Consultants call for study of patients re-admitted to hospitals

Hospital consultants will this week call on HSE chief executive Prof Brendan Drumm to establish a national re-admission study to assess how many patients had to be taken back into hospital with the same illness within a short period of time after discharge.

The call comes in the wake of management moves to instruct consultants to discharge up to 50 patients a day in some hospitals to relieve pressure on A&E departments.

In a meeting with Prof Drumm on Thursday, the Irish Hospital Consultants' Association (IHCA) is expected to formally claim that health service management also breached the terms of the Sustaining Progress national agreement in January, when it unilaterally abolished a type of contract that permitted senior doctors to treat fee-paying patients in private hospitals.

Relations between the IHCA and Prof Drumm, who is a former member of the consultants' body, have been strained in recent weeks and the meeting is expected to be tense.

In January, the board of the HSE decided no new consultants should be appointed on category II contracts. Arguments over this issue, among others, have led to a deadlock for the last two months in negotiations on an overall new contract for hospital consultants.

Last weekend, the National Council of the IHCA criticised Prof Drumm over the abolition of the category II contract, as well as over moves by management in some hospitals last week to ease pressure on A&E departments by directing consultants to discharge up to 50 patients daily.

As part of the the national hospital re-admission study to determine how many patients were re-admitted after discharge, the IHCA will ask for an examination of the reasons patients had been sent home in the first place.

The Secretary General of the IHCA, Finbarr Fitzpatrick, said last weekend that University College Hospital Galway management had last week directed consultants to discharge 50 patients per day. He claims management said no more than 10 patients could be allowed on trolleys in A&E under a new HSE policy.

He said that the directive instructing consultants to discharge patients did not take account of their condition and whether they needed to remain in hospital.

Mr Fitzpatrick said that there were serious medico-legal issues involved in such a policy.

The IHCA will argue on Thursday that the proposed study should examine whether re-admissions took place because patients suffered a relapse of their condition or whether pressure had been brought to bear on their doctor during their original stay in hospital to discharge them prematurely.

The IHCA will claim that the HSE breached Sustaining Progress as it abolished the category II contract without any consultation.

Several weeks ago, the Government's plans to out-source driving tests were blocked after objections by public sector unions were upheld by an Arbitration Board.

The board maintained that core civil service work could not be changed without union agreement under the terms of Sustaining Progress.

At its national council meeting at the weekend, the IHCA maintained that Prof Drumm had persistently attacked consultants and other staff in recent weeks. Consultants were also critical of Prof Drumm's stance that investment in community services and not additional hospital beds should be prioritised.

Prof Drumm has, in recent weeks, criticised hospital practices as contributing to pressures in A&E departments.

He has, however, denied criticising consultants personally and has maintained that the vast majority provide the cornerstone of health services.