Fears for future of A&E despite soothing noises

By David Tucker

Published 23/07/2016 | 00:00

HAPPIER TIMES: Brendan Howlin TD, along with Paul Kehoe, Davy Hynes, John Browne, Michael D'Arcy and Lily Byrnes and other hospital representatives at the marking out of the site for the €20m development at Wexford General A&E back in 2011.
HAPPIER TIMES: Brendan Howlin TD, along with Paul Kehoe, Davy Hynes, John Browne, Michael D'Arcy and Lily Byrnes and other hospital representatives at the marking out of the site for the €20m development at Wexford General A&E back in 2011.

The Department of Health says a study into developing a national trauma policy is not about closing hospital Emergency Departments or diminishing services, but it has still not calmed fears about the future of the trauma service.

It was responding to questions posed by this newspaper following publication in weekend newspapers of a leaked report suggesting that trauma care would be axed from nine hospitals, including Wexford.

The Department said the study was concerned with getting the best outcomes for a particular, small category of patients who sustain traumatic injuries.

'It is not about closing Emergency Departments or diminishing services. There are currently no plans to close or remove trauma services from any hospital,' said a spokesperson for the Department.

The leaked draft report led to a chorus of angry protest in County Wexford, with former Minister Brendan Howlin, who opened Wexford Hospital's new showpiece Emergency Department in 2014, saying that any move to remove any services from town and county should be firmly resisted.

The following day, Mr Howlin said Tánaiste Frances Fitzgerald in addressing the Dail, missed an opportunity to give reassurances that there will be no diminution of services in hospital trauma centres.

'When asked about the status of the report from the Trauma Steering Group, a simple statement to assure people that there would be no reduction of services in any centre was required,' said the Wexford deputy.

'Unfortunately, that simple statement was not made. Now it is up to the Minister for Health to put this to bed by making it clear that there will be no reduction in services and that he is giving an instruction to the HSE in that regard.

'In particular, it would be ludicrous to undermine in any way, the €20m investment that I helped to secure for Wexford A&E as Minister for Public Expenditure in the last government.' Meanwhile, the Department said a trauma patient needs access to the best care service that has the right resources to match their often multiple and critical needs in the shortest time possible. The aim of developing national policy on trauma networks is to ensure that trauma patients are brought to the right place at the right time for the right care so they can make the best recovery possible. 'It is about building on the strengths of pre-hospital care, all of our acute hospitals and post-acute services to provide an optimal configuration of trauma services. The need for a national trauma system has been recognised for many years.'

In June 2015 the National Clinical Programme for Trauma and Orthopaedic Surgery published the Model of Care for trauma and orthopaedic surgery and strongly recommended that a national approach to trauma services should be taken. The RCSI (the professional body representing all surgeons and emergency medicine specialists) also called for its establishment at their annual scientific meeting last year.

Last year, the Minister for Health appointed Prof Eilis McGovern as Chair of a National Steering Group to develop policy on a major trauma system for Ireland. Prof. McGovern is a cardiothoracic surgeon, ex President of the RCSI and current National Programme Director for Medical Training in the HSE. This is a joint initiative from the Department of Health and the HSE, developed in recognition that we do not have a coordinated trauma network structure in Ireland.

The implementation of Hospital Groups provides an opportunity for hospitals to work together to develop an optimal configuration of trauma services. Prof. McGovern has been working with the Department of Health, the HSE and all relevant HSE National Clinical Leads in Surgery, Orthopaedics and Trauma on the development of the policy.

'Contrary to the impression created by media reports, the group has not yet reported. The Minister has not seen any output from this group and the Group's recommendations are not expected until later this year,' said the Department spokesperson.

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