The avoidable death of a young child while under the care of our health service is deeply tragic. As we await the outcome of the inquiry ordered by the Minister for Health, Mr Martin, into the death of two-year-old Roisín Ruddle, a number of facts are emerging.
The postponement of the child's cardiac surgery did not arise directly from a lack of current-year health funding. The Eastern Regional Health Authority (ERHA) has confirmed that Our Lady's Hospital for Sick Children receives €1.5 million a year specifically to recruit intensive care nurses. However, there is a chronic shortage of these highly-specialised health professionals, with up to 50 posts vacant at our national centre for paediatric cardiac surgery at any one time. Eight of the intensive care unit's beds cannot be used because of the key role played by specialist nurses in the post-operative management of critically-ill children.
The respected cardiac surgeon Mr Freddie Wood has stated that more children will die if the situation is not resolved in the short term. He has personally had to turn away about six out of 50 patients over the last six months because of the problem. And a senior anaesthetist at Crumlin has expressed fears about the hospital's ability to open new operating theatre facilities this summer because of the embargo on public service recruitment .
While direct funding issues may not be a factor in this week's tragic death, they have a role to play in the poor state of facilities at Our Lady's Hospital for Sick Children. The hospital's infrastructure has been neglected for years, so that the current environment for patients and staff is Dickensian. With many institutions chasing their services, who can blame intensive care nurses if they choose a modern facility in some other country in which to work? They are more likely to choose somewhere that shows an appreciation of their skills by paying a premium for the stressful work they undertake.
Amid the hype surrounding the recently-announced structural reforms for the health system, the immediate crisis within the service had faded from view. Roisín Ruddle's death brings a new perspective. The reforms in the health structures, however worthy, will not impact on the quality of care received by patients for a minimum of three years. In the meantime, there is an urgent need for transitional arrangements if the risk of further tragedy is to be ameliorated.
Publication of the ERHA report on the circumstances surrounding this week's tragic death should be accompanied by immediate corrective action by the Minister. As a minimum, Mr Martin should instruct health authorities to renew the temporary contracts of specialist nurses in the State. He must also order the short-term pooling of nursing resources between Dublin's Temple Street and Crumlin hospitals. And he must approach the Minister for Finance to approve a pay premium for skilled nurses working in specialist areas to maintain entry levels in a noble and much-needed profession.