A significant gap in public-health services in the Republic has jeopardised the management of cross-Border disease outbreaks, according to a senior public-health doctor in Northern Ireland.
As public-health doctors in the State embark on strike action, The Irish Times has learned that the Department of Health was informed a year ago of a risk to the public arising from the un- availability of rostered public-health doctors in the Republic.
A letter from the chairman of a cross-Border committee charged with drawing up a protocol for the management of infectious disease outbreaks, states that in cases of food-borne illness, "unlike in the Republic of Ireland, Northern Ireland staff can be made aware of the outbreak outside of normal hours".
Dr R. Smithson, a consultant in communicable disease control in the North, said that as a result, "public health would be put at risk due to the delay in investigation and in implementation of control measures. If the outbreak involved serious illness such as E coli 0157, salmonella infection or botulism, then there may be severe consequences".
His letter was sent to the North Western and North Eastern Health Boards and subsequently forwarded to the Department of Health in the Republic.
The Irish Times has also obtained correspondence be- tween Mr Paul Kavanagh, CEO of Our Lady's Hospital for Sick Children in Crumlin, and the National Disease Surveillance Centre (NDSC) expressing concern at the absence of a protocol which would allow the hospital to inform public-health doctors of incidents of meningitis which occur outside normal working hours.
In a reply, the director of the NDSC said: "The current situation is deplorable and relates of course not just to cases of bacterial meningitis but also to outbreaks of severe food poisoning ... and more recently to bioterrorist threats."
The director advised Mr Kavanagh to redirect his letter "to those who have the power to resolve this issue".
Public-health doctors are not paid for out-of-hours work. Many undertake weekend and evening work on a pro-bono basis in response to public-health emergencies.
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