Fractured lines of solidarity

Heart Beat/Maurice Neligan: Not surprisingly, the choice of location of the new children's hospital has not met with universal…

Heart Beat/Maurice Neligan: Not surprisingly, the choice of location of the new children's hospital has not met with universal approval. The solidarity expressed by all the contending institutions and doctors before the decision was announced has fractured along anticipated lines.

Some unease has been expressed about issues like helicopter access. The story of helicopters and the Mater goes back to the terrorist IRA campaign and the use of a helicopter to facilitate the escape of prisoners from Mountjoy. At this time such flights in the vicinity of the prison were prohibited.

Now Mountjoy is due to relocate to the costly fields of Thornton Hall and with it will go any residual problems with flight access to the hospital. Such access will benefit not only the paediatric hospital, but also the main hospital and its specialist departments. In particular, the programmes for heart and for lung transplantation, where time is so vital in getting donor organs to recipients, will benefit greatly.

I spoke last week at the dinner of the paediatric intensive care specialists in Killarney. This group of dedicated professionals perform wonderful feats in treating the sickest and most vulnerable children and can preserve tiny and flickering lives that would certainly have been forfeited in the not too distant past.

READ MORE

They deserve the best facilities that we can give them for their work. Such skills I appreciated at first hand in my surgical career, and indeed the advance of cardiac surgery in children would have been impossible without their developing expertise.

In all honesty, I must say there were genuine misgivings among my erstwhile colleagues from Crumlin about the move to the Mater site. Accordingly, as I wrote last week, the reasons for site selection and the plans for site development should be made known as soon as possible.

This will be the biggest medical project yet undertaken in the State and also the most expensive. Everybody should be entitled to know what is being built and how much it will cost. It is our money that is being spent.

We have also in the past week seen yet another "strategy" unveiled. Well, not unveiled exactly, more spin, more photo opportunities, more pious aspirations, but containing little of substance or definite plan. We are apparently going to have eight regional centres at locations yet to be revealed.

These, it is postulated, will provide comprehensive treatment for cancer patients by multidisciplinary teams supported by appropriate diagnostic and therapeutic modalities. We are going to screen for some cancers and not for others. We are going to "roll out" some services and "going forward" we are going to be just wonderful. Nothing too specific you understand, just a general feeling that good things are going to happen and that it will be all right on the night.

Before we can all sign up for the concept, how about telling us what this means? Actually, that is a little harsh, because we have taken one bold and innovative step. We have banned the use of sun beds for those less than 16 years.

We lead the world yet again! I don't know why the coming election keeps intruding into my sceptical mind, perhaps as George Eliot put it; "an election is coming. Universal peace is declared and the foxes have a sincere interest in prolonging the lives of the poultry."

Readers of this paper may have noticed a letter from the Tallaght Ten. This group of orthopaedic surgeons led by their chairman, John McElwain, wrote to point out that their unit had 20 beds available to deal with their elective work. Furthermore, they pointed out that even this meagre stock was frequently infringed upon by pressure from the hospital A&E unit. Even my limited mathematical skills are equal to the task of dividing 20 by 10. I think the answer is two.

How long, I ask myself, does it take to do a ward round on two beds? This is a disastrous and intolerable situation. These highly trained surgeons would have no professional life were it not for the private system. Is this the way we want to go?

How do we train our doctors and nurses of the future if all they meet in the hospital is dictated by the A&E departments? This unit should have a minimum of 70 and preferably 100 beds, and then there would be no need for the waiting patients to be diverted into the maw of the unaccountable National Treatment Purchase Fund (NTPF). They could be treated by the surgeon to whom they were referred by their primary care physician.

It is not only in Tallaght hospital that this farcical situation exists nor indeed only in orthopaedics. It will continue until there are enough beds to allow everybody to be treated expeditiously in the hospital to which they were referred. How many are now waiting? We do not know. The NTPF, with its penchant for obfuscation, is the guardian of the hospital waiting lists. How convenient that proves to be.

Many other things happened of which more anon. Hanly briefly surfaced again in regard to hospital services in the northeast. It will submerge again just as quickly in view of the impending election.

Prof Drumm has no problem with his €32,000 bonus. Pretty well everybody else does, Professor. We have loads of highly paid administrators and we can't afford to pay our nurses. That's some outfit you are running.

"Si monumentum requiris, circumspice", if you seek a monument, look around.

• Maurice Neligan is a cardiac surgeon.