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Wednesday 22 November 2017

Niall Hunter: HSE hospitals plan is gambling with our children's lives

Meningitis, or any sudden illness that strikes children, is every parent's nightmare.

A major worry is trying to get access to emergency care as quickly as possible.

Many parents are now, however, concerned that HSE plans for hospitals might prevent them getting quick emergency care for their children in future.

With meningitis, parents will be aware of symptoms but it is difficult to know whether these are danger signs. Doctors are advised not to underestimate a parent's instinct that something is wrong.

Caroline and Matt Kennedy from Co Wicklow knew there was something wrong when their daughter, Aine, started to display meningitis-type symptoms and quickly accessed emergency care.

Unfortunately, despite everyone's best efforts, Aine could not be saved.

Aine's recent tragic death has raised two issues for the HSE. Firstly, it appears it mixed its condolences with a well-meaning but unfortunate statement urging parents to be vigilant about meningitis and to get help early.

In this case it was the right message at the wrong time.

The parents felt it implied that they had not acted quickly enough to help their child when the opposite was the case.

There is another important issue here -- how quickly in future will parents be able to access emergency care for sick children?

It's worth noting that Caroline and Matt Kennedy have been campaigning against the possible closure of the A&E at Wexford Hospital under HSE rationalisation plans.

Aine Kennedy was first taken to Wexford, where she was stabilised, and was then placed in an ambulance and sent to Crumlin Hospital, where medics were, unfortunately, unable to save her.

However, if current reorganisation plans go ahead, within a few years, not only will there no longer be a fully-fledged paediatric A&E service in Wexford, but there will be none at Crumlin either.

In fact, there will be no Crumlin hospital at all, as it is due to move, along with Tallaght's children's hospital and Temple Street, to the new paediatric hospital at the Mater in 2014 or thereabouts.

So by around 2014, a vast tract of the country from north Dublin and along the east coast area will have just one 24-hour, fully fledged children's A&E -- at the Mater. If Wexford A&E is closed, between north Dublin and Waterford there will be no 24-hour children's emergency unit.

The only other emergency service will be a new minor illness and injury unit at Tallaght. This unit will close its doors at 10pm each evening and not open again until 7am.

The hospital action group in Tallaght is concerned about emergency care for children once the new Mater children's hospital is open and the others are closed down.

It points out that Tallaght is not well served by out-of-hours GP services, yet in a few years time there will be no 24-hour children's A&E on Dublin's southside.

There are reasonably sound logistical arguments for centralising many hospital services. These arguments, however, may well be lost on worried parents with sick children living in south Dublin, Wicklow and Wexford trying to access emergency care in a few years time.

Many felt a solution for children's services would have been to have one hospital on the northside and one on the southside of Dublin.

It remains to be seen whether the HSE's hospital reorganisation will work and whether the new services put in place will meet the emergency care needs.

Many worried parents will be hoping this gamble with children's health pays off.

Niall Hunter is editor of irishhealth.com

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