'Trauma services need more staff'

Orthopaedic surgeon at Tallaght hospital, Prof John McElwain, is retiring after 28 years

‘ALL YOU hear about Tallaght are the bad things, you never hear the good things,” says Prof John McElwain.

As head of trauma at Tallaght hospital and an orthopaedic surgeon there since it opened 14 years ago, he thinks the place gets a bad rap. “It’s a very credible place I can tell you, despite all the bad publicity we get.”

The hospital’s problems in recent years have been legion – in 2010 it was subject to investigation after thousands of X-rays had gone unreported to consultants while many referral letters from GPs had not been processed.

In May this year, a report by the Health Information Quality Authority cited “a history of longstanding challenges in leadership, governance, performance and management at board and executive level of the hospital”.

McElwain says the bad publicity is unfair. “The quality of work here is outstanding, it’s just that we’ve always been the subject of bad publicity. The work that’s done in Tallaght is of the highest order.” He describes his own patch – the trauma service – as “the best in the country”.

The Galway native trained as an orthopaedic surgeon in Dublin and subsequently in Toronto. Specialising in the treatment of pelvic and acetabular or hip joint socket fractures, many of the patients on his operating table will have had a close brush with death.

“I’m not talking about granny fracturing her hip. I’m talking about high-velocity major trauma, multiple injury patients,” he says of those he treats.

“The vast majority of them have been in a high velocity road traffic accident. Quite a few of them are equestrian accidents as well where people can be crushed by a horse.”

He describes operating on the socket part of the hip joint, the acetabulum, as “one of the most difficult operations you can do”.

“There aren’t that many of us in the world who are doing them, it’s kind of an elite organisation if you want to put it that way.”

McElwain has treated 1,600 trauma cases in his 28 years of practice. Stepping down from his post in Tallaght next year, he says just three of those patients died.

But he believes there is room for improvement in how Irish hospitals treat such injuries, with faster treatment critical to survival or avoiding complications such as pulmonary embolism, damage to blood vessels, arteries and veins, rectal problems, urinary tract infection and pressure sores.