Fears increasing over state of health services

Campaigners have this week said that their fears are increasing over the way the State’s health services are being run in the Mid West.

The Mid West Hospital Campaign group cited the decision by the Minister for Health Stephen Donnelly and the HSE to repurpose Nenagh’s new public nursing home as a step-down facility for patients from University Hospital Limerick (UHL) as one of a number of developments that, it says, is leading to increasing concerns by the group over the way services are being run.

The group made the statement as it reacted to reports that the chief executive of UHL, Colette Cowan, is facing possible disciplinary action relating to the death of Shannon teenager Aoife Johnston in the overcrowded emergency department of the hospital in December 2022.

It is reported that Ms Cowan has stepped aside from her position as a condition of the process, pending the outcome of an investigation and it is understood a small number of other senior figures in UHL have also been notified of possible disciplinary proceedings.

The Mid West Hospital Campaign group said: “While we welcome her [Ms Cowan] stepping aside as a result of the disciplinary process, we are concerned that there are others facing action who we presume are still operating within the hospital and UL Hospitals Group. This is of concern to us.”

The group said the death of Ms Johnston did not happen in isolation. “There have been many families who have suffered in that ED [Emergency Department] as a result of overcrowding both before that date and sadly since.”

APPOINTMENTS CANCELLED

The group said the fears and concerns of its members for the people of the Mid West have been further increased by some recent decisions made by Minister Donnelly, the HSE and UHL management.

“These include the decision to cancel many appointments and surgeries with a day’s notice. These cancellations began on August 7 2024 and, to date, are still ongoing.”

The group then went on to refer to the decision to repurpose the new public nursing home at Tyone, Nenagh. “A purpose built nursing home, built to accommodate the needs of the vulnerable communities of Tipperary and East Clare, was handed over to a private company to run.

“This decision was made with no consultation or discussion with those most affected.”

The group said it had also learned that 20 beds at Cahercalla Nursing Home in Ennis are to be taken over for the same purpose.

“All 70 beds are to be used as a step-down facility for patients from UHL. There are still no clear indications of what is being provided in terms of rehabilitation and staffing. It is yet another way of reducing trolley numbers at UHL.

“It would also seem to give the impression that great strides have been made by HSE management in reducing those numbers at UHL where it is in fact just shifting the problems elsewhere.

“It is disturbing that some of our elected representatives have welcomed this as a positive move while others have not commented. There seems to be no care or concern for the members of our communities who would have had access to those beds for long term care or respite. Neither has concern been raised for the families who now have the additional burden of care, usually in unsuitable conditions.”

SECOND EMERGENCY DEPARTMENT

Meanwhile, the Mid West Hospital Campaign has said it is “gravely concerned at the unacceptable length of time” it will take to review the case for a second ED in the region.

HIQA last week published the terms of reference for an independent review to inform decision-making around the design and delivery of urgent and emergency healthcare services in the Mid West. The report on its findings and recommendations will be provided to the Minister for Health and published in summer 2025.

“It is neither exaggeration nor hyperbole to state that lives are being lost now,” the MWHC stated in response. “The crisis at UHL has been the subject of several reviews and none have had any meaningful impact on the patient experience. Indeed, during the past 15 years, the UHL ED has only become a more dangerous place in which to seek treatment for a medical emergency.

“We have previously welcomed the announcement of this review as a long overdue first step to normalising the delivery of emergency department health services in Clare, Limerick and North Tipperary. In our conversations with government and HSE leadership, we are on record as supporting the reversal of the failed 2009 hospital reconfiguration and the reopening of emergency departments at St John’s, Ennis and Nenagh.

“The terms of reference for this review promise meaningful consultation with key stakeholders across the region and nationally. We would remind HIQA that communities qualify as key stakeholders. Those who have suffered negative medical outcomes as a result of the botched reconfiguration, are key stakeholders. The families of those who lost their lives on a UHL ED trolley or as a result of time spent on a UHL ED trolley, are key stakeholders. All of these groups and individuals must be consulted during the course of this review. The MWHC believes that this must be a truly independent review as promised, and the sectoral interests of any individual group must not dictate the outcome and recommendations.

“We trust that this review will result in courageous recommendations that will be quickly implemented by the government,” the group said, adding that it looked forward to engaging HIQA on the issue.