, Editor www.irishhealth.com]

        'This just in' as they say, on the thorny topic of closing down major surgery and emergency care in smaller hospitals, a debate which has feverishly dominated headlines in recent weeks.

        A major report entitled 'Outline of the Future Hospital System' seen by irishhealth.com says:

        * Even if there were no limitations on financial resources, it would clearly be unrealistic and a waste of money to attempt to develop so many hospitals to desirable standards of staffing and accommodation.

        * The requirements of a modern hospital service have become so complex that we can only meet them by a radical reorganisation of the system involving a considerable reduction in the number of centres providing acute treatment.

        * Few of our smaller hospitals are in a position to provide the type of complex care that some patients need.

        * Small, understaffed and incompletely equipped hospitals cannot treat patients as safely as larger, more comprehensive units. Mortality and morbidity of even relatively common conditions, such as acute appendicitis, declines as the hospital size, and thus the staff, increases.

        *Smaller hospitals, once major treatment services are transferred from them, should become community treatment centres with improved diagnostic testing and outpatient facilities.

        The report proposes that major treatment services be moved out of hospitals such as Loughlinstown, Roscommon, Mallow, Navan, Portlaoise and Wexford.

        Cue local outrage, political bandwagon-jumping and administrative hand-wringing. We've seen it all before.

        Actually, we definitely have seen the above report before - at least some of the 'oldies' among us may have - all of 43 years ago in fact.

        The above recommendations in the 1968 Fitzgerald report, as it became known, have largely been studiously avoided over the years as our health system and Governments have failed to grasp the nettle of safe and cost-effective service provision.

        Some reconfiguration and closures of hospital services have admittedly taken place since 1968, not necessarily for overriding altruistic patient safety reasons but due to financial imperatives, medical indemnity issues or the politics of the latest scandal.

        As smaller hospitals again contemplate their future, we are seeing 'At last the 1968 show' being played out yet again.

        We are still left with the detritus of the Fitzgerald's unfulfilled legacy, culminating in Health Minister James Reilly's declaration last week that most of our smaller hospitals, in the way their services are currently organised, are inherently unsafe.

        In fact some of our bigger bigger ones don't look too safe either. Not many locals would, if they had a choice, choose to attend Tallaght Hospital's emergency department at the moment, but that's another story.

        The hospitals that Dr Reilly is now telling us may be unsafe were effectively declared unsafe by Fitzgerald 43 years ago.

        Yet many of them remained open, providing an all-singing all-dancing, poorly-staffed and infrastructured, diluted critical mass that could not always guarantee safe care, yet, begob, they were were our acute hospitals..so......like...shut up...and you can't count on my vote come election time, so there etc.

        The arguments propounded by Fitzgerald have been put forward in numerous reports since but were studiously ignored. Everyone thought these plans were great until a hospital near to them might be faced with 'downgrading'.

        Many who opposed this downgrading seemed not to realise that the hospital was actually failing to make the grade in terms of training facilities or critical mass.

        In fact, and this is where it gets really depressing, the argument for changing the role of local hospitals and concentrating services in big centres was also, Fitzgerald pointed out, put forward in similar reports in the 1930s and the 1920s.

        Yes, our culture of 'a brain surgery unit at every crossroads' has a long history.

        Now that we have an independent safety body (the existence of which some interest groups seem to begrudge) and a Minister for Health who seems willing to face up to safety realities, the role of smaller hospitals will change, and change utterly. It is just a matter of time.

        What was due to close and in which hospital was put forward pretty clearly in a safety update provided by the HSE to HIQA back in the spring. Navan, Loughlinstown, Roscommon, Bantry Mallow and to a lesser extent, Portlaoise, were on the 'hit list'

        This update emerged from HIQA safety investigations into treatment quality issues at Ennis and Mallow Hospitals.

        Yet, for reasons unknown, or perhaps very well known to the HSE, it didn't exactly shout these plans from the rooftops.

        They were only discovered recently in an obscure section of the lengthy HIQA report on Mallow Hospital originally published back in April.

        Now, the political temperature has risen and the Minister is now getting it in the neck in the neck for being candid about the safety imperative in hospital reorganisation.

        The waters have been muddied muddied further by the now annual 'crisis' of junior doctor recruitment, which although of concern, is essentially a side issue in the larger depressing scale of things.

        You could have the required complement of the best trainees in the world staffing hospitals from next week, but this would still not remove the safety issue.

        Throughout all of this debate, the HSE, has remained coy about the details of and timelines for closure of various services, even though it probably has a fairly good idea of what these are.

        Last Friday, journalists were hastily called into a press conference about safety issues in smaller hospitals and the type of services they could provide in future.

        The old pulses started to race. This was it , we thought, the balloon is going up. Cue big map on the wall with guy sticking electronic pointy thing at 'downgraded' local hospitals.

        Nothing would ever be the same again.

        In fact everything was the same as before. The old message about the need to move major surgery and 24-hour ED away from smaller hospitals...a new role for these hospitals...medical assessment and minor injuries... diagnostic tests and outpatients still have an important role locally...hospitals still pretty safe even though Minister doesn't seem to think so...don't panic...well, do, just a bit...

        Much of what was said by the HSE at the press conference made perfect sense. It could, however, have been read out from the 1968 Fitzgerald report. Except unlike in Fitzgerald, there was no map provided with likely locations of where services will change.

        Since that press conference, the HSE has finally bitten the bullet on the Roscommon Hospital issue and has announced that its A&E is to be axed from next Monday.

        To be fair to local people who are worried about the future of their local hospital and healthcare services, the HSE has not done itself any favours by being frustratingly vague up to now about which hospitals are set to lose services and what will be put in their place in terms of emergency/ambulance cover and alternative facilities.

        It's all very well making general statements about changing hospital roles. Local people want to know what to expect a few weeks or months down the line. And not all the local interests are of the 'keep everything open at any cost' brigade - they just want some clarity and certainty from the people running the health service.

        So far, the only people who have been straight on this issue, however unpalatable the news might be, are the Minister for Health, the Taoiseach and HIQA. The HSE should take their lead.

        However, it is possible to make some predictions, based on the HSE's report to HIQA and nudges and winks, on which hospitals will more than likely lose major surgery and 24-hour A&E and provide less complex services to their local communities in the coming weeks and months.

        These are - Roscommon, Loughlinstown, Mallow, Bantry and Navan. It is likely that Portlaoise will keep its major surgery and A&E service, but given that we already two other sizable general hospitals in the midlands, this may not last.

        The future role of other smaller hospitals not mentioned in the HSE's HIQA update, such as Wexford, has yet to be clarified.

        Once the cultural millstone of keeping smaller hospitals running unsafely has been well and truly flung away, we can then get on with trying to ensure that the remaining larger hospitals are as safe and efficient as possible, backed up by realigned services at smaller hospitals and by properly resourced GP and primary care services.

        Comment


        • #5
          How they dare? Are people no demonstrating?

          Ireland is not a Celtic Tiger never was and never willl be

          Enda broke his promise toi the people
          Last edited by Red Biddy; 22-07-2011, 03:04 AM.

          Comment


          • #6
            Budget-wise, it makes economic sense to operate fewer surgical groups in a region for many reasons. In addition, many surgeons may prefer to not live in a small town, so finding the surgeons is then a problem as for the staffing. It's easier & more rewarding for the surgeon to work in a large, cutting edge research group than alone as for staying ahead in his or her own field, and they find this most desirable.

            BTW, I am the lead financial person for a large surgical group. I see issues with everything from quality of life the MD's expect to support staffing required, practice management, operating room expenses and scheduling, etc. It is good business sense to consolidate. My surgical group has doubled in size in five years while surrounding surgical groups have shrunk, and ends up being far more efficient.

            How is Ireland's air ambulance service working since by helicopter, can cover a massive distance in 15-20 minutes, and then actually the emergency patient could be taken to a large hospital faster than over land to a smaller one. Do they start a radio dialog and therefore treatment with the emergency medicine doctor en route to the hospital from the air ambulance upon patient pick up, etc.
            I believe in.......

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            • #7
              yeppers i even saw a photo you posted of the charge and was stunned...i know when i was in ennis...i had to fork over 40 e before they would see me..i also had to fork over 40 e for a dr somewhere to look at me...all this while having a heart attack and organ failure...i shudder to think what would have happened had i not had the cash or me handbag lol.....daft........mind you i did get immediate attention..albeit a bit beaten up by the emergency dr who thought i was having a reaction to street drugs.............the idiot.

              Comment


              • #8
                Originally posted by Mykidsmom View Post
                yeppers i even saw a photo you posted of the charge and was stunned...i know when i was in ennis...i had to fork over 40 e before they would see me..i also had to fork over 40 e for a dr somewhere to look at me...all this while having a heart attack and organ failure...i shudder to think what would have happened had i not had the cash or me handbag lol.....daft........mind you i did get immediate attention..albeit a bit beaten up by the emergency dr who thought i was having a reaction to street drugs.............the idiot.
                I do not have an issue with having a co-pay, it makes people think about going for emergency care that perhaps they should not because it's not an emergency health situation, BUT they can charge their copay on the way out of the emergency room. Or, talk to the family about once the situation is stable. Last time I took someone to the ER here around 2005, was given the option of being billed by mail for the copay......that made sense.
                I believe in.......

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                • #9
                  ive no problem with the co pay either trish..but heres the thing...the drs wouldnt even come close to me until id handed over the cash.....there was a rush to find my purse get the cash..then they distributed the treatment...here everyone going to a dr has free consultation and treatment from clinics to the hospital emerg...and i wondered in ireland what actually happened to seniors or very low income families who needed the treatment but couldnt afford it...100 e to see an emergency dr is like $150 then if you need medication....being sick is very expensive at the time in seniors lives they should be getting a bit of a break..

                  Comment


                  • #10
                    Originally posted by Mykidsmom View Post
                    ive no problem with the co pay either trish..but heres the thing...the drs wouldnt even come close to me until id handed over the cash.....there was a rush to find my purse get the cash..then they distributed the treatment...here everyone going to a dr has free consultation and treatment from clinics to the hospital emerg...and i wondered in ireland what actually happened to seniors or very low income families who needed the treatment but couldnt afford it...100 e to see an emergency dr is like $150 then if you need medication....being sick is very expensive at the time in seniors lives they should be getting a bit of a break..
                    Now I can't agree with the co-pay up front in the emergency room.....they could have checked you in and asked your husband a bit later on.

                    But, back to the Roscommon situation, personally I'd rather be taken by air ambulance to a larger facility.
                    I believe in.......

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