Warning that national genetics centre proposal could lead to ‘huge clinical risk’

Staff at centre resisting downgrade of unit as part of HSE reorganisation of genetic services

Eilish Hardiman, chief executive of the group overseeing the merger of the three children’s hospital: said there were “issues” with the functioning of genetics

Eilish Hardiman, chief executive of the group overseeing the merger of the three children’s hospital: said there were “issues” with the functioning of genetics

 

A plan to dismantle the State’s only national service for families with genetic conditions will lead to a “huge clinical risk” to patients and create unnecessary extra costs, according to the staff involved. Senior staff at the National Centre for Medical Genetics are resisting the downgrading of the unit as part of a reorganisation of genetic services by the Health Service Executive.

They are supported by patient groups who say staff are being treated unfairly for highlighting shortcomings in genetic services over the years.

The centre, which has been based at Our Lady’s Children’s Hospital in Crumlin since 1994, is to become a department within the hospital. The announcement was made by Our Lady’s chief executive Lorcan Birthistle, who told staff, in a letter seen by The Irish Times: “It will no longer be appropriate to refer to the service as the National Centre for Medical Genetics. I appreciate this will represent a difficult change for many but it is necessary if the governance is to be clear and unambiguous,” he said.

Integration of the centre into the hospital was in the best interests of staff and the service, given the “very major changes” in the years ahead. Crumlin hospital is due to merge with the two other Dublin children’s hospitals and move to the new national children’s hospital at St James’s in 2019.

The decision was made following the completion of two reviews of the centre, which were critical of its management and of under-resourcing of genetic services.

Earlier this month, senior staff wrote to Minister for Health Leo Varadkar outlining their concerns. While accepting many of the recommendations made for the future of the service, they questioned the proposal to change its status.

Almost 60 per cent of patients seen by the centre are adults, and almost half are seen outside Crumlin. The letter, signed by geneticists Prof Andrew Green, Dr Sally Ann Lynch and Rosemarie Kelly, questions how these patients will be dealt with when the centre becomes a department of the children’s hospital in Crumlin. The change means other genetic centres could be developed in a fragmented way, they say, with no integration of family records nationally.

“A dismantling of this integrated service runs a huge clinical risk and it incurs unnecessary financial costs as other hospitals will have to resource an independent genetic IT system and genetic charts. This excess workload on an already understaffed unit will also increase risk of clinical errors.”

Mr Varadkar referred the staff letter to the HSE and on its behalf, Eilish Hardiman, chief executive of the group overseeing the merger of the three children’s hospital, replied.

Ms Hardiman said there were “issues” with the functioning of genetics, adding that national issues relating to genetic services could not be progressed until internal clinical and team-working issues are addressed.