No hospitals will be “downgraded” or closed as part of a reconfiguration proposed by the Department of Health in Northern Ireland, a public meeting has been told.
An information session was held at Tullyglass Hotel, Ballymena, on Wednesday evening, as part of a consultation by the Department relating to hospitals in the Northern Health and Social Care Trust.
The Department’s aims include “creating a safe, better health service and making best use of the entire hospital estate by adapting to changing health needs” with “no hospitals to close or downgrade of any hospital”, it was stated.
Causeway Hospital, in Coleraine, is listed as a proposed general hospital. Antrim Area Hospital will remain as an area hospital. Regional centres will deliver specialist regional in-patient services for Northern Ireland.
Consideration is also being given to designating Causeway Hospital as an “elective care centre”.
Elective care is scheduled or planned and can involve outpatient appointments, diagnostic tests, surgery and review.
Neil Martin, the Northern Trust’s divisional director of strategic planning, performance and ICT, said the Northern Trust is the largest in Northern Ireland with 479,000 residents. It has two acute hospitals, Antrim Area Hospital and Causeway Hospital and five community hospitals.
He indicated Antrim Hospital, which has 424 adult acute beds, “struggles for space”.
Mr Martin stated:
“We want to restate our commitment to 24/7 emergency care. Causeway will remain an acute hospital. Nothing in the consultation will change that. We believe Causeway is well-positioned to deliver elective care.”
He said the Trust is working through responses to its recent review of general surgery. The Trust has proposed locating all emergency surgery at Antrim Hospital and planned operations at Causeway Hospital with a proposal to be brought to the Trust board in March.
“We were really pleased with the range and quality of responses received,” he added.
Diane Spence, the Trust’s director of community care, said:
“The Trust’s community hospitals are an essential element of intermediate care.”
She reported that Mid-Ulster Hospital has 21 beds; Robinson Hospital, Ballymoney, 21; Dalriada, Ballycastle, 20; Moyle Hospital, Larne, 16 (Inver Ward) and Whiteabbey, 23 beds. These have been designated as local hospitals in the reconfiguration proposal.
She added that each community hospital has a dedicated team, nursing occupational therapy, physiotherapy and social work with medical input provided by GPs.
However, these facilities may also accommodate hospital patients from the Belfast Trust and Western Trust.
A retired Causeway Hospital physician expressed concern over the proposed general hospital re-designation for Causeway, which he described, as “vague” and questioned the future of the ICU (intensive care unit) in the hospital.
“From a professional’s point of view, who would want to work in such a place? No-one wants to work in a hospital where their career hangs by a thread in terms of not being properly supported,” he commented.
He also expressed concern over Antrim Hospital, which he suggested, would be “swamped by a vast sea of new patients which it will not be able to cope with”.
Mr Martin said one of the reasons for publishing a strategic vision for Causeway Hospital is “to try to give prospective employees a sense of where the hospital is going”.
“We have successfully recruited recently a couple of consultants.”
Gemma Brolly, chairperson of SOS Causeway Hospital, a campaign group, referred to the pending loss of the Ross Thomson mental health unit at Causeway Hospital saying she believed there would be a consultation.
The planned new £126m Birch Hill Centre for Mental Health will be constructed at Bush Road, on lands south of Antrim Area Hospital, replacing the current provision at Holywell Hospital and the Ross Thomson Unit.
Mr Martin described Holywell Hospital during the meeting as “horrendously outdated”.
East Antrim Alliance MLA Danny Donnelly asked what impact the proposed hospital reconfiguration would have on waiting lists, for patients awaiting routine surgery such as hip or knee operations.
Mr Martin stated Causeway Hospital “should deliver increased diagnostic services” with the installation of a new MRI scanner within the next couple of months to “try to deal with those very long waiting lists”.
“We think Causeway is a really key part of that solution,” he added.
He stressed the Northern Trust is “committed to maintaining the ICU at Causeway Hospital and will work to maintain ICU at Causeway”.
Retired surgeon Fred Mullan said he considered emergency surgery to be “a pillar of a successful acute hospital”.
“If you take that away, I think the other services are at risk. I hear reassuring noises. You do not want to remove ICU. I believe you don’t want to take away A&E and emergency admissions but if emergency surgery disappears, I think the whole structure become unstable. I urge you to think of the unintended consequences.
“You should be asking what the population in this area needs, what are the skills that staff require and can we train people to do that. You need surgeons to provide a range of skills to retain services for the rural community.”
William Taylor, of Farmers for Action, criticised what he described as a potential “depletion of services in rural hospitals”.
“This is time for reality and need to be considering saving lives not losing lives.”
The Department of Health has noted the three hospitals listed in the proposed new general hospital category, Causeway, Daisy Hill and SWAH (South West Acute Hospital), “share many of the challenges of the area hospitals and in reality are competing with them for resources”.
It has been stated:
“The issues associated with the reconfiguration of these hospitals are historically the most disputed by local communities. For many reasons, these hospitals are the ones that are most vulnerable to unplanned change in service. Their geographical locations and the challenge of maintaining safety-critical medical rotas and wider clinical teams are the biggest issues.
“They cannot just be small area hospitals; the resources do not exist to perpetuate this. It is clear, however, that an achievable and sustainable solution that ensures the future of these hospitals is critical to developing a successful hospital network.
“These hospitals have a key role in ensuring our system can respond to the challenges of an ageing population, delivering a range of acute and rehabilitation services, with the advantage that they are closer to an otherwise more isolated community.”
It has been stressed the emergency departments in these hospitals “need to be sustainable on a 24/7 basis, as the area hospitals could not cope with their significant workload”.