Shock surgery cuts plan for Our Lady's

THE troubled Our Lady's Hospital in Navan was plunged into a fresh crisis this week after a leaked document suggested that cuts of 20-25 per cent in elective surgery could be made at the hospital in a programme of suggested cost savings.

The document drawn up by Health Service Executive (HSE) manager Chris Lyons proposed ways of saving money across the hospital system in the four counties of the north-east. Although the document - leaked yesterday (Tuesday) - was described as an internal discussion document designed to explore how best to deliver services within budget, it clearly shocked public representatives who were taken by surprise by the scale of cutbacks it described.

Minister for Transport and local TD Noel Dempsey said he was concerned by the document and what it contained. He said that it appeared as if a "bureaucrat" might have drafted the document without taking into account the kind of impact it might have at the coalface.

The HSE insisted that no decisions had been taken on reducing services in the region. However, it admitted that it faced a challenging year and was exploring how best to deliver services within budget. A spokesperson said it expected to be in a position by mid-February to be more definitive about the services it would provide for the year.

Just a few weeks ago, the HSE announced a cut of €1,217,070 in the annual budget at Our Lady's, sparking an angry reaction from local politicians. Sinn Fein Colr Joe Reilly said that "Harney's annual mugging of hospitals" was continuing.

It was the second year in succession that Our Lady's had suffered a reduction in its budget for alleged inefficiencies. The cuts were implemented under the controversial 'casemix' system which looks at inpatient and day case activity in the hospitals and measures efficiency relative to other hospitals in the peer group. Accident and emergency activity is not included in this measurement. The programme aims to fund hospitals for the patients they actually treat, at a cost per case.

Hospitals which treat patients at a lower cost than the average national hospital cost are rewarded as they are deemed to treat patients more efficiently and hospitals which treat patients at a higher cost than the average national hospital cost are penalised or fined.

Navan hospital campaigner Wayne Forde said that he had written to Minister Dempsey outlining his serious concern at the "continuous downgrading" at the Navan hospital. He said that, under Fianna Fail and the HSE, Navan would no be able to treat emergency surgical patients from November. All patients would have to bypass Navan and go to Our Lady of Lourdes Hospital in Drogheda.

"The Lourdes has received €11 million to upgrade accident and emergency facilities yet Navan A&E is being run into the ground. It will eventually become a band aid minor injuries unit," he said.

He asked: "Why is it that in our great county of Meath we have a one-third built motorway, no rail line and by next November we will have no A&E unit?" Mr Forde said that Minister Dempsey had promised the people of the county prior to the general election that there would be no downgrading of Navan hospital until the new regional hospital was built.

"Yet we see now that this was a blatant election promise because, when the new A&E is built, there will be no emergencies going into Navan." The people of Meath would have to bypass Navan and go to Drogheda, he claimed.

Meanwhile, the north-eastern branch of the Irish Medical Organisation (IMO) is calling for IMO and the Minister for Health to publicly declare the "current and rapidly worsening national GP manpower shortage a national emergency".

It also wants the IMO to condemn both the HSE's ongoing delay in announcing the site of the regional hospital for the north-east and its "continuing attempts to downgrade current local hospital services".

IMO officials in the region, covering Meath Louth, Cavan and Monaghan, said that the situation was becoming increasingly untenable and would likely become impossible within a short couple of years.