The general care and welfare of patients at a Co Louth hospital has been placed in jeopardy through the excess use of resources by consultant physician Mr Colman Muldoon, the High Court heard yesterday.
"The current situation in Our Lady of Lourdes Hospital, Drogheda, has reached crisis proportions," Mr Justice O Caoimh was told.
Mr Finbarr Lennon, a consultant surgeon at the hospital, said the continued excessive use of the hospital's resources and an overcautious policy on the discharge of patients by Mr Muldoon had created "a grave problem" which the majority of his colleagues had wanted sorted out.
Mr Frank Callanan SC, for Mr Muldoon, told the court that his client had been placed on paid leave and barred from entering the hospital. He said the dispute centred on a clash of interests over the length of stay of Mr Muldoon's patients and a policy of health cost cuts by the North Eastern Health Board.
Mr Lennon said decisions had to be taken on occasion to discharge patients who were in a stable condition and sufficiently well to make room for those in greater need of medical assistance.
He said that the individual doctor's right to clinical autonomy could not be exercised in an acute hospital such as Our Lady's without due regard to the rights of other doctors and, in particular, other patients.
Mr Lennon told the court that despite a scrupulous investigation into Mr Muldoon's use of resources in the hospital, he remained oblivious to the chaos he was creating. Seven of his colleagues were satisfied that patient care was being compromised by the manner in which Mr Muldoon conducted his practice.
"I believe as a medical practitioner that this is an unconscionable state of affairs and must immediately be addressed," Mr Lennon said.
Mr Roddy Horan, counsel for the health board, told the court that the hospital had been left with no option but to order Mr Muldoon off the premises. He said administrative paid leave was a temporary expedient.
Mr Muldoon, he said, would have to remain excluded from the hospital until the health board was in a position to introduce new structures, if necessary in consultation with the Royal College of Physicians. The board would be prepared to allow a review of his practices by his peers providing Mr Muldoon remained away from the hospital.
Mr Horan said that since Mr Muldoon's suspension his patients continued to receive the best of clinical care. His excess use of resources and beds had impacted adversely on others in need of hospital care.
Mr Ambrose McLoughlin, deputy chief executive officer of the health board, told Mr Justice O Caoimh that Mr Muldoon had exhibited a total disregard for the resource requirements of his consultant colleagues. He believed there was a serious risk to the welfare of patients.
Mr McLoughlin said he was satisfied that between 1,000 and 1,600 additional patients could and should be treated annually within the hospital if Mr Muldoon performed his duties within the norms of his speciality.
He said Mr Muldoon had refused to co-operate with the board and had actively impeded the board in its attempts to resolve the impasse.
Mr Muldoon is seeking to be reinstated to active duty at the hospital. Mr Justice O Caoimh reserved his judgment until next week.