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.
