Consultant surgeons at Cavan General Hospital have been warned by the Health Service Executive (HSE) that if they do not comply with a protocol governing the transfer of patients in need of surgery from Monaghan hospital, they may be reported to the Medical Council.
Despite the threat, the consultants in Cavan have refused to agree to the document, which insists surgical patients who need transfers from Monaghan should be accepted at Cavan without question and without reference to resource availability.
The protocol was devised by the HSE, in conjunction with clinicians, after an elderly man bled to death at Monaghan hospital last year. Doctors in Monaghan tried to transfer Pat Joe Walsh (75) to Cavan as well as to Our Lady of Lourdes, in Drogheda, but neither would accept him, claiming they had no intensive-care beds available. Later it transpired they both had beds free.
Yesterday, Donal Duffy of the Irish Hospital Consultants Association (IHCA), said that for the consultants in Cavan to give an undertaking to abide by the protocol "would fly totally in the face of their ethical and legal obligations".
He said the Medical Council's ethical guide said that if a doctor considered he/she did not have the necessary facilities to manage a patient, the patient should be referred on. Furthermore, he said the High Court had found in 2004 that unless a consultant was satisfied the facilities required to successfully complete an operation and allow a patient to recuperate were in place, the consultant shouldn't start a procedure.
Therefore, if a consultant undertook to abide by the protocol and accept the transfer of a patient without having an appropriate bed available, he/she could subsequently be found to be negligent, he said.
Chris Lyons, manager of the HSE's northeast hospital network, said it was interesting that everybody seemed to be complying fully with the protocol, despite the protests of the IHCA. He said around 100 surgical patients had been successfully transferred from Monaghan to Cavan so far this year.
He wanted to reassure patients that if they attended Monaghan hospital and required surgical intervention they would be transferred to Cavan. He said all hospitals across the State accepted patients in need of care whether there were beds free or not and there was no reason why Cavan should be any different.
A report into the death of Mr Walsh found the unwillingness of surgeons in Cavan and Drogheda to immediately accept his transfer in the hours before he died "unacceptable".