Brain-injured often die before seeing specialist

IMO conference: Patients with brain injury in the Republic often have died before they can be seen by a specialist, such is …

IMO conference: Patients with brain injury in the Republic often have died before they can be seen by a specialist, such is the appalling state of Irish neurology services, the IMO conference heard yesterday.

Dr Michael Thornton, an anaesthetist at Mayo General Hospital, said he had at present under his care an 18-year-old who was severely brain damaged in an injury sustained before Christmas and he could not get an outpatient appointment to see a specialist until June.

The service was so poor, the Government was "covertly rationing" it, he claimed.

Calling for improvements, Dr Thornton pointed out that guidelines stated no hospital receiving trauma should be more than two hours by road from a neurosurgery unit. Yet for patients in the west, the journey by road was more than three hours to get to the national referral centre at Dublin's Beaumont Hospital.

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Some patients could be transferred by air ambulance, he said, but he pointed out that more often than not it took several hours to organise such a transfer. Then if it was raining or at night, the air ambulance couldn't fly.

"We have had a few cases this year of young people who have had serious brain injuries who have sat in our hospital for weeks and months without getting specialist attention," he said.

Dr Thornton warned the Government that the issue would not go away and suggested army deafness claims would seem like a drop in the ocean to Government once brain injured people began to sue for being denied proper care.

Furthermore he said denying such patients swift treatment was a false economy. It cost €10 million per patient to look after a profoundly brain-damaged patient for life, a cost that could be significantly reduced if the patient was seen immediately by a specialist.

Highlighting the shortage of specialists to treat persons with brain injury, he said the European average was to have one neurosurgeon for every 125,000 people. In the Republic there was one for every 467,000 of the population.

The conference also debated motions calling for initiatives to address overcrowding in A&E units. One doctor described the way sick and sometimes dying patients are stacked up on trolleys in casualty as akin to a war zone. It was equated with Third World medicine being practised in a First World country.

Delegates also criticised the lack of services for adolescents with mental health problems and called on the Minister for Finance, Mr McCreevy, to increase the price of a packet of 20 cigarettes by €2 a packet in the next budget.

Public health specialist Dr Fenton Howell said price increases had been shown to be the most effective method of reducing tobacco consumption and on preventing young people taking up the habit. Two doctors opposed the motion for a price rise on the basis that it would be a further taxation on those in lower socio-economic groups, who tended to smoke most. However the motion was adopted.

Delegates also agreed to a motion calling for a ban on alcohol advertisements at rock concerts, sports events and cinemas, where under 18s were present.

The IMO, which represents over 5,000 doctors, continues its conference today.