The death of Patrick Joseph Walsh at Monaghan General Hospital last week from a bleeding ulcer has raised serious questions about the manner in which our health services operate.
These matters touch on medical ethics as well as operational and policy issues. There is a compelling need to reassure the public that they will receive the best possible medical treatment if they find themselves in the unfortunate position of being taken to hospital.
Greater urgency is also required in resolving long-standing problems that surround the provision and quality of healthcare in the Cavan-Monaghan region.
The family of the late Mr Walsh is understandably shocked and angry because of the circumstances leading up to his death. He broke his hip three weeks ago and was admitted to Our Lady of Lourdes Hospital, in Drogheda, where he underwent hip surgery. He also received treatment for a bleeding ulcer. Last Thursday, he was moved by ambulance to Monaghan General Hospital, where he died the following day. Attempts to transfer him to three other hospitals for emergency surgery on the bleeding ulcer failed because intensive care beds were said to be unavailable. Monaghan hospital is not permitted to conduct such a procedure. It has since transpired that an intensive care bed was available at Cavan Hospital.
The Minister for Health, Ms Harney, has observed that there is no excuse for anybody dying unnecessarily, regardless of what policy operates in a particular hospital. That is the humane approach. It also reflects the Hippocratic Oath. It is what every citizen would like to believe about doctors, members of the medical profession. Unfortunately, it does not reflect the reality of the health services being operated and funded by the Government.
No doctor should willingly withhold life-saving treatment from a patient. But circumstances can arise, as at Monaghan hospital, where doctors are officially instructed not to conduct emergency surgery, even when the procedure is relatively uncomplicated, as with a bleeding ulcer. Should they disobey the rules and intervene, they and their families are exposed to professional and financial ruin if anything goes wrong. If the Minister wishes to prevent such a situation recurring, she can address the issue of medical insurance cover, the closing of theatres at 5pm and the ban on emergency surgery at the hospital. The silence of the Medical Council on this death is disquieting.
An external review will be conducted into the death of Mr Walsh. That should be a relatively quick and simple task. This unnecessary death, however, reflects a much wider malaise involving healthcare in the region. For decades, political considerations have kept both Cavan and Monaghan hospitals open, but underfunded. Services at Monaghan were reduced. Last December, the Royal College of Surgeons found the surgery unit at Cavan hospital - which provides a joint department with Monaghan - to be dysfunctional. A drastic reorganisation of hospital and surgery services is required.