Surgeons at Our Lady's Hospital in Navan have expressed serious concern that patients presenting at the hospital in need of emergency surgery are being put at risk as a result of the lack of an around-the-clock CT scanning service in the hospital.
They also pointed out that the Health Service Executive's (HSE) decision to insist that the hospital continues to receive emergency surgery and trauma patients, even though surgeons at the hospital are not allowed do any major surgery, is a further risk factor for patients.
At present, any patient can present at the hospital day or night and if upon examination they require major surgery, they must be transferred to another hospital. Attempts must first be made to transfer them to Drogheda and if no bed is available there, attempts must be made to transfer them to Cavan or elsewhere if no bed is available there.
Restrictions were put on major surgery at Navan hospital following the publication of a report from Teamwork consultants in June 2006, which recommended emergency surgery be immediately removed from the hospital as it was being "held together by only two consultants".
There are now three consultant surgeons in the hospital and in a letter copied to HSE chief executive Prof Brendan Drumm on January 23rd last, the surgeons said the Teamwork report never proposed that patients would continue to present at Navan hospital requiring major surgical opinion or intervention.
The surgeons' letter, which has been seen by The Irish Times said: "To continue to receive emergency surgery and trauma in the presence of a non-viable service where surgeons cannot practice and basic imaging is unavailable is an ongoing serious danger to patient care."
They were responding to a draft protocol drawn up by the HSE for the management of patients now requiring transfer to other hospitals for major surgery.
"To propose to establish a protocol to formalise this practice is totally unacceptable to us as consultant surgeons," they wrote.
The CT scanner at the hospital is not routinely staffed after 5pm weekdays or at weekends.
The Irish Hospital Consultants Association (IHCA) has also been raising concerns about the situation in Navan with the HSE for several months.
In one letter in December, it said patients were being put at "very serious and unnecessary risk".
Meanwhile, the IHCA has also raised concerns with Prof Drumm about the lack of funding provided this year for the implementation of the Teamwork report's findings.
The report found patients were being put at risk by the way hospital services are currently organised and delivered in the northeast region. A plan was devised to render services safer which involved recruiting an additional 200 staff but now there is no funding.
In a letter to Prof Drumm on January 24th, the IHCA said the HSE board and Health Minister Mary Harney, by approving the HSE service plan for 2008, must accept responsibility for the inadequate provision of resources to render services in the northeast safe. It warned that if anything untoward happened a patient as a result, the HSE and the Minister would be responsible.
The health service insisted last night that it is committed to improving the safety and quality of patient care in the northeast area.
"We can expect a more challenging financial climate for the next two to three years which means that there will be a need for a much greater focus on where resources are currently not being best utilised and rapidly shifting these resources to better use.
"This shifting of existing resources will be the primary means to quickly provide the staffing and other capacity to accelerate necessary change in the interests of the public we serve," it said.