Tallaght doctors query safety of reopened paediatric unit

Doctors at Tallaght University Hospital have questioned the safety of its newly reopened paediatric unit to treat seriously ill children.

Anaesthetists at the hospital say they lack the necessary training and exposure to neonatal and paediatric intensive care medicine to provide a safe service they can stand over, The Irish Times understands.

In a submission to hospital management, the anaesthetists, who work primarily in the adult hospital, say they have grave concerns about the resuscitation and management of seriously ill children admitted to the unit.

They say the management of babies and children requires a fully staffed paediatric ICU to deliver safe care.

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The unit reopened last Thursday, six months after services had been relocated to Crumlin and Temple Street children's hospitals in Dublin so space could be provided for coronavirus patients in Tallaght. Services include a 24/7 emergency care unit along with inpatient, daycase, X-ray and outpatients department, but surgery has been moved to Crumlin.

‘Frantic’

Separate from the concerns of anaesthetists, the Irish Nurses and Midwives’ Organisation (INMO) claimed the removal of surgical services from Tallaght amounted to a downgrading of the unit.

Describing the change as "frantic" and "unplanned", the union said it had come as a "major shock" to staff working on frontline health services. "INMO members only became aware of this when they arrived to work on Monday morning, with no prior warning or discussion,"said industrial relations officer Joe Hoolan.

Children’s Health Ireland (CHI) acknowledged the safety concerns expressed by medical staff at Tallaght but said there had been no adverse outcomes for children.

"There isn't going to be a best solution until the new national children's hospital is built," said Dr Ciara Martin, paediatric executive lead at CHI Tallaght, who pointed out that Tallaght has never had a paediatric ICU.

Children arriving in Tallaght with issues such as head injuries, breathing difficulties, burns or abdominal pain will be stabilised and then transferred by ambulance to Crumlin or Temple Street children’s hospital, she said. Ambulances will now be available to provide transfers seven days a week, rather than five.

Dr Martin said the changes had taken place “faster than we would have liked” due to increasing patient numbers at Crumlin. The amount of daycase work in Tallaght is being increased to compensate for loss of surgical services.

Local TD Paul Murphy of Rise called for the changes to be reversed, saying they were "a backwards step in healthcare for children, and a massive blow to the hospital and community".

Existing services at the three Dublin children’s hospital will move to the national children’s hospital at St James’s when it opens in 2023.