High mortality rates in Limerick could be linked to health spend

Mike Dwane

Reporter:

Mike Dwane

A SENIOR HSE official has said there is no conclusive evidence to demonstrate higher mortality rates in Limerick and Mid-West are related to the relatively poor resources put into the region’s health services.

A SENIOR HSE official has said there is no conclusive evidence to demonstrate higher mortality rates in Limerick and Mid-West are related to the relatively poor resources put into the region’s health services.

But health spend could be one of a combination of factors behind CSO data showing Limerick city had the highest death rates in the country and that no region tops the rate of the Mid-West as a whole, according to Dr Patrick O’Sullivan, assistant director of public health, HSE Mid-West.

Limerick doctors have suggested the consistently high rates in the city are linked not only to social deprivation but the relatively low health spend in this region.

The Mid-West received a total allocation of €608 million in 2011 - €3 million less than what was allocated to Galway/Roscommmon, a region with 64,000 fewer people. Per capita health spending in the Mid-West in 2010 - at €2709 - was below the national average of €2830 and fell significantly short of the €3095 average spend in the HSE West, which stretches from Limerick to Donegal.

Dr O’Sullivan said there was no one reason for Limerick’s high rates but that “access and expenditure are probably part of the equation”.

“There are agendas going on as well in terms of people fighting for resources and prioritising needs. Everybody is fighting their corner these days in terms of resource deficiencies and so on. But I wouldn’t like people to think it’s all death and destruction in this area. There are a lot of positives here which don’t get highlighted so much. We have been very busy this year statistically and we are seeing more patients than in other years,” he said.

Efforts to provide clear pathways to care in the region’s acute hospitals, as envisaged under the process centralising complex cases from smaller hospitals at Limerick Regional, could in time see mortality rates improve but it was too early to say this definitively, Dr O’Sullivan said.

“I would not wish to criticise colleagues in the acute services but obviously there is a factor of what you have access to and who is delivering what service. For instance with the cardiovascular, we are addressing this by centralising coronary care services into the Regional Hospital in Limerick because we know that there is a numerical factor if you only see one or two patients a week or a month (in county hospitals), you are going to be less expert in dealing with it than somebody who is dealing with it every day.”

International best practice was to centralise such complex care and moves to reorganise the Mid-West’s hospitals into trusts were inspired by the desire to standardise and improve care across the region.

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