Northeast patients may die if agency staff and overtime banned, HSE told
A SENIOR consultant at a hospital in Drogheda has warned the Health Service Executive that critically ill patients may die if a planned ban on overtime and agency work goes ahead.
In a letter seen by The Irish Times, consultant anaesthetist Michael Staunton, lead clinician in the anaesthesia department of Our Lady of Lourdes Hospital, warned the closure of an intensive-care bed, a consequence of the ban, could increase “morbidity and mortality of critically ill patients”.
It could also lead to “increased morbidity and mortality rates” in patients requiring surgery, he said.
The letter was written to HSE regional director of operations Stephen Mulvany in response to planned measures in the Louth-Meath Hospital Group that would eliminate overtime pay and the use of agency staff.
The measures included the closure of 16 in-patient beds at the hospital, decreased opening hours of the acute medical assessment unit, the closure of an operating theatre and the closure of an intensive-care bed.
Dr Staunton said he was “appalled” that cost-curtailment directly affecting emergency care would be considered “in the main acute hospital in the northeast”.
Because of its role as an emergency hospital, Our Lady of Lourdes was unable to control the demand for its services, he said.
The closure of an intensive-care bed could mean the unit would have to change its criteria for admission and consider “refusing admission to patients who do not require invasive ventilation”.
It could also lead to delayed admission to intensive care and premature discharge from the unit.
The closure of an operating theatre could lead to delayed emergency surgery and cancer surgery as well as the cancellation of paediatric elective surgery and procedures for the management of acute and chronic pain.
Overtime pay and agency staff were not luxuries at the hospital, Dr Staunton said, but were essential to the provision of the core acute clinical service.
“The cost-curtailment measures being implemented have the potential to seriously compromise the level of quality and safety of the clinical service in Our Lady of Lourdes Hospital,” he said.
In a statement, the HSE said Mr Mulvany would consider Dr Staunton’s correspondence.
It said projected hospital group expenditure for 2012 on agency and overtime pay was in the region of €16 million and needed to be eliminated before the year’s end.
Clinical director of the Louth-Meath Hospital Group Dr Dominic Ó Brannagáin said he accepted the group faced “a significant financial challenge”.
“However, the safe provision of clinical services to patients remains my single biggest priority.
“I am satisfied that we have a robust mechanism for monitoring risk, whilst implementing these changes,” he said.
“This process has been externally validated.”