Five years to fix doctors crisis

Five years to fix doctors crisis

5 March 2014

A SENIOR health official has suggested the shortage of doctors which is impacting on hospitals and resulted in the weekend closure of the Downe’s emergency department could take up to five years to address.

Mr. Seamus McGoran made the assertion at last week’s meeting of the South Eastern Trust Board which met in Downpatrick and was addressed by a number of local politicians.

The Trust’s Director of Hospital Services said there is a UK-wide shortage of middle grade doctors, arguing it is not within the organisation’s gift to deliver what everyone would like at the Downe Hospital. Mr. McGoran said for this to happen requires decisions to be taken at regional and national levels.

Welcoming lobbying efforts at Westminster by South Down MP Margaret Ritchie to address the doctor shortage, Mr. McGoran said while he continually hears “that there are plenty of doctors out there” this is not the case.

The Trust official suggested the acknowledgement by politicians that middle grade doctors are in short supply will allow the organisation to get into a “mature debate” about what is possible for the Downe Hospital, emphasising there are no easy answers around the corner.

He continued: “There are no easy solutions to the current problems. Even if all the available emergency medicine posts were filled right now, suitably qualified and experienced doctors will not be available for four or five years. We have all seen the problems in Northern Ireland as a result of the shortage of doctors and this issue has just not affected the Downe. Emergency departments at other hospitals have closed.”

Mr. McGoran said when night-time A&E services were ended at the Downpatrick hospital three years ago, it was suggested by some that the Trust was “destroying the hospital” and would turn it into car showroom.

He continued: “All of this is so far removed from the truth. The outcome of that excellent change and introduction of an urgent care co-operative has been that we have been able to provide 24/7 access to urgent care in Downpatrick. In fact, 97 per cent of people who previously used the Downe A&E continued to use it up until we had to make changes last December.

“Challenges have been responded to in a positive and proactive way in the past but, unfortunately, we were not able to do that just before Christmas because the situation had become so critical, with opportunities and availability to access locums to fill shifts at the Downe over the Christmas period and into January becoming impossible.”

Mr. McGoran said it was widely accepted by the Health and Social Care Board and Department of Health that the Trust had no other choice than to do what it did and reduce A&E opening hours at the Downe.

“Without taking a managed approach to reduce hours, albeit over a couple of weeks’ notice, there would inevitably have been an unplanned closure which would have been unsafe for patients. We had to make a decision in the best interest of patient care and our challenge was how to mitigate the impact of a decision — which we were not keen to take — but felt we had no other option.”

Mr. McGoran said the impact of the weekend closure of A&E services at the Downe at other hospitals has been “largely negligible.” He said while the Trust is disappointed it no longer has a seven-day medical model at the Downpatrick hospital’s emergency department, local people continue to have access to 24/7 urgent care, through A&E or the GP out-of-hours service. The Trust official said GPs also continue to directly admit patients.

“I fully understand the concerns there are in the community and people’s desire to understand what has brought us to this position and what hopes we have for the future,” continued Mr. McGoran. “We are keen to work on our GP direct admissions and this has worked exceptionally well at the Downe, creating excellent access to emergency care.”

Mr. McGoran added: “I have no doubt there is significant inconvenience to a number of our patients, but there have been no major issues highlighted. Some patients have had to go elsewhere as a result of the weekend closure, but we are making sure they get back to the Downe as soon as possible.

“Whilst this is a difficult time and I understand people’s frustration, anger, passion and annoyance about the decision we have had to make, it was not an easy one. Unfortunately, it is impossible to have a 24/7 emergency department service at the Downe. What we really should be doing is focussing on what is possible.

“We will continue to work with recruitment agencies and seek opportunities to recruit middle grade staff, but I can say hand on heart that I am not optimistic we will have any major gain.”