Health warning for Cork A&E cuts

Posted on October 14, 2011 by

The closure of the South Infirmary Victoria University Hospital A&E Department will negatively impact on patient care and will affect patient lives, according to Independent Cllr Mick Finn

WHEN the HSE’s reconfiguration report was first issued, opposition parties denounced it as a ‘dismantling of the health service’. It wasn’t, they said, a re-organisation but a strategy that would lead to severe difficulties for the health service.

In its policy document before the last General Election, Fine Gael bemoaned the fact that an average of 350 patients daily were on trolleys in emergency departments up and down the country. Targeting  this ‘crisis’ and eliminating lengthy waiting times in A&E departments was a key policy platform; one which no doubt helped in its sweep to power.

On one particular day last week, 365 patients were on emergency department trolleys. That same day, it was announced the 24-hour A&E unit at the South Infirmary Victoria University Hospital (SIVUH) would close early next year, after first being downgraded to a 12-hour unit by December 12.

Eight months after the election, the goalposts have clearly moved.

Cork will lose one arm of its Accident & Emergency response capabilities with the axing of SIVUH services and no amount of HSE spin can alter that fact. When people present for A&E services in Cork, they will have less options and will be forced to endure longer waiting times, more suffering and anguish and more complications as a result of this deficit.

And if the Mercy University Hospital (MUH) downgrades to 12 hour (and possible eight-hour) cover as proposed in the reconfiguration plan, it will mean the city and county of Cork will be served by just one full 24-hour A&E unit at one of the busiest hospitals in the country, Cork University Hospital (CUH).

This is a cutback, not a configuration….plan and simple.

The HSE has suggested the relocation of orthopaedic services to SIVUH from St Mary’s, as well as the consolidation of elective services at the Old Blackrock Road site, will guarantee the future of the hospital. It also claims the provision of an urgent care unit at St Mary’s will offset the loss of emergency service at SIVUH.

This is utterly false logic. For a start, the new unit at St Mary’s will run on a 12/7 basis, not a 24/7 basis. Secondly, there will be no extra staff or facilities provided at the CUH emergency department to cater for extra burdens….in other words, that A&E Department will simply have to subsume the workload from SIVUH, Mallow General (if plans to close A&E services there goes ahead) as well as taking in all major emergency cases from the county.

It makes absolutely no sense to remove A&E services from the South Infirmary, move orthopaedic services from St Mary’s to SIVUH and then open an urgent facility in St Mary’s. It’s a needless shuffling of the deck.

On the other hand, it does make sense to move the medical rehabilitation unit from SIVUH to St Finbarr’s to maintain all services under the one roof. It is also understandable why cardiology services will move to a new purpose-built cardiac renal unit at CUH. They key to these two changes is that the full services will be retained in new locations; in the case of the axed A&E services, they are simply being merged into an already over-worked infrastructure with no plans for any expansion.

The A&E at SIVUH provided an important overflow vent to the service at CUH which is liable to explode at any time. We all have personal stories of long waits for diagnosis and triage and even longer waits for treatment at the University Hospital, simply because of the scale of the workload facing staff. It simply cannot cope with the patient load it has at present: what will be the situation when it has even more cases to contend with?

If Health Minister James O’Reilly is serious about his job – which I believe he is – he must intervene and halt the closure of the SIVUH A&E unit. Instead, he must upgrade it to a 12-hour facility that can dovetail with a similar unit at the Mercy. At least, in such a scenario, Cork would have full 24-hour over across three locations. It still means a reduction in A&E services, which is not ideal for a city and county of Cork’s size, but if cost cuttings have to be made, at least provide this would represent a viable alternative.

Clearly, cost is at the root of this latest downgrade and closure. The centralisation of A&E services is, in theory, about providing expertise under one roof in the interests of patient care. However, the huge pressure that will be put on CUH’s A&E Department as a result of the SIVUH emergency unit closure cannot but be detrimental to attending patients: it is, therefore, only a matter of money.

Yes, the way in which patients attend Accident and Emergency Departments must change – and what Dr Chris Luke calls the ‘McDonaldisation’ of the service must be countered – but the closure of one facility as a rap in the knuckles for improper use by some patients is not the answer.

When patients attend for A&E services, they should be entitled to minimum waits for assessment, treatment and outpatient services. With three such facilities in existence in Cork at present, this cannot be delivered: with two, it will be impossible. All of these services cost the patient money, whether it’s a direct A&E fee, the cost of GP referral or the cost to the taxpayer of paying for medical card patients and patients are not being given services befitting of these payments.

Government parties talk of Dutch and French models of delivering the best possible public health service. They talk of universal health cover and of being patient led. It’s time now that common sense entered the equation.

Existing A&E services were put in place decades ago to meet the needs that prevailed then: those needs are as valid now – in fact, they are considerably greater in the light of population growth – and cutting proper access to these services is anything but common sense.

The move to close A&E at the South Infirmary Victoria University Hospital is an ill considered one and should carry the following warning…. axing emergency services can seriously damage your health.

Posted in Community, Health | Leave a comment

Barrack Street Regeneration

Posted on July 6, 2011 by

THE €600,000 upgrading of lower Barrack Street is a great boost for the area, but plans to make the lower stretch one way haven’t received unanimous backing, according to local independent councillor Mick Finn. Cllr Finn was commenting on plans to upgrade the streetscape in one of Cork’s most historic streets that got the green light from Cork City Council. “Once the project gets underway later this year, the lower stretch of the Street – from the junction with Evergreen St (near the Chinese) to Reeds’s Square will be made one-way downhill on a pilot basis and it’s important to stress that,” Cllr Finn said. “At a public meeting last year, local residents and traders called for it to be made one-way uphill to ensure that life is breathed into the street, the logic that people would walk downhill and drive uphill out of town. They will be disappointed to see the council engineers have stuck with the original plan, despite their submission and that of the local Gardai who also favoured a one-way system uphill.” At the recent meeting, Cllrs Finn, Sean Martin and Emmet O’Halloran asked that the original plan be piloted, to determine whether or not the one-way routing should be uphill. “At least that concession was secured so at least if it’s not working, it can be altered,” Cllr Finn added. “It was also felt the automatic bollards were unnecessary and would restrict both businesses and residents, so it was agreed to wire the conduits for these bollards but not put them in place until a future use is required.” Cllr Finn has again urged the owners or derelict properties to either spruce up their premises or hand them over for community usage. “Some of the buildings are appalling, especially the block by Fort Street: owners should at least paint them up to fit in with the new improvement scheme which will make a huge difference to the street. Hopefully, the campaign to open up Elizabeth Fort will also be successful, as the City Manager expressed at the meeting.”

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Douglas Street One Way?

Posted on July 6, 2011 by

CORK City Council is to press ahead with the process of making Douglas Street one way, which will involve extensive public consultation, according to Cllr Mick Finn. Cllr Finn, along with other ward councillors, proposed that measures be taken to ease the traffic chaos prevalent on the Street, including the possibility of making it one way and the introduction of calming measures. “I am delighted that the request was received positively by the council and that the process will get underway shortly,” said Cllr Finn. “There is generally a reluctance in making streets one-way, but the increased volumes of traffic since Evergreen Street was made one way has led to inevitable calls for similar action on Douglas Street.” He urged local residents and commuters to get involved in the process so that a new system can be worked out, “in the interests of everybody”.

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TD’S on notice in ‘probation period’

Posted on March 4, 2011 by

DEFEATED general election candidate Cllr Mick Finn has said he is putting TDs on notice that their record on delivering for Cork will be put under the microscope ‘every day of the week’ for the duration of the new Dail.

Cllr Finn, who polled almost 3000 votes as an independent candidate in Cork South Central, said he will be watching the constituency’s five TDs ‘like a hawk’.

“In congratulating Micheal Martin, Ciaran Lynch, Simon Coveney, Jerry Buttimer and Michael McGrath on being elected, I also want their voters to keep close tabs on them and see if they deliver what they promised,” Cllr Finn said. “They should consider this a probationary period: if they do well, they should be re-elected, if they fail to perform, they should be thrown out.”

Issues like flood defences, Docklands and increased funding for social housing and repair of roads in the city and county were among the citywide concerns that he will be following, he said.

Cllr Finn also alluded to the deficit of services in Carrigaline and the fact that voters opted to return the status quo in terms of two Fianna Fail and Fine Gael TDs with one Labour. “That a community the size of Carrigaline has no cinema, public pool and other leisure infrastructure – and mindful of the failed promises of addressing chronic traffic problems – yet returns the same TDs is baffling.

“I believe they should now make a contract with the existing TDs, demanding delivery of what they need and if this doesn’t happen, well…they will know what to do at the next election.”

* Cllr Finn also thanked his legion of volunteers and voters for their support during the campaign and looked forward to their help again in the future.

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Newstalk gives Finn a chance

Posted on February 16, 2011 by

FORMER Fine Gael minister Ivan Yates has given Cllr Mick Finn a chance of the last seat in Cork South Central, following an Irish Examiner poll pitching the Independent candidate on 5% of a 500 sample vote.

Even though Cllr Finn’s name was omitted on the first occasion the Red C polling group carried out the research – and was subsequently added on – a creditable 5% share was achieved.

“It’s a timely snapshot of the constituency so I just have to keep going the way I’m going and hope that I can progress the good work already being done by my excellent team of volunteers,” Cllr Finn said.

“It’s interesting too that the Examiner doesn’t allow for any transfers to me which is contrary to what I’m hearing and perhaps suggest an agenda, but polls don’t win elections,” he added.

Cllr Finn urged people to come out and vote on February 25th. “I am saying to voters- your vote is your voice, don’t lose it!”

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A&E services under threat?

Posted on February 10, 2011 by

IS the HSE closing the A&E department at the South Infirmary and restricting emergency services at the Mercy?

That was the question posed today by Independent city councillor and election candidate Mick Finn who has written to the head of the Executive for answers.

“My information from staff in both hospitals is that the A&E in the South could be gone by April and that restricted hours will be introduced in the Mercy. This is a scandal as anybody queuing or on trolleys for hours in the CUH will attest,” Cllr Finn suggested.

“If this further reduction in services is being planned then the major parties need to come clean and make it an election issue: only then can it be brought to the fore, as we have seen in recent days regarding the closure of St Mary’s on the northside of the city.”

Alluding to the first televised leaders’ debate, Cllr Finn asked if the Fianna Fail leader would consider this prospect of a ‘fatally injured’ A&E service in Cork as another ‘success for the HSE that he established’.

“While reform of the health boards was essential, creating the monster that the HSE has become is hardly something to boast about. Former minister Martin is lauded for the smoking ban, but equally, he must accept some criticism that Dr Jekyl has become Mr Hyde in terms of the HSE’s dministrative character.”

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General Election 2011

Posted on January 24, 2011 by

Dia dhuit, hello

I am running as an Independent candidate in the General Election. In 2009, I was elected to the city council at the first attempt. Since then, I have been encouraged to go forward for the Dail.

It’s not going to be easy up against the parties and their money but I do have a great team of volunteers supporting me.

I set out here what I hope to achieve and welcome any suggestions you might have. My motivation is rooted in a belief in the power of communities and is driven by common sense in terms of addressing local and national problems.

I know it’s a leap of faith for people in some parts of the constituency to vote for me but I’m very positive about what I can do for you. I ask your No 1 Vote: my promise in return is to fight for you and Cork in Dail Eireann.

Thanks,

Ordinary people are capable of extraordinary things

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Finn to take on political dynasties in David v Goliath election battle

Posted on January 10, 2011 by

ELECTED at his first attempt to Cork City Council in 2009, Independent councillor Mick Finn is throwing his name into the ring in the upcoming general election, bidding to become the first Independent TD for the Cork South Central Constituency.

Cllr Finn, who received the second highest number of first preference votes in his ward last time out says he has been encouraged by friends, family and people in the constituency to put his name forward.

“It’s a big ask really but I’m willing to have a cut off it,” Cllr Finn stated. “I know full well that I face an uphill struggle it in what will be a bloodbath constituency battle. Apart from competing with some of the best-known names in the Dail, I will also be up against big political dynasties with huge money behind them and I realise I will be facing a David v Goliath face-off to make an impression when the votes are counted. My campaign will be short, community driven and will be based on a common-sense approach to the local and national political problems ensnaring us.

“Despite the challenges I will face as an Independent, I believe there will never be a better time to attempt this. People are sick to the teeth of the prevailing status quo in the party system and while there is sure to be a change after the election process, and some parties annihilated, it could well be a case of a shuffling of the chairs once the music stops.

“Yes, the role of an Independent TD will be put under the microscope and questions will be asked as to the effectiveness of having such a representative in the Dail, but I will be informing people in the coming weeks of what I believe I can do for the people of the Cork. If they believe in that, then I will be asking for their vote. If they don’t, they can opt for more of the same!

Cllr Finn acknowledges also that profile beyond his current ward boundaries will be a challenge. “I would hope to garner support in parts of the constituency that are under-represented at present…when you look at it, all of the current TDs live in the east and south East of the ward resulting in areas like Ballyphehane, Greenmount, Togher and Bishopstown being under-represented. As a matter of fact, I receive many requests for help from these areas on national issues simply because they are not being handled as effectively as they should be. I realise too that it would be a leap of faith for the people in the other parts of the constituency, Douglas and Carrigaline etc, to vote for a city councillor whom they largely don’t know, but I will be offering them such an option. I won’t pretend to be suddenly au fait and expert in all the issues facing all the constituency areas: if elected, I will work on such issues on a step by step basis.”

Since his election to Cork City Council, Cllr Finn points out that he has worked on many individual issues and that he has been successful in resolving many, while he continues to work on some. “I would hope that if elected to national government, I could work on the root causes of deficits in local council services – such as the release of boarded-up local authority housing, better housing maintenance -shambolic HSE and Department of Social Welfare practices and a priority would be facilitating access to local employment schemes for those crying out for work.

“The country has been messed up by government parties which have gotten away with so much because the groupings on the other side of the room did so little to knock them out when they were on the ropes. Independents have a role to play in national politics and I aim to prove that.”

Posted in Community, Economy | Leave a comment

Finn slams ‘deceitful and dishonest’ budget

Posted on December 9, 2010 by

THE rationale behind the Budget – that people who have most will be hit most – is a complete farce, according to Cllr Mick Finn who said ‘the latest lie is proof that our governors are like balloons let off in the sky – completed disconnected from reality’.

“I watched with incredulity the statements of the Finance Minister in our national assembly, commenting that we all have to take a hit and that those who could afford it most will have to pay most…what a load of rubbish!” Cllr Finn said.

“For a start, minimum wage income earners stand to lost almost €2,100 annually…those on €70,000 more, on €100k, will be worse off by €1,600: where’s the relative burden there? It baffles me how government ministers and TDs can stand by this type of false economising. They simply do not understand that those earning €100,000 know little about the reality of what life is like on €30,000 and to say this is a fair deal is deceitful and dishonest. It merely compounds the class lines in our state.”

Cllr Finn said the budget was also anti-family and anti-children. “I wonder is this the start of a Chinese-like attempt to constrict population levels? Children’s allowance is cut and low-income earners with children, who are already put to the pin of their collars, are literally penalised for having children…it’s a far cry from cherishing all the children of our nation equally.”

He added that the failure to incentivise job creation – ‘actually stifling it by reducing PRSI exemptions for employers’ – would sound the continuing death-knell for an economy on its last legs. “The lack of imagination in terms of job creation is perhaps the saddest reflection on this government: that it cannot attempt to secure the future of the country for our working youth is akin to throwing the towel from the corner of the ring and saying ‘we’ve had enough, we can’t go on…stop the fight and leave the external referees take over.”

The city councillor, who intends to run in the general election, says the Finance Minister also missed a chance to lead from the top and decrease TD salaries by at least 20 per cent. “Cutting top ministerial salaries by €10,000, in real terms, was merely a gesture. If the salaries of all TDs and Senators – the biggest representative group – were cut by 20 per cent, then that would be seen to be leading from the front.

“I believe all the newly elected TDs, in the absence of a decrease from the top down, should provide the equivalent of a 20 per cent cut in salary in a Constituency Fund (like a Ward Fund) to which community groups could apply for assistance. Sports and arts got the usual recession time hammering in this budget, because they are seen as peripheral, so the great community work being done in these areas will now also need a helping hand.”

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HSE needs to step up on child protection

Posted on October 27, 2010 by

INFORMATION from the inquest into the death of Cork teenager Christopher O’Driscoll two years ago, as well as revelations from the Roscommon Childcare Case are hard to stomach, particularly for those who may have worked with these children and could do little to prevent what happened. Many in the social care and education sectors feel they are hitting their heads off brick walls in efforts to combat bureaucracy. The failings and inadequacies in the HSE’s social work system, as shown up in both these cases, can and must be acted upon to prevent similar occurrences in the future.

That at least 188 children died in the state’s embrace in the decade to 2010 came as no great surprise to those of us whose work intersects that of state agencies. The system currently in place to deal with children and families in crisis is over-stretched and held together with sticking plaster. A serious lack of national government funding, embargoes on recruitment, overworked social workers and a completely un-coordinated approach to dealing with root causes are at the heart of this problem.

As part of my daily work in areas of social and educational disadvantage, I know only too well the problems facing children, young adults and families. Each tale is sadder than the next, invariably involving some of the following histories: family alcohol and drug addiction; an endless cycle of family poverty; criminality; early school leaving; abuse; depression; suicide; and social depravation. We see the fruits of this cocktail every day on newspaper and TV reports or hear it on the radio. These people are crying out for help; their calls largely falling on deaf ears.

There is a belief among the earning classes that this strata of society is doing little to help itself and that ‘it’s their own fault; these are the people who have their hands out for everything and wouldn’t do a day’s work to save their lives’. As in every other grouping there are obviously such cases but the vast majority of people caught up in this net are not equipped to empower themselves and break the cycle. And when there are indications by Government of altering the conditions for single parent families, or cutting jobseeker’s allowance among school leavers, such policy is serving only to compound the cyclical nature of the problem. This is not to cherish all children of the nation equally!

The first thing that needs to be done is a complete review of social work practices. There are many good people in the system, but their efforts are being hampered by bureaucracy and a major chasm exists between the services provided by an out-dated education mechanism and our health infrastructure. There is some semblance of hope for those youngsters in the education system up to 16 but after that, there is little if no back-up supports for those who do not fit easily into the education sector or those who often get into trouble with the law. The services are also very un-co-ordinated: one hand doesn’t know that the other is doing.

In one recent case, I witnessed at first-hand how slowly the apparatus of the social care system moves. It required much prodding and poking for an initial emergency intervention, a sustained and frustrating effort thwarted by red-tape to keep that involvement going and a vain hope – rather than anything more tangible – that some sort of longer-term support would be put in place.

Such a scenario is extremely difficult for those affected but also for those working within the system. When you put years into helping and guiding a young man or woman, or family, it only serves to compound the frustration, annoyance and sadness when something goes wrong. Clearly, a new joined-up approach is needed.

I am glad to see the HSE coming out strongly and saying ‘it takes its responsibilities in relation to child protection very seriously and is committed to developing the services it provides to families and children’. I’m not sure how the Executive is going to achieve this in light of the current cutbacks and employment embargo. The Government can seem to find extra resources at will to fund the banks or help other European countries out of financial turmoil: it now needs to focus its resources in the area of child protection and social work so that the seriousness of the problems already coming down the pipeline can be capped, filtered and redirected.

Sharing of information between schools, health professionals and social workers should be a first priority and must be a key facet of any change in legislation. There is no room for bargaining here and even the most liberal of civil liberty groups would surely concur: if schools, GPs or social work teams have information that will help children, adults or families break out from the cycle of social poverty, it must be shared and used to everyone’s benefit.

The 2001 Children Act says that it is desirable to allow the education of children to proceed without interruption; that it is desirable to preserve and strengthen the relationship between children and their parents/ family member; and that it is desirable to foster the ability of families to develop their own means of dealing with offending by their children.

It is more than just desirable: it is a right. We should start by insisting on a new emergency and after-hours social work strategy for teenagers at risk. We should also ensure that all teachers and youth workers are given Children First training…another government aspiration that has some way to go.

Unfortunately, it does take high profile cases and reports to get authorities moving. The publication of the Roscommon report is the latest such report. How many more will it take to get action at the coalface where it’s needed?

Posted in Health, Youth | Leave a comment