BACKGROUND:ROSCOMMON COUNTY Hospital has been a hot political potato for decades. In 1989 the county elected its first hospital action candidate in Tom Foxe, and since then several hospital candidates have succeeded in local elections.
Even in the most recent general election, pledges to retain all services at the hospital, including its emergency department, were seen as essential by the politically savvy if they were to win votes. Minister for Health James Reilly made such a pledge.
He even wrote what might have been regarded as a cheeky letter to the HSE, in advance of polling day, saying it should not withdraw any service from the hospital until after the election because if he was re-elected and got the health ministry he wanted to review the changes which were proposed.
The result was that two Fine Gael TDs – Denis Naughten and Frank Feighan –- were elected in the Roscommon-South Leitrim three-seat constituency, as was the Independent Luke “Ming” Flanagan, who reportedly told a HSE official in recent days if he were in his position he “would get a rope and hang myself”.
Despite all the protests and the now broken promises, the writing has been on the wall for the Roscommon hospital for years.
It has a 24-hour emergency department seeing about 13,000 patients a year, which is significantly fewer than other hospitals with round-the-clock emergency services. Even Ennis hospital, which lost round-the-clock emergency services in 2009, dealt with more than 14,000 emergency presentations last year.
Patients attending the emergency department in Roscommon are usually treated by junior doctors. There is no full-time consultant in emergency medicine to supervise these doctors apart from a specialist who visits from Galway one day a week. While consultant surgeons and physicians in the hospital can also tend to patients in the emergency department this is not regarded as ideal.
As far back as 2003 the then locum consultant in emergency medicine who visited the unit from Galway on Wednesdays said the service would require a big commitment in funding and staffing to bring it to an acceptable standard. It didn’t happen.
So regardless of whether the country has too many hospital emergency departments or not, Roscommon hospital has been caught in a bind. Without proper resourcing it could not meet standards acceptable to the Health Information and Quality Authority for a smaller hospital and without proper resourcing it cannot attract sufficient numbers of doctors. Like many other hospitals, it is short of junior doctors for July 11th, speeding up its demise.
Most people now accept their chances of a better outcome are increased if seen at a hospital which deals with large volumes of patients. The HSE has been saying this for years. Yet it has gone about preparing the ground for the closure of the emergency department at Roscommon hospital in a hurried and ham-fisted way. It has learned nothing from reconfiguration in the northeast but would do well to remember what happens those who fail to prepare.
It has also claimed for days no decision had been made on the emergency department’s future in Roscommon when this clearly was not the case. How can the public put its trust in the changes they now propose when they refuse to be upfront with the people?