The future of Navan Hospital

On 30th October 2010, I had the honour of addressing 10,000 people at the 'Save Navan Hospital' Rally. At that time, I referred to the ongoing HSE attempts to downgrade Our Lady's, a shameful proposal also known as the 'Transformation plan'. This appalling document essentially recommends that only two hospitals in the north-east, Cavan and Drogheda, should be allowed to accept acute medical emergencies. In my opinion, in the absence of a new regional hospital, this "centralisation" policy is idiotic and puts lives at risk. For the vast majority of patients with common illnesses requiring admission, there is no evidence whatsoever that being forced from a local hospital bed onto a trolley 40 miles away improves their clinical outcome. On the contrary, as the Irish Association of Emergency medicine has pointed out, A&E overcrowding potentially causes dozens of unnecessary deaths every year. Since 2010, we have had a change of government. James Reilly, who stood by my side at the Navan rally, is now the Minister for Health. Under the new administration, I had hoped that our hospital's long-term future would be secure, that the hideous 'Transformation plan' would be dropped and that the HSE bureaucrats responsible for it would be brought to heel. Unfortunately, none of this has happened. The truth is that our new government has retained every senior HSE administrator in the north-east in their current positions. I believe these people are still operating to the same agenda and I fear they will stop at nothing to achieve it. Within weeks of taking office, the HSE decided to test James Reilly, as Roscommon Hospital was targeted for downgrading. Having promised locals before the election that their hospital was safe, once he achieved power, I am afraid Dr Reilly folded like a deck of cards. When asked to justify this blatant u-turn, the minister referred to the Health Information and Quality Authority, the statutory body in charge of 'patient safety'. This organisation had already produced a nice, politically convenient, hatchet job on small hospitals known as the 'Mallow Report'. As a result of a selective interpretation of this document, nine hospitals in Ireland are now targeted for official downgrading with the removal of 24-hour emergency departments. Regrettably, Our Lady's, Navan, is on that list. Due to the political sensitivities involved, I believe the minister has delayed making any announcement on this issue. The HSE agenda also became a lot harder to defend when a report was published earlier this year, which revealed that regional administrators had ordered the unnecessary and unwarranted cessation of surgery in Navan. The effect of this management failure was to force hundreds of patients from County Meath onto trolleys in Drogheda and Dublin. Those responsible have never been held to account for their actions. I attended Dail Eireann on the day this report was published. To my amazement, in spite of the damning indictment of the HSE that it contains, our Minister for Health has yet to make any public comment on its contents. This silence beggars belief. However, the most sinister developments have yet to come. Speaking on Newstalk radio on 9th December, the minister announced that January would "hopefully" see the publication of a new "small hospital framework document". I genuinely fear this will contain a recommendation that Navan should lose its ability to have 24-hour medical emergency admissions. In order to deflect attention away from this shaft, the HSE spin department will probably announce that Our Lady's will instead receive additional 'elective surgery', 'outpatient clinics' and perhaps a 'minor injuries unit' where paper cuts will have band-aids applied. All of this will be intended to reduce local outrage and make it seem as if the government is actually doing the people of Navan a favour. In reality, to borrow an American phrase, "you can put lipstick on a pig, but it is still a pig". Under these potential new arrangements, if you need to have a toenail removed next month, or a hernia repaired, you will have this done locally in Our Lady's. But if your elderly mother gets a bad chest infection, and requires a few days in hospital, she will not be in a bed in Navan; she will instead find herself on a trolley in Drogheda sharing a portable commode with dozens of other patients in one of the most overcrowded emergency departments in the State. The HSE will then make the derisory claim that such a disgraceful state of affairs is in the best interests of 'patient safety' and will refer objectors to 'HIQA guidelines'. Over the past few months, I decided I was no longer prepared to stand idly by and watch as this nightmare scenario slowly evolved. Thus, earlier this year, I wrote to HIQA asking them to carry out a formal inquiry into the severe overcrowding in Our Lady of Lourdes hospital in Drogheda. My motivation was simple. If these appalling conditions were found to pose a significant risk to 'patient safety', then the government would be forced to address them. Furthermore, any plan to force Navan patients to attend Drogheda could no longer be justified. My letter was supported by the chair of the Save Navan Hospital Campaign, Peadar Toibin, TD. It was also signed by his party colleague, Deputy Gerry Adams, in Co Louth. I understand that, despite being publicly asked to do so, local Fine Gael TDs have declined to back this initiative. Unfortunately, HIQA have refused to carry out the full inquiry that we called for. This was in spite of the fact that Drogheda, notwithstanding the heroic efforts of its staff, had the worst trolley count in the country on many occasions this year. It seems that HIQA is content to allow itself to be associated with the downgrading of Navan, while refusing to formally investigate the facility that local patients would consequently be forced to attend. This apparent 'a la carte' approach to 'patient safety' is a disgraceful reflection on those running our health service. Regrettably, rather than confront this looming disaster, it appears some government supporters have decided to accuse those who would defend Navan Hospital of "scaremongering". Worse still, I have heard the insulting suggestion that the SNH campaign is somehow a 'front' for one political party - Sinn Fein. Let me be clear here. I am not a puppet for any party, nor am I interested in petty political posturing. I am motivated solely by a desire to see that the people of Meath and Louth receive the standard of medical care that they deserve. The next few months will determine whether your sick loved ones will have an excellent local hospital to attend, or the trauma of a Drogheda trolley to endure. We must ignore the lies, the HSE propaganda and the government spin. Regardless of who you vote for, we must stand together if Our Lady's Hospital is to be saved. Dr Ruairi Hanley is a GP, member of the Save Navan Hospital campaign and a columnist with the Irish Medical Times.