Madam, - The recently published Hanly Report, which proposes the closure of acute medical, surgical and accident and emergency services at the General Hospitals in Ennis and Nenagh, does not have the support of the general practitioners in Co Clare.
There are some aspects of the report that we welcome. In particular, the expansion of hospital specialist numbers to enable the provision of an improved and easily accessible consultant provided service.
However, the loss of acute services in Ennis, effectively reducing the hospital to a day care unit, concerns us greatly and will lead to a deterioration in medical care. The downgrading of Ennis General Hospital is unacceptable.
We, as general practitioners, oppose Hanly's intention to centralise all acute medical care to Limerick Regional Hospital. We believe that this proposal is fundamentally flawed. Centralisation to bigger institutions will not, in our view, lead to a more efficient or a more effective medical service for the vast majority of patients who can be appropriately treated and, in a more cost effective manner, in peripheral general hospitals.
Hospitals like Ennis and Nenagh have been starved of proper development funding in the past. Yet, in spite of this neglect, they have continued to provide exemplary service to their local communities.
Such hospitals should be adequately resourced to expand their services rather than be downgraded. Adequately resourcing general hospitals and increasing their consultant staff numbers can be accommodated with flexibility and imagination, while still meeting the staffing levels required by Hanly and, at a vastly reduced capital outlay.
In relation to the closure of Accident and Emergency services at Ennis General Hospital, the transit time to Limerick Regional Hospital, from many areas in Clare, West and North of Ennis, for seriously ill patients, is in excess of what is internationally acceptable.
Hanly has not taken geography and seasonal demographics into account. Co Clare is a very popular tourist destination and the holiday resorts along the west coast have an explosion of population during the summer months. These visitors will be as vulnerable as the local population should they need acute care.
Finally, we believe that the Hanly model for acute hospital services is more suited to large urban centres which have a high population density and where geography is not an issue. - Yours, etc.,
Dr MICHAEL HARTY, Chairman, Clare Faculty, Irish College of General Practitioners, Kilmihil, Co Clare.