Cavan General to take Monaghan"s acute services

The Health Services Executive (HSE) has finally confirmed its plans to remove all acute care from Monaghan General Hospital by the end of November and to downgrade it to a Minor Injuries Unit. The confirmation came by way of letter to Monaghan Sinn Féin TD, Caoimhghín Ó Caoláin, and has sparked concern about Cavan General Hospital"s ability to cope with the additional load from Monaghan. 'The HSE has confirmed the death sentence for Monaghan General Hospital and the sentence of hard labour for Cavan General Hospital,' said Deputy Ó Caoláin. He sought clarification on the matter after the announcement last week that a new Medical Assessment Unit is to be in place at Cavan General Hospital from October. In a direct reply to Deputy Ó Caoláin, HSE management at Cavan General Hospital confirmed they are continuing to implement the Teamwork Report and to work towards 'the transfer of acute care to Cavan General Hospital, which is targeted for the end of November 2008'. Earlier this year, Deputy Ó Caoláin revealed internal correspondence from senior consultants in Monaghan General Hospital to HSE management stating that plans to remove acute medical services from the hospital could result in a 'catastrophic situation'. Four senior consultants at the hospital - Dr. B. MacMahon, Dr. P. Muthalagu, Dr. CG Murugasu and Dr. Maria Szlyk-Augustyn - signed a letter warning of 'mortality for patients' if acute services are ultimately withdrawn from Monaghan. Pressure Commenting on the latest development, Deputy Ó Caoláin told the Anglo-Celt: 'While a Medical Assessment Unit in Cavan General Hospital in itself would be welcome, it must be placed in the context of the overall reduction in acute beds between the two hospitals and the loss of services, which the downgrading of Monaghan will entail. 'A huge additional burden will be placed on Cavan, where staff are already stretched to the limit.' Deputy Ó Caoláin refers to a claim by the HSE that it will have specific measures 'in place and bedded down prior to or in parallel with the transfer of acute care to Cavan' but asks what 'in parallel' actually means. Meanwhile, a HSE statement has confirmed its intention to proceed with the implementation of the recommendations in the Teamwork Report. The report states that it is not viable to provide full emergency medical services in Cavan and Monaghan as the populations are not generating enough emergency work to justify a full team of consultants and, if such a team were to be placed in such circumstances, they would progressively lose their skills due to lack of the required patient throughput. 'Acute Medicine at Monaghan General Hospital, in terms of the totality of patients it caters for, must rely on other specialties and support services to operate safely and effectively,' read the statement. 'Since Monaghan General Hospital does not have the critical mass to provide the other key specialities and support services safely and effectively, this has obvious implications for acute medicine, which necessitates its centralisation at Cavan General Hospital. The HSE has reiterated that: 'The Cavan and Monaghan hospital group is committed to ensuring that there is a well planned and structured change process, which provides for specific measures to be in place and bedded down prior to or in parallel with the transfer of acute care to Cavan General Hospital, which is targeted for the end of November 2008.' These measures include: the enhancement of ambulance services with a 24-hour service and an additional ambulance taking the total to three, the establishment of a Medical Assessment Unit in Cavan and the conversion of the Treatment Room at Monaghan to a seven day, 12-hour Minor Injury Unit. Some 26 non-acute hospital beds will remain in use in the Monaghan wards for respite and rehab patients, while ten additional community care staff will be based at the hospital for primary care services. The report also aims to reduce the average length of hospital stays, to achieve the same impact as opening 25 new beds. Deputy Ó Caoláin is now calling on all public representatives and the people to oppose plans to withdraw acute services from Monaghan. 'There are currently 3,000 acute medical admissions to Monaghan General Hospital per annum. By the end of November this service will have to be provided by Cavan General Hospital, which already has to cater for 5,000 acute medical admissions per annum and has 160% bed occupancy. This is to be done under this plan without a single extra bed being provided in Cavan,' he said.