In light of current finances can the HSE deliver a future for Roscommon Hospital?

In Blog by Denis Naughten

If the future of the hospital itself is to be protected then the people of Roscommon need to see HIQA approved services begin to move from Galway to Roscommon at the same speed the HSE moved to close our A & E.

We are waiting for the HSE to identify these services and the Consultants who will provide same and a specific timeframe in which all of this will happen. In order to bring this to fruition all medical equipment required must be secured, the required financial resources earmarked and the working environment to allow the Consultants operate in a safe sterile environment.

The plans for additional diagnostics and screening, including colorectal cancer screening, that is, colonoscopies, at Roscommon is positive, but without the necessary capital investment, this cannot happen.

Limerick Regional Hospital is now 26% over budget, at least some of which can be attributed to the fact that Ennis and Nenagh have been downgraded and more people pushed into Limerick. Instead of making savings it is now costing more to run the service because of the reconfiguration. Presently, HSE West is €94m over budget.

It is also important to point out that the proposed capital investment will be warmly welcomed and will be of direct benefit to the staff & the local economy , this is not a replacement for the removal of a 24/7 emergency service.

To achieve this, the HSE & Government should at a very minimum consider the plan for Bantry General Hospital which was put forward by HSE South and published on 18th November 2009 “Review of Emergency Departments and Pre-hospital Emergency Care in Cork and Kerry” which proposed the following:

B. Bantry General Hospital

B.1 Bantry Hospital serves a remote, rural population. It should therefore continue to provide a
24/7 medical admissions function supported by an Urgent Care Centre with existing radiology and
laboratory services.

B.2 Provision of an Urgent Care Centre open up to 12 hours per day (depending on patient
numbers and attendance patterns) seven days per week linked to a mobile rapid response doctor
and/or Advanced Paramedic. There should be bypass protocols to CUH and telemedicine links to
facilitate emergency surgical opinion.

B.3 The Southdoc base should ideally relocate to the hospital site to facilitate patients who may
need hospital services out-of-hours.

B.4 The BGH radiology service should continue as currently staffed to provide diagnostic services
(X-ray, ultrasound and CT) for the hospital catchment area and should maximise their support of
the new MAAU by extending the working day. PACS technology should link BGH/KGH/CUH.

B.5 The BGH laboratory services should continue as presently staffed to provide diagnostic
services to the hospital catchment area. The laboratory should maximise support of the MAAU
by extending the working day.

B.6 The full time cardiac technician should be retained.

B.7 The Medical Assessment Unit should be developed into a MAAU Medical Assessment and
Admissions Unit with opening hours best suited to the attendance patterns of the hospital but
accessible for medical emergencies 24/7 facilitated by appropriate hospital out-of-hours rosters. It
should be established and run according to commonly developed functions, protocols and
procedures, and supported by robust local diagnostic services open from 10am to 6pm but
accessible for medical emergencies 24/7 facilitated by appropriate hospital out-of-hours rosters.
Patients requiring advanced airway care, critical care and intensive care should be managed in
consultation with CUH ED and relevant acute services using appropriate scoring systems and
transfer protocols. Surgical and anaesthetic services should be provided on a day case basis
from regional teams of general surgeons and anaesthetists. Thrombolysis should be available for
early intervention for STEMI?, Non STEMI? and Stroke. A clinical lead should be appointed to
ensure smooth roll out, consistency of staffing, facilities and operating protocols in MAAUs
throughout the region.

B.8 A new telemedicine link with CUH, with agreed arrangements for surgical visiting, should be
put in place to provide reliable surgical opinion for medical in-patients and ED patients. This
service should be supported by in-house CT with defined protocols for 24 hour use.