The Writing's On The Wall

Tuesday, 25 April 2017

The Writing's On The Wall thumbnailMEMBERS of the Save Daisy Hill Committee, from left to right Fiachra Fullerton, Sarah Devlin, Gavin Malone and Seana Grant with Louise Young, Canal Court Hotel Manager pictured ahead of last night's public meeting.

A FORMER member of the South Tyrone Action Group (STAG), which tried, unsuccessfully, to save acute services in the South Tyrone Hospital has issued a frank warning as regards services at Daisy Hill.

Mr Jim Kerr was involved with STAG for 17 years, and outlined that, in his view, the permanent closure of the Emergency Department at Daisy Hill is very much a possibility.

The campaign to save acute services in Dungannon began with a fight to save its maternity department, with protests of 25,000 people taking to the streets and pregnant women chaining themselves to beds back in 1999.

That struggle lasted some five to six years, before STAG eventually had to concede defeat.

The closure of the A&E department followed, and today South Tyrone Area Hospital is effectively closed, bar the minor injuries unit, at 5pm each day.

In Mr Kerr's view, services at hospitals like Daisy Hill are like "a house of cards".

He explained that one of the three general surgeons who used to work in South Tyrone left, which meant that the other two were under increased pressure. It proved difficult to recruit other surgeons because they wanted to work in the bigger hospitals.

“Once the surgeons went, everything else went," said Mr Kerr.

“Because it's like a house of cards. Once that goes - you might be able to keep some things in the hospital, but not everything because there's nobody there to really deal with emergencies from the patients who are actually in the hospital."

Mr Kerr says that the loss of general surgeons at hospitals such as South Tyrone and Daisy Hill stems from the increasing specialisation trend among medical practitioners.

“South Tyrone Hospital was a small local hospital," he said.

“South Tyrone had a population, that it was serving, of about 80,000 people. And in the late 1990s, there were three main surgeons in the hospital along with other consultants who were acute medicine people.

“If you had a car accident and you came into A&E, then one of the on-duty consultants would have rushed down, and said: 'Right this guy needs his leg amputated, or needs something done - bring him up to theatre straight away.'

“But then later on that day, that same surgeon would be taking out your appendix, or would be carrying out heart surgery, or whatever.

“That was the norm in those years, but what has happened in the last 20 years or so has been specialisation. So you will get specialist A&E consultants who only do A&E, you will get specialist surgeons who only do orthopaedics, or who will only work on lungs.

“But you need three of those for each of those specialities because each one has to get time off. So 80,000 people wouldn't justify enough work for three orthopaedic surgeons, three surgeons who are doing whatever - you are talking about maybe 30 or 40 consultants in the hospital."

Mr Kerr points out that this specialisation trend has been brought about by advances in medical practice, and by the demands of the general public.

In Mr Kerr's view, what also places a hospital like Daisy Hill in peril are fears over litigation, amid warnings that with the lack of doctors and adequate cover, the hospital may be "unsafe".

Giving the example of an unwell child, Mr Kerr said: "[Let's say] your child gets rushed to Daisy Hill and there isn't a specialist paediatrician on call to deal with that child, but there is a team in Craigavon who are on duty all the time.

“[If] the paediatrician has to rush from Craigavon and by the time that he gets there, the child is not well enough to be operated on - the first thing you would be saying is why am I not getting the same treatment there as I would in Craigavon?

“Some people will start saying: 'Right, we're going to sue you, because you actually hadn't got a team to be able to deal with my child there'.

“So that is classed as being unsafe from the medic's point of view. They are trying to protect themselves because they don't want to be left open because they haven't got all the required people that should be there to look after that child."

On the bright side, Mr Kerr explained that the doors of South Tyrone Hospital were able to be kept open because local people adapted to the circumstances in which the hospital found itself.

“Our community, with donations, built two of the best operating theatres in Northern Ireland," he said.

“We also bought a CT scanner - the community raised up the funding. That CT scanner is doing most of the outpatient scans for the Southern Trust area.

“Our operating theatres - people come from all over the Trust for day procedures.

“And the other thing that we fought for very hard, and we've been pleased with it now, is a minor injuries unit. Minor injuries might seem like a misnomer, you might think that's pathetic compared to an A&E.

“But 90 percent of all injuries are minor injuries, and they can be dealt with by doctors very, very safely.

“And whenever we had a full A&E in South Tyrone, the doctors and nurses there were dealing with 24,000 patients a year.

“South Tyrone minor injuries unit is now the biggest in the UK. There are 31,500 patients a year going through there. And they are coming from Newry as well to go to it sometimes because they can't wait in Newry or Craigavon."

Looking at the situation in Daisy Hill hospital with an outsider's eye, but crucially with direct experience of a very similar situation, Mr Kerr said: "I hate to have to say it, but if it's based on what way things are going at the moment, and also the fact the health service is under-funded and that there aren't enough doctors to go around, they will play this 'unsafe' card.

“And once they play it - nobody can fight it because if a doctor's says it's unsafe, what do you do?"

“What I would suggest that the people of the area look at is: 'OK, let's have a look at our hospital here, let us educate ourselves on what we actually can keep here.'

“And look at other places, maybe models in Scotland and places like that where there are a lot more isolated places than here which have got full size hospitals going, and which are being maintained by local trusts because of where they are.

“They are not going to be able to keep everything, and almost certainly I would say - the way things are going at the moment and because of the demands of the public - I would see that A&E will not be viable for much longer in Daisy Hill."


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