Delays in closing Navan Hospital’s emergency department due to political opposition put the lives of critically ill patients at risk, the hospital’s clinical director warned.
Jerry McEntee, whose nephew Helen McEntee, Minister of Justice, is one of those who oppose the current HSE plan, has sharply criticized politicians who he says use “badly inflated figures” to justify their concerns about a reconfiguration plan that the Navan A&E and leads some patients to Our Lady of Lourdes Hospital in Drogheda, Co Louth.
“Currently, the critically ill at County Meath are not being given the best chance of survival,” Mr McEntee told the Sunday Independent.
“For various reasons, politicians object to it and if the process is delayed, the risks of a critical incident being fatal are present all the time and continue.”
Mr. McEntee’s intervention, his strongest to date, comes amid ongoing anger over the plan to downgrade Navan Hospital, which has caused a political headache for Health Minister Stephen Donnelly and the government.
While the HSE insists that it continue with the reconfiguration plans based on patient safety, Mr Donnelly, who is ultimately in favor of downgrading Navan’s ED, asked him to interrupt the plan for the time being and develop a more comprehensive proposal. To address concerns that more patients will end up in Drogheda than the HSE claims.
Amid strong local opposition in Navan the Sunday Independent may also reveal that six emergency medicine consultants at Our Lady of Lourdes Hospital have claimed their A&E department will have to deal with up to 45 additional patients each day if the plan goes ahead.
In a letter sent last Friday to Mr. Donnelly was sent, the consultants said the additional workload “can not be managed safely” without a significant increase in resources. The six consultants said the “public message” that the closure of Navan’s emergency department would result in only four to five extra patients being referred to Drogheda per day.
However, the consultants said their analysis, based on the HSE’s own internal figures, is very different. They calculated the average daily attendance at the Navan Emergency Department from figures on the hospital’s internal iPIMS system.
“An additional workload of 35 to 45 patients per day equals an increase in activity of at least 25 pct in adults who offer,” the letter reads.
They said the majority of the additional patients who will attend Drogheda from Navan will require “significant clinical input”. The six consultants said they accept there is a clinical risk associated with Navan emergencies.
They warned of the deaths associated with overcrowding and long waits in emergency departments. They said the proposed reconfiguration of services could potentially result in risk being “simply transferred from one hospital to another without resolving that risk”.
The consultants warned about the mortality associated with overcrowding and long waits in emergency departments.
There was a “serious underestimation of the workload involved and a failure to provide the necessary support to Our Lady of Lourdes Hospital to manage the transition safely”, the letter reads. The consultants asked for more resources to manage the transition safely.
The intervention is the second in a week of consultants at Our Lady of Lourdes Hospital. Seventeen specialists at the hospital wrote to the minister separately last week, also warning of a risk to patient safety if the critically ill patients were transferred from Navan to Drogheda without the former having proper resources.
This newspaper also saw a nine-page HSE memo outlining the rationale for changing Navan’s ED to a 24-hour medical assessment unit with the support of a local injury unit.
The memo, which was given to local politicians at a June 13 meeting and said the final stages of implementation would begin last Thursday, said the HSE could no longer stand over the safety of the Co Meath facility .
“The ED no longer meets ‘best in class’ clinical standards and clinicians and other medical staff have gone on record to express their concern about the safety of the unit,” it said.
“It will be a duty of duty for us to ignore it with the risk of patient safety.
“Empirical evidence exists in several published reports over the past 14 years that have been clearly highlighted by the Department of Health and the HSE on behalf of the Department of Health and the HSE, clearly highlighting acute services at OLHN [Our Lady’s Hospital Navan] is unsafe. ”
Navan is already bypassed by all trauma ambulances, for heart attacks and for suspected strokes, while for more than a decade no acute surgery or acute surgical recordings have been allowed in Navan.
The memo feeds to the hospital in Drogheda has increased its beds by 100, added three surgical units and expanded its emergency department and that additional budgets from the Navan hospital will be carried over to allow Drogheda to accommodate the estimated five to six extra patients per day to handle.
However, this HSE plan is opposed by politicians, including Justice Minister McEntee – who is also Fine Gael TD for Meath East – as they said it “caused further concern as it did not address serious capacity issues” .
Mr Donnelly’s spokesman said that while the health minister acknowledged the expert clinical view that Navan could not provide the full range of emergency services in the future, he also heard “the very real concerns of senior clinicians working at other hospitals,” which will be affected at a time when all health services are under intense pressure ”.
The spokesperson said: “These concerns need to be addressed comprehensively. The minister asked the HSE to interrupt the final reconfiguration and to develop a more comprehensive proposal for consideration. “
But the HSE said it had planned for and was already putting in place the extra resources needed to switch Navan to what is known as a Model Two hospital. “This change is supported by HSE national clinical leadership, clinicians at Our Lady’s Hospital in Navan, and Meath Faculty of GPs,” the HSE said.
“The HSE understands the concerns of the local community and public representatives. This concern was reflected by the Minister of Health, who also understands the important patient safety risks behind the changes that are needed. We are working to address these concerns. ”
Aontú TD Peadar Tóibin, chairman of the Save Navan Hospital campaign group, said: “The minister must either introduce or reaffirm his authority over the HSE, whichever word is more appropriate, here is a lack of authority. Civil servants tell the minister what to do. “
But in an interview with this newspaper last Friday, Navan Hospital’s clinical director, Mr McEntee, said: ‘A delay is likely to jeopardize the health and safety of critically ill patients coming to Navan.
“Any delay for whatever reason, whether it comes up with another proposal or for whatever reason, means that these critically ill patients are still not being offered the best chance of survival.”
He claimed that due to reconfiguration there would be 10 to 12 extra patients a day attending Our Lady of Lourdes Hospital in Drogheda or almost 4,000 a year and not the 10,000 or 25,000 extra demanded by some politicians not.
“Those statements are incorrect and of those 10 to 12, based on our data, four to five will require admission and of those four to five, one to two of those patients have already been admitted to the surgical service in Drogheda as we speak.
“We are therefore left with three to four medical patients who have to be admitted per day and not the badly inflated figures that some of the politicians claim.”
He refused to be attracted to the opposition of his own cousin, Ms McEntee, to the current HSE plan, other than to say: “The Minister of Justice is a TD who represents the ingredients of East Meath. I am a clinical director at Our Lady’s Hospital Navan and my job is to represent the health and safety of the patients who come in and that they are given the best chance of survival. That is my only concern. ”