The Irish Times view on trauma services: the case for an overhaul

When it comes to choosing between their own welfare and the retention of an inefficient system, people sometimes opt for the latter. This became a recurring phenomenon when communities defended “their” local hospitals against a perceived threat posed by improved services elsewhere. Coordinated systems dealing with cancer care, strokes and heart attack went on to reduce death rates significantly, but their introduction generated considerable resistance. The focus has now moved to effective trauma care.

At the moment, 26 hospitals offer trauma care services in the State. But not a single one has all the necessary trauma services on site and one in five patients has to be transferred to a second hospital. In addition, no hospital has a sufficient throughput of severely injured patients to maintain the skills of doctors, nurses and other healthcare professionals. Access to professional care is, therefore, compromised. Failure to address these issues, according to the National Office of Clinical Audit, has resulted in “significant ongoing and avoidable loss of life.”

Some of the most severe cases arise from road crashes. But the majority of trauma injuries take place in the home, involving falls from a height of less than two metres. Older people areparticularly vulnerable, as are children. Reducing the incidence of these low-fall injuries will require better home design and engineering, the report suggests, along with new medical approaches.

The absence of a co-ordinated trauma service means that two avoidable deaths take place every month while four persons face avoidable, long-term disability. The establishment of major trauma systems in London and in Australia reduced the fatality level among patients there by half. Development of a coordinated system here, the report says, would not only save lives, it would reduce the recovery time required for up to 60 per cent of patients. The restructuring of trauma services may be resisted by some local groups and by vested interests. They should be ignored. A coordinated service offers a life-enhancing approach.