SERIOUS CONCERN was expressed in the midwest yesterday about the implications of a Health Service Executive (HSE) report recommending that round-the-clock AE services should in future be provided only at one hospital in the region.
The confidential report commissioned by the HSE says 24-hour AE services at Ennis and Nenagh general hospitals and at St John's Hospital in Limerick should be stopped and replaced with nurse-led minor injury units and all emergencies transferred instead to the Mid-Western Regional Hospital in Limerick.
Details of the report's findings, which also recommend that major surgery and critical care services be centralised, were published in yesterday's Irish Times.
While the report was completed a year ago it still hasn't been published by the HSE, which is moving ahead with its implementation. The HSE was refusing to comment yesterday.
In Nenagh there are fears the AE unit at the local hospital will cease providing a 24-hour service from March.
Chairman of the Clare branch of the Irish College of General Practitioners, Dr Michael Harty, described the proposals as "neither safe nor sensible". He said GPs have been unofficially told acute surgical services at Ennis will be removed in April and May. "This is a keystone to the hospital's structure and if you take that away, everything else will fall."
Labour's health spokeswoman Jan O'Sullivan called on the HSE to immediately publish the report. "There needs to be a genuine interaction with the people in the region around this, rather than this secret behind-closed-doors implementation . . . it's a totally wrong way for the HSE to do business," she said.
She was particularly concerned, she added, at "the downgrading proposal for the smaller hospitals" in the region and that some people would end up having to travel a long distance to get to AE.
Fine Gael's Joe Carey, a TD for Clare, also called for the HSE to publish the report. He said many patients, if the report was implemented, would be over an hour away from emergency treatment.
Dr Christine O'Malley, a consultant at Nenagh hospital, said she had serious concerns about the plan and it appeared to her the solution was worse than the problem.
While the report said some patients in AE were being seen by junior doctors unsupervised by consultants, the solution seemed to be that some patients in local hospitals would now only be seen by AE nurses, she said.
She added that while Limerick Regional Hospital would be expected to take on extra patients under the plan every week, at present its bed manager was refusing to accept the transfer of patients from Nenagh because there were already patients on trolleys waiting for beds in Limerick. The HSE is to brief nursing unions on the proposals next Monday.