29 March 2013 No Comments by The Northern Standard

Recent calls by Monaghan Town Council for beds at Monaghan General Hospital to be used to provide respite care on a temporary basis while major refurbishment takes place at St Mary’s Hospital in Castleblayney were regarded as unfeasible by representatives of the Health Service Executive who met with the Council membership on Tuesday night.

HSE General Manager Bridget Clarke said there was little spare ward capacity at the hospital, and there was nowhere at the hospital that would fulfil the written criteria laid down for the provision of respite services.

“Monaghan is not a registered centre for the provision of such care,” Ms Clarke informed the meeting. “Because of HIQA standards, you can’t change beds from acute beds into something else.”

The General Manager, replying to questions from Fianna Fáil councillor Robbie Gallagher, added that there were very strict standards, for very good reasons, relating to the environment you needed to provide respite care, or any sort of care. Monaghan Hospital had elements of acute care provision and was not an area that lent itself to respite.

However, a brighter vista for the Monaghan Hospital site in the context of plans to develop a Primary Care Centre there was outlined to the meeting by the HSE’s Service Development Manager for Cavan/Monaghan, Cathal Hand.

Mr Hand said that over recent weeks he had been conducting a very detailed exercise looking to establish how much existing vacant space there was at Monaghan General Hospital to allow the development of a co-located Primary Care Centre on the site. He had found that there was minimal vacant capacity within Monaghan Hospital at present which was not being put to good clinical and appropriate use.

He believed that, when the outcome of the feasibility study was finally decided upon, if the Primary Care Centre was to be located on the site of the hospital it would have to be a new build on that site, for the reason that there was minimal spare capacity.

Mr Hand told the meeting that the completion of the feasibility study had been delayed, but this was on the basis that local service managers had insisted that every single avenue was followed through and explored fully to ensure that the North Monaghan Primary Care Centre could be accommodated on the site of Monaghan General Hospital.

“If this happens, Monaghan will have a future-looking hospital that will be delivering services, not the way we did it twenty years ago, but the way we need to do it twenty years from now,” the Service Development Manager stated.

Colr Gallagher, who noted that he had initially proposed that the hospital be considered as a site for the Primary Care Centre development, welcomed the fact that this possibility was being fully investigated, although he expressed some regret at the delay in the feasibility study.
“We should pull out all the stops to try to get the appropriate site,” he stated.

David Maxwell commented that if the Primary Care Unit proposal came off, there could be exciting times for Monaghan Hospital.


Ms Clarke also told the meeting that the HSE were expecting an announcement on the introduction of a new grouping structure for Irish hospitals.

This would see the Cavan/Monaghan Hospital Group linked to a tertiary hospital, which could be one of the major Dublin hospitals such as Beaumont, the Mater, St Vincent’s or St James’, and the formation of a direct clinical and managerial governance structure.

The HSE General Manager said that this was the new trend of national health policy, but emphasised that under any new grouping the HSE was still committed to the provision of its 2013 service plan for Cavan/Monaghan. The new grouping structure would provide direct clinical pathways for local patients into a major Dublin hospital, formalising the pathways which were already in place.

“There will be an announcement on this in the future and when there is more information it will be made available,” she stated.

Addressing the issue of hospital budgets at the outset of the meeting, she said that in 2013 the number of people attending the Emergency Department in the Cavan/Monaghan Hospital Group increased by approximately 20% on 2011. This situation presented challenges for them going into 2013.

It was important to note that in 2012 there was a huge commitment by clinical staff, working with management, in improving Emergency Department care. She knew this was important to all their hearts, and it was a national target for the HSE to make sure patients did not have to wait for a significant period of time.

To accommodate the increase in patients, the Medical Assessment Unit at Cavan Hospital had been relocated in order to double the amount of patients who could be seen there. This service now allowed them to divert patients from the Emergency Department.

This development had come into place on December 12 and had been hugely helpful, enabling them to cease trolley care in any corridor. It had cost €200,000, and they had obtained the funding on the basis of good Emergency Department performance.

The results were now …

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