FINBAR LENNON,
Sir, - I refer to your editorial on Monaghan Hospital (August 10th) which was fair and balanced and will find broad support within the medical profession. Its final paragraph provides a template to resolve the current controversy and similar ones that are likely to arise in the acute hospital sector in this country.
There is growing consensus at medical, management and political levels that maintaining some general hospitals as acute stand-alone units will be very difficult and may no longer be in the patients' best interests. The cost of manpower, infrastructure and resource requirements are very high. The Minister and Department of Health know this and also know that the new health strategy demands that each hospital entrusted with delivering such services be adequately funded. Other factors that are also important for a viable acute hospital include an appropriate range and throughput of patients and the on-site presence of the necessary professional expertise.
Safe quality care and best practice are not negotiable and must be stringently applied in all hospitals responsible for delivering 24-hour acute medical and surgical services. The clear and firm approach of the medical regulatory authorities to training and best practice is justified.
Failure to address long-standing structural faults in the delivery of acute hospital care not only puts patients at risk but also deprives young doctors of hospital training which in Ireland is widely acknowledged to be excellent.
The above perspective is not inconsistent with the survival, development and enhancement of hospital services in all the country's smaller general hospitals. The challenges facing the North Eastern Health Board (NEHB) are indeed "difficult and unenviable". Your editorial signals the importance and national dimension of its task. - Yours, etc.,
FINBAR LENNON,
Medical Advisor to NEHB
Management,
Our Lady of Lourdes Hospital,
Drogheda,
Co Louth