Thursday 26 April 2018

Transplant surgeon's offer to train his replacement turned down by the HSE

Answers vague about new programme

Dr Hickey blames the bureaucracy of the public service for his decision to retire from the post, which remains vacant
Dr Hickey blames the bureaucracy of the public service for his decision to retire from the post, which remains vacant
CRITICAL: Dr David Hickey’s offer to stay on was refused
Donal Lynch

Donal Lynch

The transplant surgeon who set up Ireland's pancreas transplant service which has come to halt since his retirement believes the life-saving programme could have been kept going.

No operations have gone ahead in 2015 following Dr David Hickey's decision to step down from his post Beaumont Hospital in December 2014. It emerged this week that the HSE has so far been unable to recruit a replacement surgeon, despite their best efforts .

Dr Hickey told the Sunday Independent this week that he offered to stay on at a locum rate, far below his previous salary, but this was rejected.

He also offered to train in a successor, but said this offer was also rejected.

The surgeon blames the bureaucracy of the public service for his decision to retire from the post, which remains vacant.

"The early retirement is a perverse incentive within the health system to get rid of people who are older," he told the Sunday Independent.

"You're penalised for staying on. They want to get rid of guys in their 60s because they cost more and they cause more trouble.

"I was being dragged to meetings of no importance, where the only thing that was ever decided was the date of the next meeting, and it all became more prevalent as management took over the health service."

The truth of the matter was that he didn't want to retire in the first place, he explained.

The Dublin football legend - and current selector for the senior panel - still felt passionate about his work as a surgeon and would have happily remained on at Beaumont Hospital in Dublin.

The situation has given rise to serious concerns for the welfare of patients.

"You hesitate to spell out the dangers because you really don't want to frighten patients but the mortality for a type 1 diabetic on dialysis is that 20pc of them die within five years," said Dr Hickey.

He added that in the absence of effective lobbying by patient advocacy groups, the patients themselves have now taken over.

A petition with 15,000 signatures was handed into Beaumont this week. One woman awaiting a transplant, Ciara Kelly, said she is getting weaker "day by day".

A spokesman for Minister for Health Leo Varadkar said in a statement yesterday: "A very constructive meeting was held in the Department of Health with the HSE and Department officials, and representatives from St Vincent's and Beaumont. The pancreas transplant programme will recommence in St Vincent's in September subject to a suitable donor recipient match being available."

Speaking to Morning Ireland, another patient, Rachel O'Hora, expressed scepticism that the service could be resumed quickly.

"I don't see how, in such a short space of time, they would resume," she said, noting that the doctor would need to be trained up.

According to the HSE, the pancreas transplant service will indeed resume in September at St Vincent's in Dublin, but there is little detail on how this will happen.

Ann McLoone, a spokeswoman for the HSE, told the Sunday Independent that the operations will recommence in September and that the new programme will run on a "combination of current expertise and expertise that they have recruited to the programme", but she could give no details on new hires or how the programme will be structured.

"It made sense to collaborate between Vincent's and Beaumont so that you would have a sustainable service. They have a full complement of specialist staff from September," she said.

When asked about Dr Hickey's offer to say on at a locum rate, she said: "I can't comment, but hypothetically even, you can't take on a locum like that unless they're available 365 days a year, 24/7, to do transplants."

David Hickey remains sceptical about the how effective the new programme could be. "You don't want to predict disaster for people trying to do their best.

But it takes a lot longer than one month to recruit someone who can do this job. There is currently nobody in Ireland other than myself and Antonio Zimmerman who have performed pancreas transplants in the last 20 years," he said.

"If they are to do this in September, someone should have gone in June to a centre in the States to see how it's done. The whole process of actually getting someone suitable in place would take over a year. And, to be honest, it would be made even more difficult by the fact that nobody wants to work for the HSE," he added.

Dr Hickey set up the pancreas transplant programme as a pilot scheme at Beaumont in 1992, building it up into one of the most reputable programmes in the world and performing operations on 2.8 people per million, the fourth-highest rate in Europe and the sixth-highest in the world.

The unit hosted the World Congress of Pancreas and Islet Transplantation in 2005. Dr Hickey has also supervised operations carried out by Dr Antonio Zimmerman, who has performed eight of the last 11 pancreas transplants in Ireland.

Sunday Independent

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