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How many HSE doctors does Navan hospital's emergency department have? None

Four of the five locum/agency doctors at the hospital’s emergency department went on wildcat strike two weeks ago in a row over plans to slash their rate of pay.

shutterstock_378639124 Shutterstock / Blur Day Blur Night Shutterstock / Blur Day Blur Night / Blur Day Blur Night

A HOSPITAL IN Co Meath currently has no non-locum/agency doctors working in its emergency department.

Our Lady’s Hospital Navan (OLHN) recently became a centre of controversy when it emerged that its emergency department was on the verge of closure due to staff shortages after agency medical staff declined to turn up for at least four days.

While at least three other hospitals were affected by the stoppages, Navan was particularly exposed due to its higher ratio of agency staff to HSE employees.

That situation, which first came to light a fortnight ago, lasted for most of a week with the department eventually bolstered by staff drafted from other areas of the hospital, until the HSE was finally able to replenish the hospital’s roster using alternate agency workers four days later.

Now new figures released to TheJournal.ie show that every doctor currently working in the hospital’s emergency department is a locum (a temporary replacement for a permanent worker, typically earning a far higher rate of pay).

A spokesperson for the HSE said that there are five agency doctors in the department who rotate shifts, and who have access to a consultant’s advice after hours (with that consultant typically being based at another hospital).

Work stoppage

The five doctors described above staff the hospital’s emergency department on a rotational basis. Each of them is an agency worker, retained at an hourly rate of €75.60 (more than double the pay of a staff registrar), or an annual cost of at least €766,000 (sources suggest this figure is in reality in excess of €900,000).

navan Our Lady's Hospital Navan Google Maps Google Maps

It’s understood that four of those five doctors failed to show up for work from Monday 4 September, while at least one of the missing has since returned to work at the hospital.

Those five doctors join roughly 23 nursing staff, an emergency department consultant, and an associate specialist (neither of whom are full-time) in forming the department’s total complement of staff.

The situation which sees all doctor positions within the department filled by locum staff has been in place since at least January 2016.

Work stoppages by agency staff ensued at Navan and at least three other hospitals two weeks ago in a row over pay, with the HSE attempting to slash the hourly rate of agency staff in an attempt to bring it more in line with that of in-house workers.

The HSE has struggled in recent times to fill permanent positions given the more attractive rates on offer to workers retained from outside the health authority (LocumExpress being one such agency for temporary medical workers utilised by OLHN).

Navan hospital has faced an uphill task in filling permanent positions in the emergency department for over a decade since a decision was taken to limit the number of consultancy sessions on offer for doctors each week to eight (which is not sufficient to qualify for training recognition by the Royal College of Surgeons in Ireland [RCSI]) in the early 2000s.

“The emergency department in Our Lady’s Hospital Navan has five agency registrars (doctors) who rotate shifts,” a spokesperson for the HSE said when contacted about the ratio of agency-to-HSE staff at Navan by TheJournal.ie.

The Ireland East Hospital Group has put in place a formalised arrangement where the locum emergency department registrars will have access to consultant’s advice after hours [it's understood that the consultant in question is based at the Lourdes hospital in Co Louth, situated 17 miles to the east].

It has long been suggested that a long-term plan with regard to Navan is to transfer the hospital’s emergency facilities to the Lourdes in Drogheda, in line with the closure of similar departments in Monaghan and Dundalk.

Campaign

A local campaign to save the provision of services at OLHN has been operational since 2010.

Chair of that campaign, Sinn Féin TD Peadar Tóibín, has decried the situation which has left the hospital’s emergency department staffed entirely by agency doctors, describing the “near collapse of service” as “scandalous”.

“The reason why Navan was so especially exposed to this strike is that our emergency department is scandalously staffed 100% by agency doctors,” he said.

What organisation in the world would staff an emergency facility with personnel that are far more expensive than full-time staff and are by definition far more transient?
It has come to light that two-thirds of the consultant surgeons within our hospital are to be let go this October. While these positions may yet be re-filled, the changes and lack of continuity are yet another blow to our hospital. Our emergency department was on a HIQA (Health Information and Quality Authority) list of nine emergency departments throughout the state that were to be closed. All of the others are gone. Navan is the last one standing.

“It is clear to me that because of the health authority’s staffing strategy and the attendant loss of services that the HSE see Our Lady’s Hospital emergency department as a temporary site. There are 200,000 people in the county. HSE chaos in surrounding hospitals means we don’t have alternatives,” he added.

It is not the first controversy to affect the hospital in recent times. In late June the HSE confirmed that OLHN had yet to establish a fully operational mental health day service, some nine months after the closure of the 24-hour psychiatric unit at the hospital.

Read: Fine Gael is riding high in the latest opinion poll

Read: Poll: Would taking disciplinary action against gardaí over fake breath tests be ‘a waste of time’?

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24 Comments
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    Mute gareth kavanagh
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    Jan 3rd 2013, 12:21 PM

    My thoughts and prayers are with all effect by this.

    163
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    Mute John O'Sullivan
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    Jan 3rd 2013, 12:11 PM

    What a load of crap – I’m originally from the town and was actually there on Saturday and heard the horn sounding.

    Years ago the only way to summon the fire brigade was to go to the town hall, break the glass and activate a siren that sounded all over the town – that drove all the dogs mad as well and no one complained about that.

    Mr. Fitzgerald and his council colleagues would be better exorcised trying to keep businesses open in the town which are being strangled by idiotic parking regulations and mercenary traffic wardens

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    Mute Richard O'Callaghan
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    Jan 3rd 2013, 12:21 PM

    Well said. You are probably too young to remember the hooter from the Tannery – bloody thing used to wake the whole town every morning. On hols as a kid down in Carrick it used to scare the life out of me.

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    Mute John O'Sullivan
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    Jan 3rd 2013, 12:35 PM

    I remember it well – morning, lunchtime and then again in the evenings. It was a steam hooter run off the boilers in the tannery

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    Mute Collie Bartley
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    Jan 3rd 2013, 1:26 PM

    In fairness to the others, it is just bobby running on this , and again earlier in the year on another station related nonsense.

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    Mute Pubcrawler Pubcrawler
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    Jan 3rd 2013, 11:58 AM

    quiet right too. It is just politician jumping on a bandwagon to get noticed

    143
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    Mute Paul Doyle
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    Jan 3rd 2013, 11:57 AM

    Blow my whistle baby, whistle baby let me no

    68
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    Mute everlast mccarthy
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    Jan 3rd 2013, 1:04 PM

    Any chance of restricting annoying Councillor’s unnecessarily sounding off?

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    Mute Alan Quinn
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    Jan 3rd 2013, 12:07 PM

    It must be the slowest moving object on the planet. This must be the only country in the world that a public bus is faster than the train, Galway to Dublin in 4 hours but sometimes your treated to a bus ride from Athlone when it breaks down.

    65
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    Mute William English
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    Jan 3rd 2013, 1:11 PM

    Train services between Galway and Dublin range from 2hrs and 35 mins to 2 hours 50 mins, quiet a bit off 4 hours…

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    Mute Alan Quinn
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    Jan 3rd 2013, 1:36 PM

    I know what its supposed to be William but my last 4 journeys were at least 3.45 – 4 hrs

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    Mute William English
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    Jan 3rd 2013, 2:13 PM

    I find that hard to believe, you must have had serious terrible luck in that case. Using that line very regularly, my last ten trips on which only one was delayed by more than five mins and that was due to a medical stop where a passenger had a suspected heart attack and the train had to remain at the next station until an ambulance arrived.

    And there is no bus which will get you from Galway to Dublin in less than 2 and a half hours.

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    Mute John Handelaar
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    Jan 3rd 2013, 3:52 PM

    Cork Kent to Heuston by road: 2h23m (Source: Google maps). Which assumes nobody ever exceeds the limit in a car.

    Average time by scheduled rail: 30 mins more.

    We have a third-world railway.

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    Mute Michael Skellig
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    Jan 3rd 2013, 5:52 PM

    No John, we don’t have a third world railway. We have a small country with good motorways between main cities.

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    Mute Alan Quinn
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    Jan 4th 2013, 1:02 AM

    Luck has nothing to do with it. The bus is 2.30 btings u into the city centre/ O’Connell street and costs half the price. We are one of very few western world nations using diesel trains still. And I’ve had to get a bus from athlone on 2 previous ocassions for sheep on the track or something. 3hrs min at least is the shortest journey.

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    Mute Richard O'Callaghan
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    Jan 3rd 2013, 12:15 PM

    Train drivers receive instructions to sound their horns at certain spots, especially in places where the may be line works going on. Train doesn’t go through Carrick that often anyway.

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    Mute Donncha Lane
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    Jan 3rd 2013, 12:35 PM

    As a friend of mine says: ‘SAVE YOUR HORN FOR YOUR WIFE LOVE!’…….:)

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    Mute Gus Whearity
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    Jan 3rd 2013, 12:00 PM

    I love it when the train gently takes of then slowly moves up the track gathering pace all the time. It’s getting faster now with the tunnel in sight. The train bursts with excitement as it enters the warm tunnel …… Be right back ;-)

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    Mute Creamy Hamstrings
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    Jan 3rd 2013, 12:03 PM

    Bursts with excitement as soon as it goes in?! I feel sorry for your missus

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    Mute Gus Whearity
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    Jan 3rd 2013, 12:12 PM

    Missus ????

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    Mute sean
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    Jan 3rd 2013, 12:56 PM

    Interesting how Bobbys office is right next to the station lol, but have to agree, it is fairly disturbing at 7am. My only concern is that we only get 3 trains each way per day and one of those is already under threat. The train beats the bus hands down on comfort, speed and costs so let’s not jeopardise this.

    I think what would solve the issue amicably is the installation of an automatic barrier. No need then to blow a horn (this really is the only reason to blow a horn) and less time spent waiting for the barrier to be opened for traffic (sometimes 10 mins).

    On a side note though, working in Waterford, I’d actually like a train to arrive at 8.30 in time for me to start work! Not at 10.35 which may be ok for the occasional shopper. The last train is at 4.40 from Waterford which also makes no sense at all. Irish rail should start using some common sense and run a working schedule. Revenues would increase exponentially on the route as there are many people travelling from Clonmel and Carrick who work in Waterford. I though Irish rail wanted to make money, but I guess as a semi-state organisation that’s probably asking too much!

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    Mute Collie Bartley
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    Jan 3rd 2013, 1:02 PM

    Did u verify the 100, or even ask to see if a hundred complained. this is such nonsense story – it really is

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    Mute vanessa
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    Jan 3rd 2013, 1:44 PM

    It’s great to see Bobby dealing with the real issues in Carrick-on-Suir! The rate of unemolyment in the town is huge with little sign of any new businesses or investment coming into the town but that’s obviously not a priority for this public representative!

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    Mute Collie Bartley
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    Jan 3rd 2013, 1:03 PM

    This is also a councillor who complained that so0me one could die if the railgate was down when a ambulance was passing – again a once in a life time occurance,

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    Mute Joseph O'Brien
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    Jan 3rd 2013, 1:06 PM

    Carrick-on-suir has a high proportion of small rail crossings between fields, farms and other land. That is likely the reason for sounding the horn so often, to reduce the risk of accidents. As it is there are only three return services passing through it everyday. These will probably be the same people crying about their reduced rail service in a couple of weeks when then new Irish Rail timetable comes into effect.

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    Mute MariaPiaSavoyKelly
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    Jan 3rd 2013, 1:39 PM

    I can barely believe that I’m reading this…

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    Mute _doesnotcompute
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    Jan 3rd 2013, 2:17 PM

    Believe it. Irish parish pump politics at it’s worst.

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    Mute Emr Daly
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    Jan 3rd 2013, 2:25 PM

    This story really made national news?? Yes the train is needed for Carrick, and yes the horn is there for a bloody reason… if someone was hit along the track and the train horn had not been used.. would that councillor be as quick to discuss the use of a horn then??

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    Mute tommy phelan
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    Jan 3rd 2013, 7:49 PM

    I grew up next to that station at a time when beet, mail and liner trains ran through the night. They weren’t silent rail cars back then, but noisy locos that you would hear passing thorough kilsheelan let alone carrick. No one complained back then. I’d say one person said it to bobby and he jumped on his political high horse, just like the rest of them.

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    Mute Michael Skellig
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    Jan 3rd 2013, 5:53 PM

    I’m sure the train driver is hooting the horn out of safety considerations. People will complain about anything these days. Years ago, people like that were ignored and called moanbags.

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    Mute Dr.fury
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    Jan 3rd 2013, 11:30 PM

    I heard the drivers were told honk if you think Carrick on suir is full of councillors and people with too much time on there hands to actually do something useful for the town

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    Mute rail commuter
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    Jan 9th 2013, 7:27 PM

    Has the learned councillor raised his concerns with the railway safety commission ? He appears to want Irish Rail to abandon long established safe working practices. Carrick must be a really quiet place if the councillor’s top issue is the sounding of a train’s hooter half a dozen times a day.

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    Mute Ciaran De Bhal
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    Jan 3rd 2013, 6:08 PM

    Maybe Irish Rail could replace all their horns with really loud bells and buy themselves some time and keep everyone happy in the short-term. Simple

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