Consultant defends mid-west hospital plan

An emergency medicine consultant at the Mid-Western Regional Hospital in Limerick has said the hospital has sufficient resources to cope with the transfer of out-of-hours emergency services from Ennis and Nenagh hospitals to the regional unit.

Dr Cathal O'Donnell, who also works at Ennis General Hospital, said he supported the plan to reorganise acute hospital services in the region.

Under the HSE's plan for the reorganisation of acute hospital services in the mid-west, out-of-hours A&E services are to transfer from the two smaller hospitals to Limerick around March, with all emergency surgery and most major elective surgery transferring to Limerick during the summer.

However, Dr O'Donnell told irishhealth.com that under the reorganisation plan, there will not be a huge movement of patients from Ennis and Nenagh to Limerick.

"There will be some increase but it will not be dramatic and they will mainly be surgical emergencies from these hospitals."

He said current attendances in the A&Es in Ennis and Nenagh outside normal hours are low.

Dr O'Donnell stressed that there had been no suggestion from the HSE that all round-the-clock A&E services will be phased out completely at Ennis or Nenagh in the short or medium term.

He said medical staff at the two hospitals will still see medical emergencies if they are GP-referred on a 24-hour basis.

The HSE said this week it important to recognise that access to local hospitals for GP-referred medical (as opposed to surgical) emergencies will continue on a 24-hour basis, although all surgical emergencies will be dealt with in Limerick from June.

Dr O'Donnell said under the plan, from March the emergency departments at Ennis and Nenagh will be closed overnight for ambulance cases and from June, all surgical emergencies will go straight to Limerick.

In addition, Dr O'Donnell said, advanced paramedic mobile response units will be made available in Ennis and Nenagh in a matter of weeks.

These units, he said, will be able to deal with incidents out-of-hours at the scene including road accidents, head injuries, cardiac events, and diabetic emergencies, and the paramedics will be able to administer the necessary drugs to patients.

They will be in 24-hour contact with the emergency department at Limerick Regional Hospital.

Asked about the Teamwork report recommendation that Ennis, Nenagh and St John's Hospital in Limerick eventually deal only with minor injuries and illnesses under the care of an advanced nurse practitioner, Dr O'Donnell said the HSE was not slavishly following the report's recommendations in implementing the reorganisation plan.

The HSE plan says a medical assessment unit at Ennis and Nenagh will deal with direct access for all GP-referred medical emergencies, while a local emergency centre which will be medically supervised, will deal with self-referred acute emergencies and minor injuries and be open 12 to 14 hours a day.

Dr O'Donnell said it was his understanding that medically-staffed A&E services would continue for the forseeable future in Ennis and Nenagh.

[Posted: Tue 13/01/2009]

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