12 April 2018 No Comments by The Northern Standard

There was a time when no politician be they of national or local livery – nor even the humble presspersons whose lot it is to record the pronouncements and prognostications of the political class – could traverse even a short distance of public thoroughfare without being posed the question in our title. The fate of what was once Monaghan General Hospital and now merely Monaghan Hospital was a pressing public preoccupation in our circulation area for decades. From the time of then Health Minister Barry Desmond’s notorious “close and dispose” edict of the early 1980s it became the predominant political and social issue in this area, as a succession of campaigns were waged in the public and eventually legal arena to save the hospital and its services from the axe being wielded by the agencies of health administration.

The campaign moved through various manifestations and had its successes, setbacks and disappointments. But, while it is hard to refute the argument that we probably would not now have any hospital at all were it not for the exceptional efforts of the Monaghan General Hospital Retention Committee and its Hospital Action Committee successor, the attritional processes of policy implementation eventually took maternity and other prized services away from the facility. Although the desire to see services restored to the hospital never really abated, as an issue it had lapsed into relative quietude in recent times.

Over the past year, however, as the Government struggled to deal with the mounting overcrowding problems in the country’s major hospitals, a compelling force was lent to the argument that surely those hospitals, Monaghan among them, that had been stripped of services in the past could now have a measure of what was lost restored to them in order to act as a release valve for the explosive pressures that had built up in those Emergency Departments that remained open around the country. Minister for Health Simon Harris TD seemed open to exploring this avenue of addressing the problems for which he had to find a rapid and effective solution. One of the Juniors at his Department, Jim Daly TD, was extremely open to the suggestion of Monaghan Hospital being given an enhanced role when it was put to him by Cavan/Monaghan Fianna Fáil Senator Robbie Gallagher in a Seanad discussion, and accepted Senator Gallagher’s invitation to visit our hospital in order to see how such a plan could be implemented.

Hope, they say, is one of the most dangerous things to take hold of the human mind. Perhaps in cognisance of this, and certainly under pressure from the senior civil servants of his Dept, Minister of State Daly subsequently announced that he had been advised that it would be inappropriate for him, whose spheres of responsibility lay outside those of hospital services, to trod the path that previous political occupants of the Health Ministry hot seats had long been fearful of treading. Mr Daly cancelled his trip and lobbed the invitation into his senior partner’s court. While all this was going on, Monaghan Co Council had caught the straws in the wind signalling a possible shift in thinking that could be exploited in Monaghan Hospital’s favour, and at their January meeting passed a motion (not without some heat of debate) that set out a blueprint for the hospital’s possible resuscitation and sought a meeting with Minister Harris to discuss it.

The Minister got around to replying to the Co Council in time for their April meeting last Monday, and the diagnosis for Monaghan Hospital contained in his reply was not an optimistic one. There was no mention in the Minister’s letter of the detail of what the local authority members had urged on him to consider – and, tellingly, no translation into print of the progressive noises that he and Minister Daly were heard to make when the pressure over the overcrowding crisis was at its most intense. In a nice way, Minister Harris put Monaghan Hospital firmly in its place – the one assigned to it by the HSE and those influential professional medical bodies who have shaped the direction of hospital policy in this country for the past three decades with calamitous results. Monaghan was a “Model 2” hospital, and, lest it get ideas above its station and aspire to “Model 3” status, the Minister was clear that its role would continue to be as the junior component of the Cavan Monaghan Hospital Group, a designation he was sure would continue to give it “a stronger role…in delivering less complex care.” The Minister is, by the way, coming to Monaghan.

There is a strong assurance from the Fine Gael members of the Co Council that the visit is committed to, although a convenient gap in the Minister’s diary has yet to be found. No assurance of similar weight has been offered, however, about the Minister meeting the members of the Council on his visit to discuss the detail of their motion with him. Government Ministers usually sojourn outside the precincts of their Dublin offices with gifts to bear to their places of destination. Minister Harris is breaking that unwritten protocol by bringing expectations for his Monaghan Hospital visit to such a low point that any enhancement measure he might deign to hand out will be seen as a gesture of unexpected largesse.

With a General Election hovering somewhere in the medium distance, there is surely some kind of Machiavellian method to the Minister’s apparent madness. Raising hopes of services being upgraded at Monaghan Hospital is the last thing that the current senior player in Government would want to have circulating in the fervid campaign air – better for the issue to remain backgrounded and not have to make any promises about it at all, than to have to mouth promises in the knowledge that the HSE and those who influence it will never allow them to be kept.

Monaghan Co Council were doled out a portion of what passes for realpolitik in this country in the form of Minister Harris’s politely repudiating letter on Monday. As the councillors go about the difficult business of digesting it, they should still be refining those arguments they made about the hospital’s future in January (and stoking the heat with which they made them) on the offchance that the Minister spares them five minutes or so when he takes his (no doubt carefully) guided hospital tour. Because, even though many in health administration and political power would hope it would never be posed again, the question, “What about the hospital?” is one that most Co Monaghan people certainly think is still worth asking.

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