Varadkar backtracks on St John’s A&E upgrade ‘review’

Mike Dwane


Mike Dwane

Former Minister for Health James Reilly had pledged to 'closely examine' the need for a model 3 hospital in the Mid-West, a process in which the board of governors at St John's Hospital was keen to be involved
ANY hope that the A&E at St John’s Hospital might be upgraded appears to have been dashed by the Minister for Health Leo Varadkar.

ANY hope that the A&E at St John’s Hospital might be upgraded appears to have been dashed by the Minister for Health Leo Varadkar.

In a letter from his private secretary David O’Connor to Limerick City and County Council, it is stated that the current arrangements in relation to emergency care in the region are “satisfactory”.

The hospital board had written to Minister Varadkar’s predecessor James Reilly this summer declaring its interest in being part of any review which might establish a model 3 hospital in the Mid-West.

This was in the wake of a HIQA report on the UL Hospitals group which was damning of emergency department (ED) overcrowding in Dooradoyle and which noted this region is unique in not having a model 3 hospital.

Within the UL Hospitals group, the Dooradoyle site is classed a model 4 hospital, including a 24-hour ED; St John’s is a model 2S and Ennis and Nenagh are model 2 hospitals. Model 3 hospitals offer 24-hour emergency care and a number of politicians have been arguing for the redesignation of St John’s as a model 3 to allow for the return of a 24-hour emergency department.

While there was no absolute commitment from government to upgrade one of St John’s, Ennis or Nenagh, former Minister for Health James Reilly did pledge to “closely examine” the need for a model 3 hospital in this region in the wake of the HIQA report.

St John’s CEO Fearghal Grimes confirmed in August that the board had written to the minister “looking to be formally involved in any review process for upgrading any of the hospitals”. Members of Limerick City and County Council subsequently backed a motion from Cllr Cian Prendiville looking to have St John’s upgraded to a model 3.

But in his response, Mr O’Connor notes that this course of action had never actually been recommended by HIQA. Nor was it sought by UL Hospitals Group itself.

“ULHG, serving a population of some 400,000, is the smallest of the hospital groups and is unique as it does not include a model 3 hospital.

“However, it is noted that the Group’s strategic plan 2014-2016 does not propose any reconfiguration of services to provide a model 3 hospital,” Mr O’Connor states.

“It is also noted that HIQA did not raise any concerns over the fact that ULHG does not include a model 3 hospital. In the circumstances, it is considered that the current arrangements are satisfactory.”

Mr O’Connor pointed to the plan to open a new emergency department in Dooradoyle in 2016.

There was also a need to “ensure services are balanced” across the hospitals “in order to achieve optimal use of the model 4 and model 2 hospitals”.

“By maximising the use of the clinical facilities available in the model 2 hospitals, the pressure on the University of Limerick Hospital ED arising from inappropriate referrals and attendances can be alleviated. The question of the need, if any, for a model 3 hospital might be considered at a future stage as the configuration of services across the group is processed and finalised,” Mr O’Connor states.

But this slim prospect of a model 3 hospital in the Mid-West has failed to impress Cllr Prendiville who this Wednesday accused the government of “breaking another promise”.

“The reality is the closure of the A&Es at St Johns, Ennis and Nenagh has been a disaster. The government recognised this June, when the Minister for Health (Reilly) talked about the need for a review, with a view to restoring A&E services to at least one of the local hospitals.

“Now they are trying to pretend like everything is all right, despite the fact that yesterday there were 30 people on trolley’s in A&E and a further 16 crammed into extra trolleys on the wards - the worst in the country,” Cllr Prendiville declared.