10 July 2010 No Comments by The Northern Standard

No matter how the Health Service Executive try to legitimise it with cant and their own odious take on the Orwellian conceit of newspeak, the decision revealed this week to remove the location of important emergency ambulance services away from the North Monaghan area can only be described as one showing outrageous disregard for the health and safety of local people.

The relocation of these services to Castleblayney in order to serve North Louth as well as North Monaghan beggars belief, particularly as the Rapid Response Vehicle concept was ‘sold’ to the local population at the time of the removal of acute services from Monaghan General Hospital as, if not a perfectly feasible substitute for what had been lost, then a sound safety-net which would guarantee the delivery of an expedient and expert emergency medical service.

The veracity of that claim was always hotly disputed by the Monaghan Community Alliance, who regarded the provision as a dubious and potentially unsafe replacement for what the hospital had been stripped of. But whatever crumbs of comfort the North Monaghan population could glean from the realisation that the RRV service was reasonably close at hand should a medical emergency befall them have now been disdainfully swept away by a decision which an official HSE statement seems to equate with the provision of a “a consistent high standard of service to the local community”.

The decision, coupled with the closure of the Emergency Department at Louth Co Hospital (and perhaps intended to be cloaked by the furore provoked by it), makes perfectly clear that patient safety, certainly in the less populated parts of the country, no longer plays any significant part in the rationale behind the ceaseless reconfiguration of hospital and medical services generally in this country. Statistical imperatives that take no account of the way in which the population of rural North Monaghan is disseminated, and which seem profoundly incompatible with the Hippocratic principles which have traditionally exercised a compassionate governance over the practice of the medical profession, now hold sway, and there are no longer any effective processes of accountability that the people or its political representatives can turn to in order to restore sanity to the situation.

Fine Gael spokesperson on Health Dr James Reilly when in Monaghan on Monday held out hope of a restoration of acute services to Monaghan General Hospital should his party be returned to power. Close analysis of Dr Reilly’s comments show them to be little more perhaps that a more positive restating of previous FG pronouncements on the hospital issue. Party leader Enda Kenny’s gloomy prognosis that it would not be possible for FG to perform this feat of resurrection now seems to have been recanted. But the pledge that replaces it is, in essence, of the “we’ll do what we can” variety only. It is razor-wired with caveats – according to Dr Reilly, the clock is already fast ticking towards the time when the restoration of on-call medical services will no longer be feasible, and if the current FF-led administration sees out the remaining years of its term, “it would be hard to know what would be possible.”

Monaghan Hospital aside, there does appear some hope in the “Fair Care” health system being propounded by FG of radical reforms that would restore the patient to something approximating the centre of considerations when scarce health resources are being disbursed. The exercise of placing proposals for a universal system of health insurance, and quite fundamental reforms in the manner in which hospitals are budgeted, before the public at forums across the country is commendable, and stands starkly at odds with the perfunctory nod towards consultation and transparent communication of information which currently accompanies major service changes such as those implemented by the HSE this week.

Dr Reilly might not have all the answers, but his open and flexible approach to addressing the questions is to be greatly welcomed.

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