Mater trauma centre decision a risk to patients, Beaumont doctors claim

Government’s decision criticised by staff at State’s main neurosurgery centre

The decision to locate the State's main trauma centre in Dublin's Mater hospital has been strongly criticised by doctors at nearby Beaumont Hospital.

The decision, announced by Government on Tuesday, will compromise the safety of patients, brain specialists at Beaumont say.

“This is a poor decision that breaks with the rule followed internationally of co-locating major trauma centres with neurological centres,” Dr Donncha O’Brien, neurosurgeon at Beaumont Hospital, told The Irish Times.

“It will lead to patients who have suffered head injuries being treated in a centre that does not have the full range of neuroscience services available to it.”

Based on international experience, it would lead to poorer outcomes for patients, he said.

The Beaumont doctors argue the decision goes against practice in recent decades of consolidating medical services and will instead lead to a fragmented provision of services.

Dr O’Brien said more than 50 neurospecialists in areas such as surgery, radiology, critical care and physiology work in Beaumont, compared with two in the Mater.

There were no neurosurgeons on the independent assessment panel that made the recommendation adopted by Government, the Beaumont doctors said in a letter sent to Taoiseach Micheál Martin last January, and, as a result, patients with traumatic brain injury had no representation in the decision-making process.

“This is unacceptable given that 60 per cent of all major trauma patients have traumatic brain injury,” the letter states. “These patients are 10 times more likely to die compared to those without a brain injury.”

In Britain, 25 out of 27 major trauma centres are co-located with neurosurgical centres, the doctors say, while "serious concerns" have arisen in the other two locations. Centres in Cork and Belfast are also co-located.

“Development of a major trauma centre in a non-neurosurgical centre will result in significant duplication of services, additional unnecessary costs and, therefore, a waste of resources and tax-payers’ money,” the doctors say.

The Beaumont doctors sought meetings with Mr Martin and Minister for Health Stephen Donnelly earlier this year, but were unsuccessful.

Selection process

Six Dublin hospitals were in the running to host the major trauma centre, but none had all the required specialties.

The HSE described the process to select the major trauma centre as “very thorough”.

Asked what neurosurgical competence was involved in the process, it said the assessment panel was made up of domestic members “with local knowledge of the Irish healthcare system” and international experts “who have experience in trauma-related specialties”.

“Neuro-trauma services will be developed at the Mater in collaboration with the National Neurosurgery Centre at Beaumont Hospital and the resources assigned to neuro-trauma can also be used to increase neurosurgical services overall and will have benefits for patients who need neurosurgery for cancer and for other non-traumatic conditions.”