Stop Merlin vanishing into thin air say worried consultants

Unit 4 at Merlin Park Hospital. Photo:-Mike Shaughnessy

Unit 4 at Merlin Park Hospital. Photo:-Mike Shaughnessy

Leading hospital consultants are urging the public to “stand up and support” Merlin Park Hospital amid fears that most of the facility will be closed down by the HSE in the next few weeks as part of cost cutting measures to help the authority balance its books.

Despite assurances from the HSE that there are no plans to close the hospital on the east side of the city there is still widespread concern among medical professionals about the future of the hospital.

This comes in the wake of a letter from the HSE last week notifying Merlin Park’s orthopaedic service of proposals to suspend elective [planned] surgery (such as hip and knee replacement, back, foot and ankle surgery and shoulder replacement ) and close medical wards at the hospital from September in a bid to tackle the debts hanging over University and Merlin Park Hospitals. This controversial decision would result in the closure of the facility’s stroke unit - the only dedicated one in the west. The two long-stay units for older people and the dialysis unit would remain open.

This proposal comes on top of seasonal money saving closures at Merlin Park which are due to come into effect for three weeks at the end of this month.

Mr William Curtin, a consultant orthopaedic surgeon at the hospital and one of seven such consultants at the facility who are concerned about the HSE proposal, fears it is an attempt by the HSE to “test the water”. While the radical decision may not be implemented now the health authority is “stirring the first ripple” and it may be introduced further down the line, he warns.

“We see the suspension of surgery as a closure. Obviously, there is a worry from our perspective that if you take people out and suspend a service, that that service will never open again. These things are brought up to test the water. Maybe they won’t do it now but they are stirring the first ripple. When it’s brought up again it won’t be new anymore. The spectre of closure was put past us last week. Since we broke the news [publicly] on Monday there has been an apparent row back.

“The HSE says the proposal is a reconfiguration but there has been no discussion with us. If it closes in September where will the service be moved to? Noone has told us it is being moved anywhere else. They [the HSE] can’t move it because there are no facilities for it in UHG. We have a dedicated ringfenced elective service, they can’t shift it anywhere else. It has specific requirements, ie, clean-air theatres to allow us to do implant surgery.”

He says he and his colleagues feel obliged to act as advocates for their patients. “What will happen to the elderly woman with hip arthritis if they close the service? She will attend her GP more, be in more pain, be on more medication, have more complications, more deformity and if she goes for an operation down the line it will be more difficult with a longer stay in hospital and more physiotherapy.”

Mr Curtin, who began working at Merlin Park Hospital in 1996, is urging the public to lend their support to the campaign to keep the hospital open.

“We want to mobilise public opinion. People in the west of Ireland benefited from this resource and need to fight to keep it going and to reject any suggestion of closure. We don’t want to see this proposal come up in six months again. We need enough of a reaction from the press and the people that this is not good enough. Why should the people of Galway and the western seaboard not have elective [orthopaedic] surgery? Do you want to have to go back to Dublin for it? People need to stand up and support the service. You never know when you will need it. It’s not just the people of Galway who will be affected. We get referrals from Limerick to Donegal to Kerry.

“We’ve taken as many cuts as we can. We are not going to take any more. I feel sorry for HSE management, they have a budget which is inappropriate to the amount of work we do. If these closures go ahead they will have an adverse knock-on effect on the most disadvantaged elements in the west of Ireland, there will be more disability and pain for very mediocre savings.”

Labour TD Michael D Higgins says the threat to medical facilities at Merlin Park Hospital is a matter of major public concern.

“Reports of meetings held between the HSE and consultants in recent days should be a matter of the greatest concern for all those who live in the western regions which it serves. The reported proposals which suggest the closure of facilities such as the dedicated stroke unit are appalling in themselves. The manner in which the HSE is putting together these proposals is neither transparent nor inclusive of practitioners and patients.

“Facilities have been built up at Merlin Park which have acquired a reputation for excellence in areas such as orthopaedic surgery and other areas. A great deal of effort has gone into the establishment of teams of personnel to which, however inadequately, and slow, were attached capital provision for equipment and building refurbishment. This was all to the benefit of the public in the west and it seems an extraordinary exercise in short term budgeting, without consideration of the consequences, to simply close the door on what has been painfully built up.

“What is in the reports as to what will remain causes me even greater concern. It has long been like a hovering ghost in recent times for the grounds of Merlin Park to be released for use other than for medical purposes. I hope the public will respond to this latest report by indicating to the HSE and their public representatives their support for the services of Merlin Park.”

Meanwhile unions representing concerned staff at University and Merlin Park Hospitals are seeking a meeting with hospital management about the health cuts.

In a letter to Dr David O’Keeffe, the clinical director of the HSE West, Janet Hughes, the assistant general secretary of IMPACT in the west, said all unions were seeking an urgent meeting with hospital management about its financial situation and planned cuts to meet the imposed break-even standard.

“We do not accept that UHG as a hospital is overspent, but rather that it is underfunded and understaffed and yet increasingly expected to deliver more for the allocation,” the letter reads.

“All staff and unions are ready and willing to engage in discussions with hospital management about how we can work together to improve efficiencies and services in the two hospitals at Newcastle Road and Merlin Park.

“In making decisions regarding the organisation and delivery of services through the hospital, management cannot assume the co-operation of the unionised workforce unless there are negotiations about the changes. Any attempts to break existing agreements as part of the planning process, will be resisted. Changes made solely for the purpose of saving money, will not in the main, be achieved without negatively affecting the level and quality of services, including access to those services.”

In a statement the HSE West insisted there are no plans to close Merlin Park Hospital.

“It provides a wide range of services as part of the Galway University Hospital campus and will continue to provide health care for patients. The GUH management team is looking at streamlining services and planning on removing duplication of services that are provided on both sites. Currently both University Hospital Galway and Merlin Park Hospital provide acute hospital services. The management team for GUH is planning to implement the Strategy for the Future as previously agreed by the medical board of the hospital to concentrate the acute services in University Hospital Galway and the elective (planned ) services in Merlin Park University Hospital. This will reduce duplication of costs and provide better quality services for patients.”

It outlined that hospital management is developing a cost containment plan to ensure that the hospitals can deliver on service targets while remaining within allocated budget.

“This plan will examine all areas to see where efficiencies and cost savings can be made. This plan has not been finalised and no decisions have been taken at this stage. Despite the financial challenge faced this year, HSE West will deliver the level of care and service targets for which it is funded, as set out in the 2010 Service Plan. This includes 14,878 inpatients, 30,000 day cases and 85,000 outpatient visits which will be delivered in 2010.

“In the first six months of this year GUH has actually carried out more procedures, treatments and clinics than it is funded to do – more than 15 per cent in some categories. The hospital cannot continue to do this regardless of its allocated budget and its agreed service plan. As such, a cost containment plan will be agreed to ensure that services continue to be provided to year end and that service targets can be met.”


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