Cabinet approves plan to reorganise hospitals into six regional groups

The country's hospitals are to be reorganised into regional groups with the treatment of serious cases removed from smaller hospitals under major changes announced by Minister for Health James Reilly.

Hospitals in each of the six groups will share services and staff, and the groups will eventually become independent, self-governing trusts.

Dr Reilly described his proposals as “the most fundamental reform of the Irish acute hospital system in decades” and promised that they would be implemented immediately.

No acute hospital will close and it is envisaged that smaller hospitals will provide a greater amount of routine services such as day surgery and diagnostics.

Local injury units
However, the plan provides for local injury units rather than emergency departments in nine smaller hospitals. Most have already lost their emergency departments but St Columcille's hospital in Loughlinstown, Co Dublin, will follow suit shortly, it was indicated yesterday.

Hospitals in Wexford, Kerry and Letterkenny, Co Donegal, are being allowed to retain emergency services because of their location.

The six groups will be located in the Dublin North East, Dublin Midlands, Dublin East, South/South West, West/North West and Midwest regions. Each group will comprise between six and 11 hospitals and will include at least one major teaching hospital and an academic partner.

Patients will not notice any immediate change after the groups are established, Dr Reilly acknowledged, but over time the amount of care delivered locally would be maximised.

Speaking yesterday at the launch of his proposals, Dr Reilly said they were in line with best international practice. “The new hospital groups, each with their own governance and management, have been designed so as to provide the optimal configuration for hospitals to deliver high-quality, safe patient care which is cost-effective and guarantees better outcomes for patients.”

Under a group structure it would be more difficult for “rogue operators to inflict damage on patients”, he said, and the risk of medical error would be diminished.

The plan contains a number of concessions designed to defuse opposition in various parts of the country. In Waterford, a vigorous campaign has been waged against the perceived downgrading of the regional hospital. Under the plan, Waterford is to retain its role as a major cancer, cardiology and trauma centre for the southeast region, despite being linked to hospitals in Cork, Kerry and Tipperary in the South/South West group.

The hospital will be upgraded to university hospital status and academic posts, including two professorships, will be provided for consultant staff, UCC announced last night.

These concessions were cautiously welcomed by local Sinn Féin Senator David Cullinane, but the party's health spokesman, Caoimhghín Ó Caoláin, said the overall plan raised more questions than it answered. Reaction from hospitals and university medical schools was overwhelmingly positive.

In Dublin, the Rotunda Hospital and its near neighbour and traditional partner the Mater hospital have been placed in different groups. However, under the plan, the two hospitals will be allowed to have joint consultant appointments.