Report Review: The Hanly reforms will not result in hospital closures, a British expert in hospital rationalisation said during a visit to Ireland last week.
The belief that the Hanly reforms will mean that "hospitals will close" and that "biggest is best" are ill founded, according Dr Peter Barrett, chairman of the Independent Reconfiguration Panel, which reviews contested plans for changes in the health services in England.
Dr Barrett was invited by the Department of Health to visit Ireland and give observations and recommendations on the Hanly report. He is due to present his findings to the Department at the end of the summer.
Dr Barrett told The Irish Times that what he read in the Hanly report did not match up with the interpretations he had heard during some of the discussions he had with various groups in Ireland.
"My reading of Hanly and the perceptions I met in Ireland was difficult to correlate," he said. "I did not see anything in the Hanly report to suggest hospitals will close. I saw lots of suggestions that they might modernise and change, but nothing about closure. There is also a perception that biggest is best, but I didn't see any evidence in Hanly to say that's going to be a solution for the whole of Ireland," Dr Barrett added.
There is nothing in Hanly to prevent "flexibility, local consultation, development of local services and keeping services local as long as it is appropriate and safe to do so", he asserted.
These perceptions are reflecting the "anxiety that people have about change", according to Dr Barrett.
The development of the primary care structure and ambulance service will go "hand-in-hand" with the Hanly reforms, he said.
On his visit, Dr Barrett met officials from the Department of Health, the Royal College of Surgeons, the Royal College of Physicians, Comhairle na nOspidéal, the Medical Council, the management team and board of Ennis General Hospital and Ennis General Hospital Development Committee.
Responding to recent research, which indicated that under the Hanly reforms victims of road traffic accidents would be less likely to reach an A&E department within the crucial golden hour, Dr Barrett said this would only happen if a "one-size-fits-all report was imposed" on the State. This, he said, was not his understanding of the Hanly report.
A modernised ambulance service, with well-trained ambulance personnel who have the ability to stabilise patients, would lead to safer delivery of care, he added.
"What is most important is that the patients get the most appropriate care at the time they need it not necessarily be seen at an accident and emergency unit," Dr Barrett said.
Consultation was the key to rolling out the Hanly reforms. The consultation must be real and have the ability to affect the outcome of the discussion, he added.
"What I have read in Hanly and what I have seen over the last couple of days means that negotiations have to happen at a local level with a view to gaining the most appropriate treatment for the patients in the most appropriate setting.
"It is very important that you are not automatically relocating services but redesigning services and that you are redesigning them with the local population, in consultation with the local population.
"It seems to me that people had the idea that Hanly was going to be imposed without debate and without discussion. I have been assured that that is not the case by the Department and there is nothing in the Hanly report that I have read so far which would stop that debate. In fact, it's the way to move things on.
"One of the things that everybody agrees on is that it is necessary. Nobody wants to be treated by a tired doctor. The way you go about that can lead to a very stimulating debate about how to modernise health services and make them sustainable and safe. And that means change. Doing nothing is not an option, doing more of the same is not an option."