HSE director defends MGH poor HealthStat rating

Survey does not reflect patient care, director stresses

Mayo General Hospital and hospitals in the HSE West region have been defended by the director of the regional health office in light of their poor performance in the HSE HealthStat report which was published this week.

The report found Mayo General Hospital to be the worst performing hospital out of 29 surveyed but Dr Seán Conroy said this was “not a damning indictment on any hospital”. He stressed that the report looked at technical issues and was not a measure of clinical care.

Dr Conroy was responding to an outburst by Galway city ccouncillor Pádraig Conneely at this week’s HSE West regional forum meeting who described University Hospital Galway as a “hellhole”.

An angry Cllr Conneely said state hospitals were failing to make the grade and referred specifically to University Hospital Galway which is now a centre of excellence. “You’re bringing cancer patients from Donegal, Sligo, and Mayo into this hellhole,” Cllr Conneely said. “The public know what’s going on. It’s a total and utter mess,” he added.

However Dr Conroy explained that the HSE thought it important to get information about how hospitals are performing under different headings. This week’s report was the first of a series of monthly reports and he urged members not to discuss the issue until May when councillors would have three monthly reports to refer to.

A motion by Mayo councillor Patsy O’Brien to spend 30 minutes discussing the report findings was defeated with the majority of members choosing to wait until May to properly debate the issue when they are in receipt of three monthly surveys and a copy of the reports. Cllr Eddie Staunton asked if Mayo’s poor performance was down to a lack of funding.

Dr Conroy stressed that the survey was not a way of measuring outcomes of patient care — whether they got better, worse, or did not survive. HIQA measures outcome of medical care, he explained. This particular survey is more technical and is intended for doctors, nurses, and hospital staff to see how the hospitals are performing and where improvements can be made.

Dr Conroy also stressed that the bar was set very high by the HSE, otherwise hospitals would have no targets to achieve.

“Yes, hospitals are not performing as well as they could but it’s not fair to worry the public about standards of care when it doesn’t measure that,” he stressed.

The regional director said he would ask an HSE official to address the next forum meeting in May where there will be three monthly reports available to assess if hospitals’ performances are improving or disimproving.

Cllr Conneely clarified that he was not targeting doctors, nurses, or hospital staff when he made his comments.

A&E access

Mayo General performed poorly when it came to waiting times for operations, routine diagnostic tests, and accident and emergency services. A statement from the hospital acknowledged their difficulties while also acknowledging the benefits of this new monitoring system as well as the transparency and accountability that comes with it.

Access to Mayo General seems to be one of the hospital’s major problems with patients being forced to wait on trolleys after being admitted to A&E. In a statement the hospital admitted there are problems in this regard but said significant progress has also been made in recent years.

During 2008 an 11-bed clinical decision unit was opened to help fast track patients through the hospital. Hospital management have also been working closely with GPs to ensure the efficient use of the emergency department and medical assessment facilities.

Another issue was the hospital’s performance within its budget. But hospital management have stressed that Mayo General has delivered on all its financial targets for the last six years and do not anticipate that 2009 will be any different.

The HealthStat system works on a green, amber, and red rating system with Mayo General receiving a red rating indicating it was “unsatisfactory and requiring attention”. No hospital received a green rating.

Hospital manager Tony Canavan has been defending the hospital on local radio this week. He said they were conscious they were starting behind many other hospitals in the country but stressed there were lots of areas in which Mayo General is doing extremely well and where other hospitals can learn from them. “We have made a lot of progress but we have a lot to do. I’m not blasé about that,” he said.

The manager added that there was no simple solution to the A&E difficulties. However, there are indications that things are improving. Mr Canavan outlined measures which have been taken to reduce A&E waiting times and which already have had a positive impact. But he asked the public to give credit to their hospital: “I have no difficultly being accountable because I should be accountable to the people who come through our doors. I ask people to give credit to their own hospital, not to Tony Canavan, but to the hospital.”

Members were told that a meeting between hospital managers and forum members would be arranged locally, and no doubt the debate will resume next month when the next round of stats are published and again in May at the next scheduled regional health forum meeting.

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