HSE unveils acute services plan

The HSE has unveiled plans for the reconfiguration of hospital services in Cork and Kerry which will see a centralisation of complex acute care at a regional centre at Cork University Hospital in a bid to streamline the system and achieve better outcomes.

Prof John Higgins, who heads up the reconfiguration project, moved to assure the public that no hospital would close and no service would be removed from any of the five local hospitals in Cork and Kerry without a replacement service being operational.

“No hospital will close but all will fundamentally change how our services are delivered and no service will be withdrawn until a replacement service has been established and tested,” he said following the release of a report on the reconfiguration of Cork and Kerry hospitals.

The report, which cost some €280,000 and was carried out by Horwath Consulting Ireland and Teamwork Management Services, recommends the transfer of all acute care from the Mercy University Hospital and the South Infirmary Victoria Hospital in Cork city to CUH.

And it also recommends the transfer of acute care from Kerry General Hospital in Tralee as well as from Bantry General Hospital and Mallow General Hospital in Co Cork, again to CUH as part of an overall plan to achieve better outcomes in patient care.

However, Prof Higgins who gave assurances in March that the HSE would not be implementing the Teamwork recommendation on KGH, stressed yesterday that it would be the principles rather than the detail of the report which would guide the reconfiguration.

And yesterday, Prof Higgins re-iterated his commitment on Kerry, saying that all current acute services at KGH including emergency departments, obstetric services, intensive care, acute surgery and acute medicine would be retained on the Tralee site.

And he also confirmed that the HSE supported the continuation of acute medical care in Bantry General Hospital, contrary to the Teamwork report recommendation, but stressed that it must be appropriately integrated into the wider hospital services in Cork and Kerry.

The question of acute surgery in Bantry is still under review as is the future of acute medicine and surgery in Mallow while it is envisaged that certain acute specialisms at both the Mercy and South Infirmary Victoria would also be examined with a view to transfer to CUH.

Prof Higgins said a separation of emergency surgery and elective surgery would lead to greater efficiency as it would allow emergency surgery to be carried out at CUH while freeing up theatre time in the other hospitals which could then carry out more elective surgery..

Under such a scheme, Bantry General Hospital, which currently carries out few out-of-hours emergency surgical procedures, would see its operating theatre being fully utilised from 8am to 8pm with elective surgery, resulting in a greater return from the facility, he said.

Questioned specifically about Mallow General Hospital, Prof Higgins said that the issue of providing acute medical care there was under review but that the hospital would continue to play an important role in conjunction with CUH, the MUH and SIVUH in Cork city.

“The three Cork city hospitals are already working closely to together in many clinical areas and by setting up single clinical teams in specialities such as medicine, surgery or anaesthetics, we can reduce unnecessary duplication.

“This frees up both financial and human resources to deliver specialist services in our local hospitals and in the community,“said Prof Higgins, adding that the aim was to try and provide as much appropriate medical care as possible locally through primary health care centres.

A Reconfiguration Forum has already been established comprising representatives from General Practice, community health services and all the acute hosptials in Cork and Kerry and this group has already set up a number of sub groups to look at specific issues.

Prof Higgins said that the entire reconfiguration project would have to carried out within the HSE South’s existing budget of €1.4 billion but with savings to be made through removing duplication, he believed investment would be possible and the project would be cost neutral.