GPs criticise closure of surgical services in hospital

MONAGHAN HOSPITAL: Proposals for the removal of full surgical services in Monaghan General Hospital, which are expected to be…

MONAGHAN HOSPITAL: Proposals for the removal of full surgical services in Monaghan General Hospital, which are expected to be finalised shortly, have been strongly criticised by a group of Monaghan GPs.

The recommendations of the steering group for the Cavan/Monaghan Hospital Group are expected to include the removal of full surgical services from the hospital; the continued curtailment of emergency services and the hospital going on call for medical emergencies only. The steering group was established by the North Eastern Health Board last April to draw up plans for a major reorganisation of the two hospitals.

The steering group's final report is expected to be presented to the health board at the end of the month.

Local GPs have been responding to a brief given to them by the health board by sending a letter to the Minister for Health, Mr Micheál Martin, outlining their concerns regarding "safe and accessible healthcare services" in the North Eastern Health Board region.

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"We felt it vital to express our concerns in advance of the release of their proposals," the letter stated. "Our main concern for Monaghan General Hospital is to see surgical services enhanced and the hospital be placed back on call, both for surgical and medical emergencies. The brief given by the CEO leaves little hope of either of these."

A surgical presence must be kept in the hospital 24 hours a day "to manage surgical problems presenting to the hospital and also to manage surgical problems arising in in-patients within the hospital". Anything else was not "adequate for the management of emergencies", said Dr Illona Duffy, a Monaghan GP. "There are ongoing issues with surgery in Cavan at the moment and the protracted problems will take a minimum of five years before these are cleared up. This means that patients in Monaghan will be sent to Dublin or Drogheda," she explained.

"Surgical services in the health board area are already under stress. Now we have a plan to move services from a hospital that was working," she said.

Previous proposals for Monaghan General Hospital suggested that five-day surgery would occur in the hospital, according to the letter.

"This would provide night-time surgical cover mid-week and the possibility of surgical on-site cover at weekends. We believe that despite the European working time directive, there are means of ensuring that moderate surgery can continue in hospitals such as Monaghan General Hospital."

The letter also contained strong criticism of the consultation process itself and said the issues were not debated and discussed properly "due to the dictatorial nature of the CEO's brief".

When the steering group was established three months ago, Mr Paul Robinson, chief executive of the NEHB, issued a number of directives regarding the reorganisation.

A protocol-driven day surgery service was all that was envisaged for Monaghan, according to directives issued to the steering group. These directives gave the members of the steering group little room for manoeuvre, said Dr Duffy. "We wish to make it clear that the steering group did not propose that surgery in Monaghan General Hospital be limited to day surgery," the letter concluded.

The Monaghan Community Hospital Alliance has announced it is holding a community rally on Thursday, August 26th at 6 p.m. "We will not accept the downgrading and removal of the basic acute services from Monaghan," said an alliance spokesman.