Saturday 17 March 2018

Specialist in strokes slates HSE four-and-a-half hour care window

Brian McDonald

A TOP specialist last night clashed with the HSE over advice that patients have up to four-and-a-half hours to get the necessary hospital care following a stroke.

Dr Ronan Collins, who is director of Stroke Services at Tallaght Hospital, was responding to comments by HSE clinical director Dr David O'Keeffe, at the announcement that the A&E department at Roscommon County Hospital will close from next Monday.

The facility is to be replaced by an urgent care centre during the day and an out-of-hours GP service throughout the night.

Responding to local concerns that stroke and heart attack patients in Roscommon would be more than "the golden hour" away from Galway University Hospital, Dr O'Keeffe said that while time was important in such incidents, it was not as important as bringing the patient to the correct location.

Dr O'Keeffe, who is clinical director of Galway and Roscommon Hospitals, said patients had a window of four-and-a-half hours to get the correct care, rather than an hour.

Yesterday, Dr Collins said he would not support that view and he did not endorse providing such information to people who may suffer a stroke in the future or to their families.

He said: "The distinction must be made between people suffering from heart attacks and those suffering from stroke and it is not accurate to suggest that patients in rural areas have up to four-and-a-half hours to receive the appropriate treatment if they suffer a stroke."

Dr Collins stressed that it was absolutely critical for stroke patients to be transported to a hospital as soon as possible.

A consultant physician at Roscommon Hospital, Patrick McHugh, who has worked there for more than 30 years, also hit back at claims by Health Minister James Reilly that the mortality rate for cardiac cases in the hospital was four times that of the larger Galway University Hospital.

Dr McHugh said: "They don't die like that. They get the best of treatment here. There is an anaesthetist, there are surgeons, nurses, all sorts of equipment and we can treat the patients well.

"These guys want to close Roscommon. They are throwing all the dirt they can at us."

Family doctors across Co Roscommon strongly criticised the Government and HSE for suggesting that new arrangements to replace the A&E department at the local hospital would lead to a safer service from next Monday.

While 12 doctors in Roscommon town have agreed to provide an out-of-hours GP service at the hospital from Monday, they will have no access to diagnostic services and seriously ill patients will have to be transported to any one of four other hospitals in the west.


Yesterday, doctors in Co Roscommon who serve a catchment area that stretches into counties Galway, Mayo, Longford, Westmeath, Leitrim and Sligo said the people served by the county hospital were entitled to be made aware of the reality of the situation.

In a statement, the doctors said: "Any suggestion that a GP co-op can replace the existing A&E services is untrue and extremely misleading to the public. Such an out-of-hours GP co-op will have no access or expertise on site to X-ray, will be unable to do CT scans to assess stroke patients and administer thrombolysis when appropriate, or do diagnostic tests to assess hearts attack and thrombolyse when appropriate.

"The impression which has been given that the closure of A&E at Roscommon County Hospital in such circumstances would lead to 'a safer' service is false and the general public and people of the catchment area are entitled to be made aware of the facts."

Irish Independent

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