The ongoing crisis at Peamount Hospital, the de facto national TB centre, reached a new level last week.
The refusal by management at the hospital to accept the transfer of an acutely ill and highly infectious patient with tuberculosis, although supported by a High Court decision, has implications which go beyond the appropriate treatment of that particular case.
Although the incidence of TB in the Republic has stabilised, with just under 400 cases of the disease diagnosed here every year, it remains a dangerous infection with potentially fatal consequences. The lesson from the break-up of the former Soviet Union is that, without an effective national system for monitoring and treating TB, it can quickly run out of control. The latest figures from EuroSurveillance, an infectious disease monitoring organisation, not only show high levels of TB infection in Baltic and East European states, but also indicate the incidence of drug resistant TB is on the rise. Now is not the time to dismantle the TB facility at Peamount, especially in the absence of an agreed and properly funded alternative.
The Irish Thoracic Society, the representative body of specialists who care for TB patients in our hospitals, has labelled the decision to refuse to admit TB patients to Peamount as "dangerous and unsafe". The Irish Medical Organisation and the Irish Nurses Organisation have jointly called for an urgent meeting of the high level group established under Sustaining Progress. And local GPs and community activists in west Co Dublin have also questioned the management decision.
It must be acknowledged that of 330 beds at Peamount, just 60 are designated for respiratory patients. The hospital provides excellent rehabilitation and continuing care services for older people and those with intellectual disabilities. Its five-year strategic plan signals its desire to expand these services by utilising the 450-acre estate in which Peamount resides.
However, no hospital in these islands, regardless of its ethos and history, has the right to abruptly cease to offer a publicly funded service. Nor is it correct that it breach the important and long accepted principle that it is doctors, and not hospital administrators, who decide on the appropriate place of treatment for patients.
It is more than 50 years since Dr Noel Browne made his name by tackling the enormous burden of TB in the Republic. The present Minister for Health, Mr Martin, who will be associated in the same way with the successful introduction of the ban on smoking in the workplace, must intervene to avert long term damage to both TB services and the practice of medicine in the State.