There has been a lot of talk recently about the state of our emergency health services and the belief that “because of HIQA” we cannot do anything about it.

But let’s get two things clear:

1. HIQA did NOT say that Roscommon A&E had to be closed but instead said that at the time it could not remain open in its current guise where every patient, regardless of complexity, was presented at the door. In other words what we actually needed was to revise our ambulance by-pass protocols – something that is currently happening at Portiuncula Hospital, Ballinasloe. We also needed to maintain the skills of our medical professionals, which former Health Minister James Reilly said would be resolved by rotating key staff with other hospitals such as Portiuncula & Galway University Hospitals. This is now accepted practice, which is in the process of being implemented in the West/NorthWest Hospital Group, of which Roscommon Hospital is a member.

2. Sadly Roscommon is not busier than it had been before the closure of our A&E. Today – and every other day since the closure of the A&E – there are less patients going through the door of Roscommon Hospital, FACT.

But getting back to where we are now, what can be done today?

Firstly, we need to accept that geographically the catchment of Roscommon Hospital is unique. The people of Castleplunkett are now one of the furthest communities in the country from a 24/7 Emergency Department, according to Maynooth University. Therefore, we need a unique set of solutions for a unique hospital.

Secondly, we need to use the resources that are currently available to us at Roscommon Hospital to provide an enhanced service.

Presently, we have a situation where ambulances are by-passing Roscommon Hospital with patients who could be treated very safely at the Medical Assessment Unit or Urgent Care Centre. This has to stop, it’s not good for patients and it is unnecessarily taking a vital ambulance out of the county which may be needed for a more serious emergency

The fact is that far more illnesses can be treated at Roscommon’s Medical Assessment Unit, particularly now that we have the safety net of the Air Ambulance which allows a situation where patients can be diagnosed, stabilised and either treated or transferred.

And with the use of technology this can be further enhanced. For example, there are presently seven new telemedicine stroke machines still in their boxes, gathering dust in a warehouse in Cork. Installing one at Roscommon Hospital, and providing our nursing staff with the required training, would mean that we could have a 24/7 emergency stroke service which would definitely save lives.

This machine could also be used to diagnose other medical emergencies and Beaumont Hospital is currently exploring its use in assessing brain injury, which could avoid unnecessary ambulance transport to Dublin.

While Roscommon’s doors close at 8pm in the evening, the on-call rosters that were in place prior to the closure of the hospital still remain in place. As a result we have access to 24/7 diagnostic services and medical and surgical cover at the hospital which could be used as a vital tool for direct referrals from the out of hours GP service, WestDoc.

All of the above services are being provided in other similar hospitals, some here in Ireland and some in the UK. But all policed by the same medical safety standards.

Now that there is talk of spending some money there are areas locally which could benefit substantially. While there are undoubtedly major projects that require investment, spending a small amount of money on three key measures could make a real difference to our local emergency health services:

1) Purchase an ambulance for each of our new ambulance bases in Loughglynn, Tuam and Mulranny, Co. Mayo. There is no point in having shiny new buildings if we don’t have any ambulances or staff to operate from them. This makes far more sense than taking existing ambulances away from Roscommon and Ballinasloe.

2) Now that we are getting our new colonoscopy suite we need a sterilisation suite (CSSD) so that we can efficiently operate the colonoscopy facility and our theatres. We don’t want a situation where we have to cancel operations because we have to wait for the theatre equipment to be sterilised in Galway.

3) Extend our emergency air ambulance service by providing an air ambulance for the southern part of the country and through agreement with our colleagues in Northern Ireland, one to cover the northern part of the island. And extend our existing service to a 24/7 emergency air ambulance service. The reason that it does not presently fly at night is because a protocol on designated landing sites has yet to be agreed (we already have a list of designated sites in County Roscommon).

Not only would these steps improve the emergency medical service for people locally, but they would also take huge pressure off our over stretched ambulance service and the emergency departments at Portiuncula, Castlebar, Mullingar and, as a result, Galway thereby benefiting all patients.

However, rather than looking at how we can maximise the existing medical service the bureaucrats in the Department of Health are now contemplating the reduction in the A&E service at Portiuncula Hospital.

Has this not gone far enough?