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Meath

Government to oppose SF motion on emergency department closure at Navan Hospital

A Government countermotion has been tabled as health and justice minister seek clarity from HSE.

LAST UPDATE | 21 Jun 2022

GOVERNMENT IS TO oppose Sinn Fein’s private members’ motion on the closure of the emergency department at Navan Hospital. 

Health Minister Stephen Donnelly said the Government would be tabling a countermotion, although he acknowledged that he agreed with some aspects of the Sinn Féin motion. 

The Government motion sets out the proposed changes and states that Navan Hospital will continue to cater for around 80% of current attendances. It cites a patient safety rationale for the downgrade of the emergency department (ED). 

The health minister said the majority of the doctors and nurses working in the hospital have warned about patient safety issues.

However, he added that on the other hand, the GP out-of-hours clinic has also raised concerns about the new proposed Medical Assessment Unit (MAU). 

Controversy 

Controversy has rumbled over the future of Our Lady’s Hospital after the HSE announced the final phase for the Co Meath hospital becoming a “model 2” facility last week.

The HSE insisted that the new MAU will still be able to facilitate around 80% of the current number of patients who present to the ED every day.

However, it has been confirmed that the planned MAU will be based on GP referrals 24 hours a day, seven days a week, while a proposed injury unit will be walk-in.

However, the GP out-of-hours service has stated it has not been consulted about the need for GP referrals, stating that its 24-hour service will be ending in August. 

Despite the HSE announcing the downgrading of the emergency department, Health Minister Stephen Donnelly and Tánaiste Leo Varadkar have said no Government decision on the ED closure had been agreed with the HSE. 

Speaking in the Dáil this evening, the health minister reiterated that the current proposal has not been approved by Government. 

He said he has concerns that additional resources have not been given to Drogheda Hospital.

‘Not satisfied’

Donnelly told the Dáil that he is also “not satisfied” about the access patients will have to the new MAU as well as the ambulance services in the area.

“All these issues have to be addressed,” he said, adding that they have “not been addressed to my satisfaction”.

Donnelly said he has instructed the HSE “not to proceed with any reconfiguration”.  

Justice Minister and Meath TD Helen McEntee also spoke this evening, stating that medical staff have been very clear around their concerns for patient safety. 

While the minister said she didn’t doubt their concerns, she said worries expressed from those working at Drogheda can also not be ignored. 

She told the Dáil that there is a risk of transferring “one risk to another” in terms of patients that would usually be treated in Navan Hospital being sent to Drogheda Hospital which she acknowledged is already “overstretched and overloaded”. 

The minister said there are different opinions at play, but said as representative for the area it is only fair and right that she ask questions and get clarity.

The HSE has not been clear about the additional capacity and resources Drogheda Hospital will get should the ED close and the new MAU be set up, she said. 

Drogheda Hospital capacity questions

Opposition TDs voiced their support for the Sinn Féin motion, with Labour’s Ged Nash, who is also a Louth TD, stating that the downgrading plan for Navan Hospital has been “badly planned and badly executed”. 

Despite seeking answers from the authorities, he said no one could tell him what additional capacity will go into Drogheda Hospital to deal with the increased number of patients.

He said a constituent had been in touch with him today to tell him that her father had been on a trolley in Drogheda Hospital nearly 12 hours waiting to be seen.

“‘And they are talking about sending patients from Navan to this hospital’ she said to me,” said Nash.

Today’s debate comes a day after Sinn Féin held a public meeting in the Newgrange Hotel in Navan on the closure of the ED.

There was only standing room in the function room of the Newgrange Hotel in Navan last night, when Sinn Féin leader Mary McDonald told the crowd attending that it is not true to claim that “taking a knife” to emergency services at Our Lady’s Hospital in Navan will improve healthcare services.

“I have no doubt that people here in this meeting this evening could give countless examples of where that facility in Navan Hospital was essential to you and your loved ones,” she said.

A number of people did speak up.

Deirdre Butler from Kells, one of the 150 or so people that turned up at a public meeting last night said she wouldn’t be here if it wasn’t for Navan Hospital.

Butler explained how she had sought treatment in the hospital after a dog bite, telling the crowd that it was urgent that she was seen quickly. 

She told the crowd that if she had to travel to Drogheda, she doesn’t believe she would have survived. 

“We cannot let this hospital go,” she said.

‘Taking a knife’ to services

Bridget Quinn spoke about having a number of ailments. “I need that hospital,” she said.

A young man stood to his feet to say he had been involved in a campaign to save the hospital over ten years ago, and that he couldn’t believe he was back at a public meeting still fighting for the services to remain in the town.

Independent councillor Gillian Toole, who is also a pharmacist locally, spoke about the pressure that is already on the GP service.

She said that some doctors are already telling patients to go to the emergency department, such is the long wait time to get an appointment with a GP.

Christy McQuillan, who described himself as a trade unionist activist, said the latest struggle “is a community struggle”.

He said he was worried to hear some medical workers speaking out in agreement with the HSE, claiming that they should be fighting to keep services in the town.

“This challenge is as big as we have ever taken on,” he said.

Clinicians at Navan hospital, including the clinical director of the hospital Gerry McEntee, have said that there are serious risks to patient care in how ill-equipped the hospital is to treat sick patients.

“I don’t know if the public really realise but this cohort of critically ill patients, who by virtue of the fact of coming into Our Lady’s Hospital in Navan, are not provided with the best opportunity of survival,” he said.

Headache

As the meeting kicked off last night, such was the crowd that gathered that a divide in the function room had to be removed, an indication that this, while being a local issue, is one that could cause a big headache for the Government. 

McDonald said that the spotlight on the issue by her party was not about votes, and that her Meath TDs, as elected reps, had a duty to listen and stand up for the community.

However, there is no doubt that the fact that a senior minister, Justice Minister  McEntee, and and two junior ministers, Damien English and Thomas Byrne, hail from the Royal County, makes this issue an easy one for the opposition to target Government on.

Rounding on the Meath ministers, McDonald said: “Silence of some TDs in this county is not credible”. She also said that Government TDs “can’t be silent indefinitely”.

McEntee and English have spoken out about the proposed downgrade, with English saying that he is “really, really annoyed” with the HSE and that politicians in the area had been reassured that the new plans for Navan Hospital were done in full consultation with GPs in the area, which he claimed is clearly not the case.

In a statement, English said he had spoken with Health Minister Stephen Donnelly several times in recent days and that he had been assured no decision regarding the HSE’s proposal has been agreed by this Government.

“It is simply not good enough that the HSE tried once again to implement proposals without a consensus from the medical experts in Meath,” he said.

He told the Dáil this evening that it is now time to “tease this through” stating that most Meath TDs want to “do the right thing for health, not for politics”. He said it should be teased out if patient safety issues in Navan can be solved by investment and if not, is there capacity elsewhere to take on the additional patients. 

HSE announcement

McDonald also criticised the health minister and questioned how the HSE made an announcement.

“The HSE says one thing, the minister says another,” she said.

“With no one, it seems to me, taking responsibility and that is unacceptable when it comes to a decision that will have very real impacts on the lives of the people of Navan and indeed the surrounding region,” the Sinn Féin leader added.

McDonald told the crowd last night that the downgrading by a thousand cuts of the emergency services at Navan hospital was “madness”, particularly at a time when emergency departments across the state are under such severe pressure.

“What we need now, to put it very directly, is a bit of cop on. A bit of cop on for Minister Donnelly in particular. I think it’s important that he hears the voices in this room,” she said.

“We can’t achieve the radical improvements badly needed in our health service by taking a knife to emergency services in Navan hospital.

“That’s actually a false argument. The idea that this course of action would somehow improve care, either in Navan or at another location, is simply not true. And the clinicians in Drogheda bear witness to that. Because they tell us already that they struggle to cope. What hope if services in Navan are to cease?

“The example of Limerick should be really taken on board. Ennis closed, Nenagh closed, St John’s closed and when people objected to that, just as you object to the stripping of services at Navan hospital, they were told not to worry.

“That in fact, the situation would improve. Well my friends, it has not.”

McDonald said University Hospital Limerick was “consistently at the top of the heap” in terms of wait times and trolley counts and that it was not acceptable for the HSE or Donnelly to not listen to locals.

This needs to stop now. I think he needs to appreciate the depth of feeling here in Navan, and accept that the people here simply will not stand for the course of action [the Minister] proposes.

Sinn Féin’s health spokesperson David Cullinane was also in attendance last night.

He urged the people of Navan to “mobilise” and to the fill the hall at the next public meeting that is due to be held next week.

“The Government will find it difficult – if not impossible – to take away your hospital” if the community pulls together, if there are feet on the ground and great numbers turn up at the protest march next month.

“I think we can force the Government to do the right thing… people power saved Navan hospital before and you can do it again,” said McDonald.

Another public meeting organised by the Save Navan Hospital group will be held in the town on 30 June with a mass rally organised for Saturday 9 July.

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