Recommendations in the Hanly report have been criticised by a hospital consultants' group today who claimed the study raises serious problems for patient access to hospital care.
Dr James O'Hare, a consultant physician and president of the Irish Association of Internal Medicine (IAIM), today told
ireland.com
no plans have been made for the structural expansion of the regional "centres of excellence" to cope with the increased patient load if local hospitals are effectively closed or downgraded.
"If Ennis and Nenagh are downgraded and other local hospitals too, you could have an additional 15,000 patients moving to Limerick. Hanly ignores this issue," he said.
He said the report takes no account of the massive hospitals-building programme required to centralise hospital services.
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Outlining the concerns of more than 65 consultants, Dr O'Hare claimed the Hanly proposals are not "patient centred and raise serious problems for patient access to hospital care."
"The recommendation to move patients directly from primary care to tertiary-care facilities is neither evidence based, necessary nor affordable. Tertiary care is significantly more expensive than secondary care."
He said regional hospitals are already overstreched. "Patients are waiting days on trolleys for admission to acute hospital beds. It does not make sense to further load these centres with extra patients who can be treated locally."
Dr O'Hare says a new hospital doctor grade between junior doctor and consultant should be established - similar to the associate specialist grade in British hospitals. This would be a means of working towards the State's obligations under the European Working Time directive, according to Dr O'Hare.
Under this rule, doctors cannot work more than 48-hour per week from 2009 and 58 hours per week from August 2004. At present junior doctors work an average of 75 hours each week.
Dr O'Hare said there was no disagreement over the need for more consultants. "The worst possible scenario is that the number of NCHDs [non-consultant hospital doctors] drops and the additional workload falls back on consultants, which is unsustainable.
A march by 15,000 people in Ennis to protest at the proposed removal of some services from Ennis General was attended by Fianna Fáil party members.
The issue is also to be discussed by the Cabinet today while the Taoiseach, Mr Ahern, will face questions on the issue in the Dáil this afternoon.
