The timing of Mr Martin's trip to accident and emergency units at two hospitals is hardly coincidental, writes Eithne Donnellan, Health Correspondent
Why did the Minister for Health, Mr Martin, make a trip to Nenagh General Hospital yesterday and to Ennis General Hospital a few days ago?
The timing of the visits, just weeks prior to the next round of local elections and as the Government, and particularly Fianna Fáil, is under fire over plans to implement the Hanly report, which envisages scaling down accident and emergency units at hospitals in both areas, is hardly coincidental.
While Mr Martin has accused hospital action groups opposed to the Hanly report's recommendations for A&E units at local hospitals of whipping up fear and anxiety in their areas as part of their electioneering in advance of the June 11th poll, his own actions in visiting both Ennis and Nenagh where he reiterated again that neither would lose their A&E units can only have been a case of him trying to beat them at their own game.
In fact even Mr David Hanly, the man who chaired the Taskforce on Medical Staffing, which drew up the Hanly report, said yesterday that, while he didn't want to be drawn into the controversy, he felt one would find that "a lot of what is going on here is very political in the context of the June elections".
And while there has been much hype about the Minister for Health rowing back on what was recommended in the Hanly report for local hospital A&E units it is still unclear for how long the hospitals in Ennis and Nenagh will maintain fully fledged A&E units.
Mr Martin said proposals put forward by the Mid-Western Health Board to staff the units with a new breed of doctor called emergency care physicians, who are neither a doctor in training nor a consultant, were acceptable to him.
In this way, he said, the units would continue to have medical cover.
This is certainly different from what Hanly proposed for these hospitals' emergency departments.
His report said local hospitals should not have fully fledged A&E units unless they had proper back-up staff around the clock in terms of consultant anaesthetists and surgeons, as well as several other consultant specialists.
He said the units should be replaced by nurse-led minor injury units that would only open during the day.
His report stressed that the full range of A&E services "can only be provided in a fully staffed and equipped major hospital".
Saying now that local A&Es in Ennis and Nenagh will soon have fully trained doctors on site around the clock should be good news for each hospital and the communities they serve, but if the rest of Hanly is implemented these units will have to be scaled down so they deal only with minor trauma, leaving major incidents to the nearest large hospital, in this case Limerick Regional.
However, when this might happen, and if it will happen at all, is anybody's guess.
All acknowledge that the Hanly report will take years to implement, and Mr Hanly himself has said the services in place at present should not be removed until 3,000 extra beds are put into the health service and the ambulance service upgraded to take major trauma victims longer distances to major hospitals.
Given that there are no immediate signs of this and no sign of hospital consultants engaging in talks with the Department of Health on new work practices until their worries about a new State insurance scheme for medical malpractice are allayed, the A&E units as currently constituted seem safe enough for several years.