Neurology: Patients with serious head injuries may have to be transferred outside the State for treatment from the beginning of next month, a number of consultant neurologists have warned.
In a letter to the Department of Health, the nine neurologists working in the Irish public health sector say the move is necessary in order to cope with the impact of reducing the hours worked by junior doctors in line with the requirements of a new EU directive.
Under the European Working Time Directive (EUWTD), the hours of junior doctors must be cut to 58 hours a week from August 1st.
Chris Pidgeon, chair of the Department of Neurology at Beaumont Hospital, Dublin, said his department had 16 junior doctors who worked an average of 72 hours a week. If their hours were cut, the number of patients which could be seen by the department would also have to be cut, he said.
But Mr Pidgeon emphasised that 73 per cent of patients coming to the neurosurgery unit were emergencies and could not be "long fingered". Somebody would have to deal with them and this was why neurosurgeons in Dublin and Cork suggested they be sent to Northern Ireland or the UK, he said.
He added that in the UK additional staff were being provided to neurosurgery units to cope with the EUWTD but it was not happening here.
"From August 1st I will no longer have an outpatients clinic with junior doctors in it. Normally there would be three of us, myself and two junior doctors dealing with up to 30 patients. Because I will be on my own I have reduced my outpatient load to 12 per session and my waiting list has now gone out to March," he said.
"And when it comes to a person with a brain tumour due to be transferred from another hospital, we will have to tell them to find somewhere abroad because we won't have the capacity to deal with them," he added.
Asked yesterday if patients would be put at risk he said: "Yes, you can't under-staff any speciality to this degree and expect people not to suffer."
Details of the neurosurgeons' letter to the Department were contained in this week's Irish Medical News.
The Department of Health, in its reply to the letter, said its priority would be to continue to provide "safe, high quality, neurosurgical services" as it moved to implement the EUWTD.
It added that while the directive may result in changes in the way service provision was structured and organised, compliance with it and continuing service enhancement were "not incompatible".
But it said its efforts to prepare for implementation of the EUWTD had been hampered by industrial relations issues, including the fact that consultants were not co-operating because of concerns they had over the introduction of a new way of insuring their practice.
In a statement yesterday the Department said: "One of the problems facing management in implementing the directive's requirements is the lack of substantive engagement by the Irish Medical Organisation [IMO\], the Irish Hospital Consultants Organisation and some of the medical training colleges.
"The refusal of the IMO to establish or participate in local implementation groups, the failure to reach any agreement on the industrial relations issues and the limited and individualised response from some of the colleges on the training/rostering issues are causing significant and ongoing difficulties in relation to implementation. The difficulties being faced in this regard have already been outlined to the European Commission in the Department's response to its consultation document on the review of the EUWTD."