TWO more hospitals are to lose their 24-hour emergency departments under major plans to revamp services outlined in a new government report.
St Columcille's Hospital in Loughlinstown, Dublin – in the constituency of Tanaiste Eamon Gilmore – and Navan Hospital in Co Meath are earmarked to lose the service and get local injury units instead.
They are among nine smaller hospitals earmarked for overhauls in the report, which promises to secure their future and further develop their role while delivering services safely.
They are the only remaining hospitals on the list – which includes Dundalk, Mallow, Bantry, Ennis, Nenagh, St John's, Limerick, and Roscommon – which have 24-hour emergency departments still open.
The 'Securing the Future of Small Hospitals Report' was published as Health Minister James Reilly announced the formation of all hospitals into six separate groups.
He confirmed the secure future of existing services including cancer care, cardiology and the 24-hour emergency unit in Waterford Hospital but denied public demonstrations on the streets about its feared "downgrading" influenced his decision.
Referring to smaller hospitals, he said they "will provide more services, not fewer" and will take on more day surgery, treatment of chronic disease, clinics and diagnostics.
Commenting on the removal of 24-hour emergency care in St Columcille's, Dr Donal O'Shea,
chairman of the medical board, said this had been planned for but it is important that the rest of the promises are followed through, otherwise it would amount to a downgrading and a cost-saving exercise.
Prof John Higgins, a Cork consultant who drew up a second report on the setting up of hospital groups, said each of the six groups will be headed by a major teaching hospital and will have an overarching chief executive and board.
There is a need to form the groups because of the haphazard way in which the hospital system here had emerged, causing duplication of human resource units and finance departments as well as fragmentation.
The most complex care will still be provided in the larger hospitals but they will divest themselves of a lot of work which can be delivered locally with staff in some cases travelling around the group.
"The benefits for patients will be high quality care which will be standardised," he said. The groups will make it easier to attract doctors to work in smaller hospitals in particular.
"The patient will not be restricted in the choice of hospital group and a GP can refer the patient to the hospital outside the local area."
A chairperson will be appointed to each group in the next eight to 10 weeks by Dr Reilly and the chair will start the process of recruiting a chief executive from within the existing health service.
Legislation will be needed to form hospital trusts and the recruitment of a chief executive will be by open competition.
Asked about concerns that the Rotunda maternity hospital is now in a group headed by Beaumont Hospital, even though it sends its patients needing acute care to the Mater Hospital, Dr Reilly said existing arrangements will continue.
Rejecting claims that public and political pressure influenced decisions about Waterford Regional Hospital he said it was a question of people not fully understanding what was involved but this was clarified over a number of meetings.
Commenting on the plan, Fianna Fail spokesman on health Billy Kelleher said there needed to be clarity in relation to some services.
"While there is a commitment that Wexford should retain its full range of emergency department services, no such commitment is provided for St Luke's in Kilkenny. We need clarity on this. The report also mentions the absence of consensus among hospitals in the south-east region.
"In the south/south-west group, four paragraphs are offered to reassure Waterford. Commitments for South Tipperary Hospital are conspicuous by their absence. Again in the west/north west group the report says Letterkenny should keep its services but says nothing about Castlebar," he said.