Patients who present with TB to Peamount Hospital will no longer be admitted there, following clarification yesterday of an interim High Court order granted last week.
Miss Justice Laffoy heard yesterday that Prof Luke Clancy, the medical director of Peamount, is concerned that the closure of the chest hospital there and the absence of any transitional arrangements to deal with new TB cases mean that new patients with TB may end up on trolleys in the Accident and Emergency units of general hospitals.
Because of that concern, Prof Clancy had continued to admit to Peamount new cases of TB, Mr Tom Mallon, for Prof Clancy and Dr Paul Kelly, senior hospital medical officer at Peamount, said. He asked that Dr Clancy be permitted to continue admitting any new cases until tomorrow, when proceedings by both doctors will be mentioned with a view to having the case heard on either Thursday or Friday.
However, Mr Brian Murray SC, for the hospital, said that while the hospital had no problem with Dr Clancy continuing to treat patients already admitted, it had a critical difficulty with new patients being admitted.
He said the hospital board, following recommendations from Comhairle na hOspidéal, had decided to close down the chest hospital and to focus on rehabiliation in the future.
He said injunctions granted last week to Prof Clancy and Dr Kelly restrained the hospital from interfering with them in the carrying out of their duties and it was unclear whether that related to the admission of new patients. If the hospital were required to allow new admissions, that would expose the hospital to a mandatory order on foot of a contractual dispute.
Miss Justice Laffoy said the injunctions she granted related only to patients already under Dr Clancy's care. There had been "a significant shifting of the goalposts" since she granted the orders on March 22nd, she said.
Urging the judge to allow new TB cases to be admitted, Mr Mallon said the issue of new patients had not arisen when the orders were sought, but the matter had arisen now.
The absence of transitional arrangements to deal with new TB cases was detrimental to the population as a whole, he said. The hospital had not denied there were no transitional arrangements.
The judge repeated that the orders related only to existing patients and said she would list the case for mention with a view to having the full hearing on Thursday or Friday.
In making the interim injunctions on March 22nd, the judge had said she was doing so because Prof Clancy had 20 patients under his care in the hospital. In Dr Kelly's case, she was making the order in light of a letter of March 18th last which indicated that if Dr Kelly was not prepared to take up a new post, which post, the judge noted, Dr Kelly had not been formally offered, he was to be treated as having resigned.
Peamount is the national specialist referral centre for tuberculosis. Last July a five-year strategic plan was published for the hospital, which stated that it wished to refocus its services to provide a range of rehabilitation and continuing-care services. On March 8th last, Dr Clancy was notified that he was to be made redundant.
He was given 12 months' notice but was told he was required to work just for a further two weeks.
The court will be asked to grant declarations that the purported redundancy of Dr Clancy was invalid or, alternatively, a declaration it was invalid until respiratory and TB-related services were transferred to another facility. Dr Kelly is seeking a declaration that he continues to be senior hospital medical officer.