Trust Confront Public Confidence Issue over Downe

Hugh McCaughey, South Eastern Health and Social Care Trust Chief Executive attended with a team to make a presentation and respond to questions following the Council’s concerns over the Trust’s reform and modernisation proposals which were rubberstamped by the Health Minister. The meeting lasted over three hours and the questions and answers were many. Council officials are to look into another format of organising the meeting in possibly preparing questions in written format so that the business of the meeting can be dealt with more efficiently. Mr McCaughey opened his remarks by expressing the Trust’s disapproval of attempts from a number of areas to undermine confidence in the new Downe Hospital. He said, “I was disappointed to see a cartoon of a white elephant in a regional paper. This affects how the Trust and the Downe Hospital is seen by the public and this is misleading and extremely dangerous. [caption id="attachment_17656" align="alignleft" width="200" caption="Mr Hugh McCaughey, South Eastern HSC Trust Chief Executive attended a meeting with the Down Council health committee."][/caption] “We wish to put on record that the Downe Hospital is succeeding. We are taking in more patients and providing more services and we are well ahead. We are doing better than we expected.  However, I regret the damage caused by the issues around the A&E in Downpatrick. Constant discussion about closures and reduction in services in the media is not helpful. “I and the Trust directors would see it as a personal failure if the Downe Hospital did not succeed. We both want the same things. But changes are coming. There has been plenty of discussion around the budget. It is therefore essential that we have a sustainable and successful Downe Hospital and A&E. We believe the proposed changes will make the model more sustainable and safe into the future. Seamus McGoran, Director of Hospital Services, then explained some performance figues and said that there was an growing range of  services provided including a Trust-wide sexual health service, Trust-wide bowel cancer screening, opthalmology, cataract service, midwife-led maternity, orthopaedics, cardiac cardio angiogram and CVT services. “The new model Downe Emergency Department will operate with the current service-hospital doctors, and from 10pm to 8am, it will run with the GP Out Of Hours team. It will be supported by a hospital nursing staff, a 24/7 support from the Emergency Department at the Ulster Hospital, with diagnostics and the abilility to admit patients.” He said, “The latest figues for the Downe show an increase in patient traffic at the hospital with day cases up 22% with no change in admissions but outpatients are showing a 5% increase. The Emergency Department has shown a 4% decrease in activity. “We cannot wait for a situation to arise when some evening we have no doctors to keep the A&E service open. We have to act now.” On the issue of recruitment, the Trust defended its record in trying to hire middle grade doctors for the Downe A&E. Eamonn Molloy, Director of Human Resources and Corporate Affairs, said, “We have to compete with the big hospitals. The market place is tight. There is no point in placing ads in papers if there is to be no response. Two ads in one regional Northern Ieland paper cost £35,000 each. We  use recruitment agencies to try and fill posts. “We look at locum doctors staffing the A&E at the Downe Hospital as possible future middle grade doctors. We use a wide range of tools including texting, the Internet, and contacting junior doctors in Northern Ireland, to fill vacancies.” Charlie Martyn, Medical Director, explained the importance of hospital by-pass procedures for patients with head injuries, major trauma etc. He also added that the fracture clinic operates at the Downe Hospital but serious injuries such as a long bone break would have to be treated at the Ulster Hospital. Walking fractures and follow up cases can be managed at the Downe. He said, “The Downe Hospital had 24/7 support from the Ulster Hospital, a dedicated nursing staff, X-ray and imaging capability, and adult patients could be referred to the medical wards. “Psychiatric and mental health care won’t alter treatment and GP’s are familiar with the emergency psychiatric scheme should it be required.” Some Comments and concerns From Councillors Billy Walker: “We are reflecting what the people in the street are saying.  And we are losing the trust of the people out there.” Liam Johnston: “Having to be referred to a hospital at night is a big problem for many people in this area. Many homes are in the very low income bracket and it could cost £70 for a return taxi fare to the Ulster Hospital from Downpatrick. This is an unreasonable tax on our poor. This is one of the most deprived areas in the Six Counties.” Mickey Coogan: “Are other Trusts following the same pattern that the South Eastern HSC Trust has? If we can’t get middle grade doctors for the downe A&E we should transfer them from elsewhere, not transfer patients to other hospitals. John Doris: ‘I am glad you have reinstated the catatact surgery service. Regarding the two page ad in the local papers recently, I think that two pages of solid print will be difficult to read. People are still saying the Downe A&E is being by-passed. If that is what they are saying then it will have to be addressed.” Jim Wells MLA: “We need clarification over the recent X-ray cover issue. How many people in Down are affected? I also welcome the bowel cancer screening unit.” Marie McCarthy: “How can we look after more patients and have less beds? The Trust closed down a 15-bed ward. Why is Down District being used as a guineau pig?” Cadogan Enright: ‘If you filled the 11 middle grade posts that you require for the Trust will you then revert back to the original format for the A&E with middle grade doctors there at nights? I have come across cases when people have been diverted to belfast to hospital and can’t afford the transport, and don’t have a mobile phone. This can’t go on year after year. Why can’t the Downe be a training hospital? And your intention to centralise psychiatric services outside the area away from a historic labour source just does not add up.” Eddie Rea: “Congratulations to the Trust officials on coming to the meeting and facing the music.  The recent walkabout by management in the Downe Hospital was an excellent idea giving them a first hand feel of what it was like on the ground. We need to start building morale now. How can we all help to rebuild our local health service and dispel this misconception we have. We should all be working together as a team.” Dermott Curran: “The Pound Lane health clinic was burned down over two years ago. If the business case has been made for a new centre we need to identify a new location.” Mr McCaughey indicated that the business case had been submitted for approval from the Department and its recommendations had been accepted. Stephen Burns: “The Trust will need to put up its own literature around this area of communication and a healthy image about the Downe Hospital on its own website as there appears to be no mentions of it, only on Facebook and in leaflets.” He added that the Trust too had used emotive language such as ‘keeping the doors open’. The meeting covered much ground. The Trust tried to iron out what it saw as PR issues of confidence and bad communication. However, councillors were of mixed feelings about the Trust’s postion over the A&E and psychaitaric care as the Trust pressed ahead with the reform and modernisation proposals. The thorny issue of the advertising for middle grade doctors has still left some councillors non-plussed, and others angry. There is still much work to be done before the Council, the public and the Trust are all singing from the same hymn sheet. Health campaigners have vowed ‘not to give up the fight’. The row will linger on probably until the next Assembly is elected. At least questions are being asked and answered, and that may well be a beginning of a resolution process to wjat is a very difficult and complex problem.]]>