Two of Dublin's major hospitals are joining forces to offer what they claim will be a greater range of care to patients, particularly those requiring specialist services. The move, by the Mater and St Vincent's hospitals, is set to signal a major realignment of medical services in the capital.
The hospitals have signed an agreement with one another and with University College Dublin (UCD) - which is understood to have ceded its medical school to the new group - and will operate as Dublin Academic Health Care (DAHC) from September. As a first step, the hospitals are to integrate consultant and non-consultant posts across the two facilities.
Run by an independent board of directors, DAHC says one of its aims is to give patients greater access to a wider range of specialists. Future medical appointments will be made by DAHC which will decide how much professional time a consultant or junior doctor will spend in each hospital. In line with expected changes to their contracts, consultants will work in teams rather than individually.
Sources said the catalyst for the development was threefold. As well as improving patient access to specialist services, the creation of a critical mass for health research and the expansion of medical training places were key aims.
Based on current numbers, DAHC will have more than 1,400 beds and will treat about 100,000 inpatients a year.
The Irish Times understands that UCD has given a commitment to cede its medical school to the new entity. It is understood that both the Minister for Health, Mary Harney, and the Minister for Education, Mary Hanafin, have responded positively to the development, while the Health Service Executive (HSE) has also been briefed on the plan.
Sources have also said that DAHC is open to other hospitals joining, with Cappagh Hospital, St Michael's Hospital, Dún Laoghaire, and Loughlinstown Hospital seen as likely candidates.
While there will be no reduction in the level of service given by each hospital to patients in its catchment area, the patients most likely to benefit from the development are those who require specialist expertise in specific disease areas (subspecialisation).
For example, with up to 15 consultant cardiologists employed by DAHC, each consultant will offer an individual expertise in a different subspecialist area of cardiac disease.
In the area of respiratory medicine, the national cystic fibrosis treatment unit at St Vincent's will have closer ties to the national lung transplant centre at the Mater.
"The overall benefit to patients is that the standard of care in both hospitals will be elevated as a result of achieving a critical mass and by the development of subspecialisation services which do not currently exist," Kevin O'Malley, consultant vascular surgeon and chairman of the Mater Hospital Medical Council, said.
Dr Risteárd O Laoide, consultant radiologist and chairman of the medical board at the St Vincent's Healthcare Group, told The Irish Times: "I hope this development will bring more co-operation and synergies, that it will transcend institutional rivalries and that it will create a more seamless environment for optimal patient care."
The Dublin Academic Health Care board will be chaired by Thomas Lynch, chairman of Amarin Corporation, a pharmaceutical research company. A director of IDA Ireland, he also chairs Queen's University of Belfast Foundation. Senior representatives from UCD, St Vincent's and the Mater are members of the board.
"International experience shows that where universities and hospitals combine . . . they have the ability to make an enormous contribution to patient care," Mr Lynch said.
Meanwhile, the board of Trinity College Dublin has announced plans to establish an integrated medical centre - the Trinity Academic Medical Centre (TAMC) - in collaboration with its major teaching hospitals, St James's and Tallaght hospitals.
"It is intended that the TAMC will eventually operate as a composite entity with a single board and mission," the university said in a statement.