The Minister for Health has rejected research that found the Hanly report's proposed reconfiguration of hospital accident and emergency services could lead to critical delays in patient treatment. Dr Muiris Houston, Medical Correspondent, reports.
Mr Martin said he had concerns about the Trinity College Dublin research team taking the Hanly report "at its most literal".
The researchers looked at the potential impact on patient travel times if changes to the location of A&E services proposed by Hanly were to be implemented. Hanly recommended removal of A&E services from smaller hospitals, with a corresponding increase in capacity at larger regional hospitals within two pilot health board areas.
Dr Joe Barry and his colleagues at the TCD Department of Public Health and Primary Care found that the percentage of the population able to reach an A&E department within an hour of a road-traffic accident would fall from 82 per cent to 72 per cent. They also concluded that 30 per cent of acute heart attack patients could have to travel for more than an hour.
The successful treatment of acute medical emergencies such as heart attacks and traffic accidents is dependent on getting the patient to an adequately-resourced hospital within one hour of a critical incident - known as the "golden hour".
However, speaking on RTÉ yesterday evening, the Minister said Hanly had suggested a scenario where there could be intermediate hospitals. "No one has proposed that there would be only one accident and emergency facility in the entire western sea board".
Speaking to The Irish Times last night, Dr Barry said: "Any reading of our research paper shows that we have not done a disservice to the Hanly report. Our objective is to show how the original proposals in the report can be rationally implemented."
The TCD research, reported in yesterday's Irish Times Health Supplement, found that only 44 per cent of people living in the North Western Health Board area would be able to access accident and emergency within the "golden hour" following a road-traffic accident. The percentage of cases of road accidents within 60 minutes of a hospital in the Western Health Board is just 47 per cent under the most literal interpretation of Hanly.
A spokeswoman for the Department of Health said the first Hanly report did not take demographics or geography into account. "Even though the second Hanly report has not even begun, Dr Barry's report has taken the conclusions for Hanly I and applied them to Hanly II. This could not and should not have been done," she said.
In their paper published in the current edition of the Irish Medical Journal, the TCD team looked at three scenarios involving different levels of A&E services. They examined what would happen if a literal interpretation of the Hanly report recommendations was to emerge. They also looked at an "intermediate" scenario involving a partial reduction in A&E services.
When the TCD researchers applied a spatial interaction model to the most literal interpretation of Hanly and compared it with the present availability of services, the percentage of cases able to access an A&E department within one hour dropped considerably.
For people with an acute heart attack, 86 per cent travel less than an hour for treatment under the current distribution of services. This figure drops to 70 per cent if A&E services are concentrated at one location in each health board.