29 March 2013 No Comments by The Northern Standard

Although the severe service reductions experienced by Monaghan General Hospital in recent times make it easy to be antagonistically disposed towards representatives of the Health Service Executive, a dispassionate observer at Tuesday night’s meeting of Monaghan Town Council would have found it difficult not to feel at least a twinge of sympathy for the situation which the HSE officials present to discuss a number of local health concerns were confronted with.

General Manager Bridget Clarke and Cavan/Monaghan Service Development Manager Cathal Hand may have assumed that the high feeling and invective generated by the hospital issue in Monaghan had cooled in the hearts of local elected representatives sufficiently to allow for a measure of analysis and reflection to predominate its modern debate.

However, old habits die hard, and the officials must have been bemused by the amount of time some councillors spent stirring up among themselves the old embers of the political blame game in order to generate a few more sparks of recrimination as to what Government or Minister had visited most harm on local hospital services by unkept promises or malign action.

Readers will search in vain among our reports of the meeting’s proceedings for the substance of these exchanges, as it is our considered editorial view that, to put it in the plainest of terms, people are fed up listening to and reading them.

Given Monaghan Hospital’s current situation, such comments generate the wrong sort of heat, producing smoke that in the context of Tuesday’s discussion threatened to occlude the substance of what the HSE people had to say – some of which at least was illuminating and to some degree hopeful.

While the people of Monaghan continue to feel very strongly about their hospital, the nature of their abiding concern is misrepresented by politicians who persist in adversarial arguments about what this or that party did or should have done.

The public are more interested in what role the hospital will play in the future – is there hope for improvement and enhancement of the services available there, or will the path of national health policy lead to its further diminishment?

In this regard the HSE officials at Tuesday’s meeting brought mixed news.

Councillors were understandably disappointed that their proposal that Monaghan General Hospital be used on a temporary basis to provide respite care beds while refurbishment work takes place at St Mary’s Hospital in Castleblayney was deemed unfeasible.

The rationale behind this proposal seemed sound – it would utilise ward space at the site which is perceived as lying idle, and it would provide a convenient locale for elderly people in the North Monaghan area needing nursing care who otherwise are compelled by the current restrictions at St Mary’s to vie for limited bed space at a distance in Lisdarn in Cavan, or perhaps find themselves dispatched even further afield, far from relatives and the reassuring comforts of a familiar environment.

It emerged, however, that in the HSE’s view there is little underutilised capacity at Monaghan Hospital that would facilitate such a plan – and even if there were, the hospital would not conform to the requirements for registration even on a temporary basis as a place of respite care provision.

It is difficult to argue against the stringent new requirements that are being put in place to guarantee patient safety and quality of care in nursing home locations – but it is equally difficult not to feel strong sympathy for the argument presented by Colr Mary Carroll that “the importance of the human needs of vulnerable elderly patients and their relatives” should form a greater component of the criteria under which the provision of such care is determined.

And Colr Sean Conlon was right to question if the shadow of privatisation does not somewhere loom in the background of the policy decisions that are being made at national level in this area of care.

If the news was displeasing in this regard, comments made by Mr Hand in relation to the proposed new Primary Care Unit for North Monaghan contained the substance of hope for a brighter future for Monaghan’s hospital.

Mr Hand said that if plans to locate this facility at the hospital site came to fruition, “Monaghan will have a future-looking hospital that will be delivering services not the way we did it 20 years ago but the way we need to do it 20 years from now.”

It must be accepted, even if we do so reluctantly, that we will never see the return to Monaghan General Hospital of many of the services systematically stripped away from it down the years.

Changes in the delivery of hospital care, dictated not merely by administrative policy but by new clinical approaches and medical advances, have shattered that dream – and promises made to the contrary by opportunistic politicians, some of whom at least knew fine well how empty they were, have surely lost meaning in the minds of all save the most credulous of hearers.

The location of a newly built Primary Care Centre on the grounds of our hospital would seem to offer a pathway to realistic enhancement, and meaningful relevance, of the facility as time progresses.

It is therefore pressing that the feasibility study on this project is expediently completed and its findings made known.

We accept Mr Hand’s bona fides that the reason for the study’s delay stems from the anxiety of local hospital service managers to leave no stone unturned to ensure that Monaghan Hospital is determined to be a viable location.

But this in turn suggests some doubt as to whether the hospital site will ultimately be successful in this ambition – given the many disappointments suffered over recent years, it is essential that this matter be clarified soon.

Only when the feasibility study is forthcoming will we know what the future holds for Monaghan General Hospital – it will be the common wish of all within our circulation area that the published document, and future political pronouncements on the hospital itself, contain more hope than heat.

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