Assessment queries quality of paediatric emergency care

The Irish Medical Council has expressed its concern at the quality of care offered to children attending the accident and emergency…

The Irish Medical Council has expressed its concern at the quality of care offered to children attending the accident and emergency unit at Monaghan General Hospital following an inspection there last May, The Irish Times has learned.

After the inspection, the council raised with North Eastern Health Board management its lack of clear policies in relation to paediatric attenders at the hospital's accident and emergency unit.

The council also said it was unhappy that there was a perception among the public and family doctors that the hospital offered a paediatric service despite the absence of a consultant paediatrician.

After a previous assessment of facilities less than a year earlier, The Irish Times understands the council recommended that the NEHB submit to it the steps it would take to ensure competent paediatric care at the hospital.

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The Medical Council asked the NEHB to outline a protocol for the management of paediatric emergencies. It also asked the health board to provide paediatric resuscitation equipment in the hospital's accident and emergency unit and for training for medical and nursing staff in using paediatric resuscitation equipment.

According to a number of medical sources, few junior hospital doctors at Monaghan hospital have completed neonatal resuscitation training courses.

Following the second visit in May, the Medical Council noted that the care of paediatric emergencies was dependent on the individual doctor available, without evidence of consistent paediatric expertise within the hospital.

It is understood that there is no designated educational programme for doctors who provide cover for the accident and emergency unit. Employed as surgical senior house officers, such doctors may have little or no postgraduate paediatric experience or training.

The Irish Times also understands that the May 2002 Medical Council assessment team expressed its concern at "the considerable uncertainty" about the exact nature of policy at Monaghan Hospital on a wide range of issues.