HSE head admits A&E may have to be cut back

The head of the Health Service Executive, Professor Brendan Drumm, has admitted that a questionmark hangs over the future of the Accident and Emergency service at the Midlands Regional Hospital in Mullingar.The Professor, who spent some hours in the hospital on Wednesday of last week, speaking bluntly regarding the current economic climate, said it was hard to justify keeping three A&E access points open across the midlands, where the population is relatively small: 'In the midlands you have three open every night for a relatively small population and it would be extraordinarily difficult to justify that going forward,' said Prof. Drumm.'Keeping three hospitals open every night in this area costs us €30,000 a night in overtime alone, for what are ultimately very small volumes of work after 10 or 11 o"clock at night.'I"m not sure that can be sustained going forward.'t was a problem the HSE faced right throughout the country:'There are A&E services open across this country in more places than they are required, and indeed in more cases than they can be afforded at this point in time,' he said. 'It would be completely wrong of me to sit here and say that A&E services in any hospital in this country aren"t subject to review at this point. I think there is something to review everywhere in terms of the costs that are there in our present system.'However, Prof. Drum did not spell out when and how the services would be scaled back:'We don"t have is a specific plan of how to address that at this moment, and that is something that I suspect will have to be addressed across the midlands, and indeed between the midlands and some of the outlying Dublin areas over the next 12 to 18 months,' he told the Westmeath Examiner.Prof. Drumm also said cuts in staff numbers were likely:'There will be a decrease in numbers in the health service because the tax payers are not going to be able to pay the number of people we have,' said Prof. Drum.'I think what"s going to happen is, we"ve got to start using what we have far more effectively. And that"s obviously different depending on whether its capital money, like new buildings, or people.'He also ruled out any future development of facilities at the hospital over the next five years, unless they can be justified by the savings they would incur in the longrun;'Investment in the Irish health system over the next couple of years in terms of new developments will be extremely unlikely to occur.'The only way the new developments are going to develop in the Irish health system over the next five years, is where people can see those developments bringing savings. In other words, if we say by building a whole new theatre block, we would be able to reduce the costs of running those theatres by €100,000 a year, then we know that we can probably invest a couple of million in those, because it is really a private-public partnership approach going forward. I cannot see funding from Government coming for new buildings at this moment.''Government have cut the capital budget under the present financial situation back to just over €200 million, so what"s concrete is that there will not be any capital developments that aren"t funded by savings brought about by those.'However Professor Drum said services at Mullingar would not suffer because of cutbacks:'We just have to be so much more efficient with what we"re doing,' he said.'Mullingar is leading the way in certain areas,' he said. 'In terms of managing stroke patients, for instance, what I saw today is just incredibly advanced. In other areas like chronic lung disease, and many other areas, there are just hugely innovative programmes going on in Mullingar.'I think people should be proud of what"s been achieved in the hospital. People from other parts of the country come and look to see what is being done here, the medical assessment unit in Mullingar is well known right across the country for instance. Actually we want hospitals in Dublin to start putting in some of the processes that are in place here.'Professor Drumm"s visit was a fact finding visit to the hospital, which rates highly in the HSE"s Health Stat system, to see how efficient practices here in Mullingar can be applied elsewhere.'I was reassured to see how well the hospital works here at Mullingar,' he said. 'Our own Health Stat process has identified Mullingar as a place that works very well, and I was here to see how that works. There is a lot to be learnt here and therefore I went around and saw where other places and people might do things better, but I was also here at the end of the day also to discuss the huge challenges that we face as a health service over the next couple of years because of the economic situation.'