A KILKENNY woman being treated for cancer in Waterford and Kilkenny has backed moves to halt the dismantling of The South East Hospital Group. Marian Murphy from Ballyragget is a cancer patient at WRH, Whitfield and St. Luke’s Kilkenny. She was operated on at both Waterford and Kilkenny, received radiotherapy in Whitfield and chemotherapy at St Luke’s. She says being treated within the region made a huge difference: “Although I’ve been down a long path, I have had incredible care along the way, in my own region, with both St. Luke’s and WRH working together on my case. I feel strongly about the South East Hospital Network being kept as it is, it’s a hard enough time for people suffering from conditions like mine without being transferred to an already overloaded Dublin hospital as just another number,” she said.
Supporters of the current system are urging Health Minister, James Reilly not to break up the South East Hospitals Group just as the network is about to realise its true potential. Thy claim that the historic underfunding of health services in the South East is set to be reversed with the introduction of the “money following the patient” principle under the Future Health document. However, they say that there will be fewer and fewer patients for the money to follow if the regional grouping is broken up.
Professor John Higgins of UCC will submit his report on hospital groupings to Minister James Reilly this week, a report believed to include the proposal that Waterford and Clonmel be grouped with Cork, and Kilkenny and Wexford with Dublin. Such a move will mean fewer patients for Waterford Regional, a smaller budget and will ultimately make Waterford’s status as a regional hospital untenable, a development that will have consequences for the entire region. According to a recent report by economist Jim Power, a downgrade of the hospital will cost the region 945 jobs.
According to the South East Hospitals Action Alliance, there is an alternative vision, one which will see the medical infrastructure of the region working in unison, delivering the best possible service to the half million people of the South East. This vision is laid out in the Improved Services Plan, published by the regional consultants at Waterford Regional Hospital. The plan sets out how the five hospitals in the South East can work more effectively together, with a more equitable distribution of services and better outcomes for patients. It calls for a single governance of Waterford, Wexford, St Joseph’s, Kilkenny Orthopaedic (Kilcreene) and St Luke’s and two-way movement of patients and staff in the South East.
The document also addresses the concerns of some hospitals in the region about how services have been shared up to now. Common governance will allow the region to escape the concept of a regional hospital based in Waterford providing outreach to the other hospitals and to move instead to a regional hospital group based across five hospital sites. Crucially, it will expand the roles of the hospitals outside of Waterford within the region, roles that have already been acknowledged by the Medical Board of Waterford Regional Hospital.
Cancer services provide a clear example of the potential changes brought about by common governance. With Waterford a designated cancer centre in the South East, the other three acute hospitals now have the opportunity to provide a regional role for non-malignant surgery with a two-way flow of patients and medical personnel. There are many more proposals that will see regional service provision in Kilkenny, Wexford and Clonmel. This will ensure a vibrant regional health service, providing services efficiently to patients close to their own homes.
But this plan needs work according to the South East Hospitals Action Alliance. The document itself says that until a single common governance structure has been formalised, it is difficult to be specific regarding how this vision might be realised. Those specifics may never emerge if the Minister decides to break up the group this month. The break-up will come just as the minister’s Future Health plan begins to take shape, one of the central pillars of which is that money follows the patient. After years of relative underfunding, this should be a golden opportunity for the South East. Yet, without a regional grouping, that money will follow the patients out of the South East and services that took a generation to build up will wither and disappear.
The potential for the regional grouping is well understood at Wexford General Hospital. Surgeon at Wexford, Ken Mealy, says sharing services within the region works: “the geographical proximity of the hospitals in the Southeast allows complex surgical operations and cancer surgery to be performed in the regional hospital and less complex work, including day case and ‘five day’ surgery to be performed in the sector hospitals. This will necessitate both surgeon and patients travelling to the nearest appropriate hospital for these services. Currently this model is working well”
Professor Ríona Mulcahy, consultant geriatrician at WRH says the region now has “a wonderful opportunity under a common governance structure to utilize all the expertise and facilities in the region to deliver services for the people of the south east in the most appropriate setting. This will involve the flow of patients and medical personnel so that the government’s vision of patients seeing the ‘right person at the right time in the right place’ is achieved.”
The potential for the regional grouping is well understood at St Joseph’s in Clonmel. Consultant General and Colorectal Surgeon at Saint Joseph’s, Peter Murchan, says sharing services is the future for the hospitals and is something that is already working well: “Many of us across several specialities, have already modified our previous single site practices and now work effectively both in local general hospitals and at the regional hospital. This has resulted in measurable clinical benefit to the patients we treat and therefore should be further developed as proposed,” he said.
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