The week the mask of patient safety slipped

HEART BEAT: ‘Rationalisation’ and ‘reconfiguration’ just mean cuts in services and hospital closures, writes MAURICE NELIGAN…

HEART BEAT:'Rationalisation' and 'reconfiguration' just mean cuts in services and hospital closures, writes MAURICE NELIGAN.

WITH APOLOGIES to our previous Chief Elf, I suppose one could say that the gloom times are getting even more gloomer. It makes you shudder, doesn’t it? But we put up with it and similar nonsense. There must be something cheerful we can talk about.

Oh some that’s good and godly ones they hold that it’s a sin

To troll the jolly bowl around and let the dollars spin;

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But I’m for toleration and drinking at an inn,

Says the old bold mate of Henry Morgan.

Oh some are sad and wretched folk that go in silken suits,

And there’s a mort of wicked rogues that live in good reputes;

So I’m for drinking honestly, and dying in my boots,

Like an old bold mate of Henry Morgan.

– John Masefield's Captain Stratton's Fancy

We’ve got them all on this little island, the godly and the intolerant, the wretched doom-preaching economists in the suits and literally dozens of wicked rogues who haven’t done anything wrong and whose reputation is unsullied, at least amongst themselves.

We’ve even had a succession of buccaneers filling the Henry Morgan role. The rest of us can wither happily in our boots.

I’ve got a couple of new word meanings or usages for you. These can take their place in a language abused by “roll outs”, “level playing fields”, “going forward”, “thinking outside the box” and other hyperbole designed to obscure meaning.

One such new word has taken its place in the lexicon of HSE jargon. It is designed to mask the evisceration of the health service. “Reconfiguration” used in this context means reduce bed numbers, cut services and close hospitals. It has figured in HSE pronouncements several times in the last number of weeks, applied both to the Midwest and the South East.

It clearly, however, has application anywhere in the country. It is designed solely to save money and has nothing to do with patient safety. This week the mask slipped and the fig leaves of patient safety and better services were unceremoniously ditched. We were told that the budget for the Midwest region was to be reduced and that savings were to be made in all the hospitals in the region.

Last week we were told that Ennis and Nenagh were to be downgraded in the interests of better patient care and that all patients needing hospitalisation were to be transferred to Limerick, which would be enhanced in facilities and bed numbers.

The promise that this would not happen before such facilities were in place was, as usual, totally dishonoured.

Now, one week later, we learn that the money across the region has been reduced and that, furthermore, at least 45 full-time jobs are to go. I would have a small wager that such job losses will bear more heavily on the clinical rather than the administrative side.

A respected colleague from Limerick reasoned for the proposed changes and claimed support, or at least forbearance, from colleagues in the region while such transformation took place. This is simply not the case and the changes were rejected by a large gathering of the GPs in the region casting their votes nem con.

The idea that GP networks like “Shannondoc” could step in and replace the services currently being supplied by Ennis and Nenagh is simply delusional.

Furthermore, Minister and minions in the HSE, doctors and nurses are not deaf and blind. They know what happened in the North East, they are impervious to the pathetic spin emanating from your department and they simply do not trust you.

The Royal College of Surgeons, through its President, expressed support for the proposed rationalisation, but with the caveat that the improved facility must be in place first. Where stand we now when demonstrably this is not going to happen?

The time for rational debate here is over, if indeed there ever was such a time. It is not the doctors, nurses, laboratory staff and paramedics who are closing hospitals and decreasing services. It is Minister Harney, Professor Drumm and the HSE.

Little or nothing is improving. Trolley numbers are at an all-time high. Hospital infections continue unabated with little prospect of amelioration. Mythical primary care teams are no solution to the problems we face.

We read that the Minister is going to open a “state-of-the-art” medical centre in Naas promoted by some big names and containing, from a medical perspective, all the most modern equipment and staff in all disciplines.

It hardly needs be said that, in time, the investment will be recouped and that eventually a profit will be made. I wonder will the Minister be there to lock the doors when Nenagh and Ennis close. If she has to send her apologies maybe she could send one of her junior ministers to carry the flag. After all, they support what she has done to a once proud and capable service.

  • Maurice Neligan is a cardiac surgeon