How we got to here.... Three decades of service stripping has led to this A&E showdown

Thirty years ago, Our Lady's Hospital in Navan was a very different place.

It was a teaching hospital with a busy surgical department, Intensive Care and Coronary Units a well as an A&E that had no problem treating children.

The hospital was a major centre for elective orthopaedic surgery, as it still is, but orthopaedic trauma was also dealt with in Our Lady's Hospital.

Over the decades, more and more services have been stripped from Navan and many more have been constantly under threat.

The hospital stopped treating children more than 20 years ago and also lost its teaching status, leaving it less attractive for medics when it came to recruitment.

One of the biggest blows to the hospital came in 2006 with an action plan to reconfigure services in the northeast region prepared for the HSE by consultants, Teamwork Management Ltd.

It found that the system then in place in the region was “exposing patients to increased risks”, “was not serving the community well, was unsustainable and had to change”.

It began a programme of change called “Transformation”, which involved moving acute and complex services from five acute hospitals to two – Our Lady of Lourdes and Cavan General – and then the two were to be replaced by a new regional hospital, later earmarked for Navan, but which never materialised.

The plan was to leave Dundalk, Navan and Monaghan as local hospitals with minor injury units and other outpatient services.

This configuration led to the HSE recruiting consultants to be shared between the hospitals in Drogheda and Navan.

The hospital was dealt two huge blows in 2010. In February, the HSE announced that complex trauma patients in the Meath area requiring surgical intervention would be taken by ambulance directly to Our Lady of Lourdes Hospital rather than Navan and later that year, the executive confirmed that all acute and emergency surgery at Our Lady's Hospital would end.

This led to more than ten thousand people protesting on the streets of Navan in October that same year.

In the past decade, Navan has also lost its inpatient psychiatric service.

In 2013, Our Lady’s Hospital, Navan was included in the list of 10 designated Model 2 Hospitals under the Smaller Hospitals Framework. All of these hospitals were earmarked for A&E closure and all are now closed except for the Emergency Department at Our Lady’s Hospital Navan.

Around the same time, the Navan hospital was included on a list of 10 hospitals, which HIQA recommended close their A&E units. The Navan A&E is the only one of those still operating.

These reports led to yet another mass rally in the town and an outpouring of support for the hospital from local people.

In March 2020 just before the onslaught of Covid, the Irish East Hospital Group, went public and stated that the A&E would close overnight at the end of March 2020, but this was put on hold because of the pandemic.