Hospital report: The majority of Irish adults with cystic fibrosis are being treated in facilities that are dangerous, a new report has found.
The report, compiled following an independent assessment of services for patients in the Republic by a UK consultant, has found patients are being treated in units with few if any isolation facilities, putting them at risk of picking up infections from other patients.
The position at the largest cystic fibrosis treatment centre in the State - St Vincent's Hospital in Dublin - was described as "bleak" in the consultant's report, published yesterday.
It concluded the lack of segregation and isolation facilities for patients at St Vincent's Hospital was "dangerous".
The unit, which has just one consultant to treat 60 per cent of the adult cystic fibrosis population in the State, is at risk of being sued if patients pick up infections from each other, it added. It could lead to litigation similar to that which surrounded the Hepatitis C infection scandal, it said.
Dr Ronnie Pollock, who compiled the report for the Cystic Fibrosis Association of Ireland (CFAI), visited 10 of the 13 hospitals in the Republic caring for cystic fibrosis patients and found the amount of commitment to cystic fibrosis, a genetically inherited disease, was everywhere "seriously inadequate, and usually the responsibility of a single individual, creating problems of cover during inevitable absences".
He found the lynchpins of the services were cystic fibrosis nurses, physiotherapists, dieticians and psychologists and again their numbers "are totally inadequate". Staffing levels, he found, were more than 400 per cent below minimum accepted standards. He also found the staff who were available were "too thinly distributed over too many, too small, units". Centralised specialist care improves outcomes, he said, adding that in future it was "essential" that care was provided by "many fewer units which are each of significant size. It is not a service to patients and families to provide ease of access at the cost of less than maximally effective services," he said.
He recommended services at Tralee, Mayo, Sligo and Drogheda cease and all care be provided from nine specialist centres. These would include the three children's hospitals in Dublin, St Vincent's and Beaumont in Dublin, Cork, Waterford, Limerick and Galway. Patients from Donegal may be able to avail of services in the North.
There are 1,143 cystic fibrosis patients in the State, with Ireland having the highest incidence of all European countries. Here the rate is one in every 1,600 births compared with one in every 25,000 in Finland.
There are "also strong indications that outcomes in Ireland are worse", the report said.
Mr Carl Rainey, chairman of the CFAI, said €21.5 million must be invested in capital infrastructure to bring it up to standard. He urged the Tánaiste and Minister for Health, Ms Harney, to recognise the "crisis" and implement the report's recommendations.
The Health Service Executive said it would establish a working group to examine the report and its recommendations.
St Vincent's Hospital said it was not always possible to segregate cystic fibrosis patients from other respiratory patients including elderly people also in need of care due to space.
When Dr Pollock compiled an independent and critical report on facilities at Our Lady's Hospital for Sick Children in Crumlin two years ago it led to the then health minister Mr Martin committing to a timeframe for the redevelopment of the hospital.