Serious concern was expressed to North-Eastern Health Board management as far back as last September about the arrangements in place for carrying out surgery at Cavan General Hospital, writes Eithne Donnellan, Health Correspondent
The medical adviser to the management team, Dr Finbar Lennon, wrote to senior officials on September 3rd expressing concern "about the current unsatisfactory situation regarding continuity of patient care and the supervision of non-consultant hospital doctors by locum consultants on particular occasions over the course of the past two weeks".
He had called for all elective surgery to be suspended given the uncertainty which followed the suspension of two consultant surgeons from the hospital over interpersonal difficulties.
However, surgery continued and while the health board refused to comment last night on the specific issue of whether Dr Lennon's advice was followed, a spokeswoman said it had, at first, recruited short-term locums but then recruited long-term locum consultants. However, when these take leave they are replaced by other locums.
Writing to the manger of Cavan General Hospital, Mr Kevin Molloy, and the assistant CEO of acute hospital services with the NEHB, Mr Tadhg O'Brien, Dr Lennon said that in view of the uncertainty about locum arrangement at the hospital it was his professional opinion that "all elective surgical activity should cease pro-tem".
His concerns have been echoed by GPs in the Cavan area since the death on Sunday of nine-year-old Frances Sheridan from Cootehill two weeks after she underwent an appendix operation. An inquiry into her death is ongoing and post-mortem results are awaited.
Dr Lennon's correspondence, released to this newspaper under the Freedom of Information Act, said emergency surgery at the hospital could "only be safely delivered with a stable and consistent locum consultant surgical presence on site".
In a follow-up letter on September 24th to the medical board at Cavan hospital, he wrote: "For nearly three weeks I have not been kept informed by either the general manager or assistant CEO about the situation in Cavan.
"You are in receipt of a copy of my letter of 3rd September 2003 to Mr Kevin Molloy. The concerns I raised in that letter have not been allayed to date.
"Based on the present disposition of management I cannot presume to have any further influence on the situation in Cavan".
The health board yesterday confirmed it was examining 14 adverse incidents which occurred at the hospital since last summer, including a number of deaths about which patients' relatives had concerns.
Meanwhile the Minister for Health, Mr Martin, announced a new national system for the reporting of adverse incidents by hospitals yesterday and revealed that between July 2002 and December 2003 some 25,760 clinical incidents had been reported by hospitals across the State under the system currently in place.