Anger over the proposed replacement of Navan A&E is entirely of the HSE's making

If the people of Navan and wider community decide that the only way to save their 24/7 A&E Department is to mobilise in their thousands on 30th October and take to the streets of Navan, that situation will be entirely of the HSE's own making.

The messaging, or lack of it, from the Ireland East Hospital Group around the plan to replace the Emergency Dept with a Local Injuries Unit operating for 12 hours a day seeing non-critical patients has infuriated a community that has lived under the cloud of various service wind downs at the Hospital for decades.

Last week began with Minister Damien English categorically tell listeners to Michael Reade's LMFM show on Monday that there would be no change to A&E services at Navan.

The next night saw Minister for Disability Anne Rabbitte hold that party line when, standing in for Health Minister Stephen Donnelly, she assured local TDs Johnny Guirke, Darren O'Rourke and Peadar Toibin there was 'no change in policy regarding Navan Hospital before going on to read a prepared statement in the Dail, stating the opposite, that the Emergency Department would be replaced by a Local Injuries Unit (LIU).

Minister Rabbitte was correct in stating there is 'no change in policy' relating to the plans for Navan Hospital. The Small Hospital Framework of 2013 clearly sets out the path for hospitals such as Navan - establishing these LIU's and the Acute Medical Assessment Units, taking out the exisiting emergency departments. That is the policy.

Navan is indeed one of the last of the hospitals in the Framework to see these changes implemented. Covid may have played a significant part in delaying any such moves but now with ICU levels and general capacity issues easing, there is little in the way to stop the implementation of the new model.

So the obvious question now is when rather than if.

The Meath Chronicle put these three basic questions to the Ireland East Hospital Group which controls Navan Hospital for response.

1. The HSE has indicated (read out in the Dail on Tuesday) that the ED will be replaced by an AMAU and LIU. When will this course of action be happening?

2. Where will Emergency Cases outside of LIU hours be transfered to and treated?

2. Can you confirm that any AMAU will have no walk-in/self referral capabilities?

The reply was the same one given to the newspaper last Monday.

"Our Lady’s Hospital Navan is part of the Ireland East Hospital Group. In 2013 Our Lady’s Hospital Navan was included in the list of designated Model two Hospital under the Smaller Hospital Framework. Every hospital in the Group, large and small, has a vital role to play within the Group, with smaller hospital, such as Navan Hospital, managing routine, urgent or planned care locally and more complex care managed in the larger hospitals.

"The Hospital Group is engaged in a programme of re-design work to further integrate and enhance the role of Navan Hospital within the Group and to ensure that it will provide more services safely and appropriately with better linkages to primary, continuing and social care.

"Ireland East Hospital Group has been developing an Implementation Plan for future service configuration at Navan Hospital. Proposed changes to any Emergency Department service will only take place in the context of overall service reorganisation in the Hospital Group and will be undertaken in a planned and orderly manner.

"Any implementation of the plan to align the hospital with the Smaller Hospital Framework will make Our Lady’s Hospital Navan safer, busier and more efficient for all and will further enhance linkages to the community which is in line with Slaintecare.

There is nothing planned and orderly about allowing pithy answers drive fear and anger through a population of over 200,000 people.

What exactly is the plan to make Navan Hospital safer, busier and more efficient for all when emergency cases in the town will have to treated elsewhere, possibly after an intolerable wait for an ambulance? Just listen to that situation laid bare on Liveline this week.

If a man collapses in Oldcastle with chest pains, where will he be taken, how long will that journey take and how long will he be left waiting for paramedics to get to him.

The three TDs, deputies Guirke, O'Rourke and Toibin told the Dail that correspondence to the HSE and Ireland East Hospital Group had gone unanswered. Minister Rabbitte is response said that was unacceptable and promised to raise it with the Minister for Health.

These are legitimate questions that people will have should the HSE and Ireland Hospital Group finally front up and present the people of Navan and beyond with the true plan for their hospital and the timeframe for same.

Until then, expect the protests to begin, the anger to rise.