Donegal doctors seek meeting over surgical hub decision
Concerned consultants and senior doctors at Letterkenny University Hospital (LUH), as well as GPs across Donegal, sought the meeting with Jennifer Carroll MacNeill to address what they describe as a "critical threat to patient care and health equality in the north west".
Regional HSE management has identified a site in Sligo as the sole preferred option for a new surgical hub in the region - a decision Donegal-based clinicians have called "flawed, unjustified, and deeply damaging".
Dr Padraig McGuinness, who is a GP based on the Fanad Peninsula, said the decision to overlook LUH "ignores both population need and geographic logic".
"Many of our patients would face round trips of five hours or more to access elective surgical care in Sligo. That's unacceptable and dangerous," Dr Mc Guinness said.
The clinicians' letter, seen by RTÉ News, said they "are ready to present data showing that LUH is a more appropriate and equitable location".
They said if LUH were chosen as the base, "no patient from Donegal, Sligo, or Leitrim would be more than 90 minutes from a surgical hub".
The clinicians referenced the Department of Health's aims to ensure equitable access to elective care across the country by developing surgical hubs.
They said: "To bypass LUH in this decision would be to disregard this equity objective and perpetuate health inequality on a profound scale".
The clinicians letter said the National Cancer Registry Ireland report showed Donegal had the highest deprivation index and a higher incidence and a later presentation of all cancers, with a significantly poorer five-year survival.
Consultant in Intensive Care and Anaesthetics at LUH Dr Louise Moran said: "Patients in Donegal already face some of the worst cancer survival rates in the country due to late presentation and access issues.
"To bypass Letterkenny again is not only medically indefensible - it's a direct hit on patient safety and regional equality".
The clinicians are seeking an urgent meeting with Minister MacNeill as well as an independent review of the HSE's rationale for selecting SUH over LUH and a moratorium on a final decision regarding the hub's location until "an evidence-based comparison is completed".
A spokesperson for the minister told RTÉ News she has not received the business case from the HSE for the location of the surgical hub for the north west.
The spokesperson said Minister Carroll MacNeill thanked the team at Letterkenny University Hospital for taking the time to speak with her during visit last month and she looks forward to engaging with them again in the coming weeks.
What is the HSE surgical hubs strategy?
Over the next two years, the HSE plans to open six surgical hubs nationwide to reduce patient waiting times.
A surgical hub will consist of four theatres with capacity to deliver 10,000-day case procedures and 18,500 outpatient consultations annually.
The first surgical hub officially opened in south Dublin under the governance of St James's Hospital in February.
Within the next two years the HSE plans to open five further surgical hubs in north Dublin, Galway, Cork Waterford and Limerick.
It is hoped hospitals will have greater capacity for patients who require emergency and complex care when day case procedures are treated in the surgical hubs.
The Programme for Government contains a commitment to explore the provision of an additional surgical hub in the north west.
In a statement, the HSE West and North West said it has prepared a business case supporting the implementation of a North West Surgical Hub.
Within that business case a greenfield site owned by the HSE in Sligo has been identified as a potential development location for a hub.
A feasibility and master planning study will also be undertaken if the business case is approved.
Last month, consultants at Sligo University Hospital told RTÉ News the hospital's orthopaedic operating theatre was no longer fit for purpose and patient safety was being compromised following leakages which disrupted the provision surgery.
After cutting the sod on a planned 42-bed unit at SUH, the Minister for Health said the issued simply had "to be resolved".
At the time, HSE Regional Executive Officer Tony Canavan said they had "prepared a proposal to develop a surgical hub for the northwest, based in Sligo".
Ambulatory Centre planned for Letterkenny
A spokesperson for HSE West and North West said that LUH requires a stand-alone facility which provides a greater level of services.
They said an Ambulatory (non-inpatient) Centre is planned for LUH that would include "all the additional surgical capacity being provided by the proposed surgical hubs being created elsewhere, such as theatres and treatment rooms for day surgery treatments".
"the Ambulatory Centre would also provide additional functionality and capacity to meet the needs of County Donegal in the form of additional ambulatory cancer capacity as well as additional diagnostic facilities".
The HSE said the hospital is currently working with HSE Capital & Estates to develop a business case for this development.
They added LUH will be making every effort to secure funding and to progress it "in as expedient a manner as possible".
Fear proposal 'being used to deflect'
In their letter to the Minister for Health, Donegal-based clinicians said while any investment in LUH is welcome, they felt the ambulatory centre proposal "lacks the ring-fenced funding, defined scope, staffing allocations, and delivery timeline associated with the surgical hub model".
They fear the ambulatory care centre proposal was "being used to deflect from the pressing need for LUH to be considered equitably in the current surgical hub decision".
LUH Consultant General Surgeon Mr Michael Sugrue said they need real surgical infrastructure was required in Letterkenny - "not vague promises".
Mr Sugrue said without adequate surgical resources they cannot attract or retain the consultants needed.
"This decision risks the future of general surgery in Donegal and the long-term viability of LUH as a Model 3 hospital," he added.
The clinicians' letter to the Minister for Health urged her to await the findings of Mr Michael Sugrue's forthcoming Letterkenny University Hospital Model 3 Clinical Care Report and Plan.
They said the report would further support their position including statistics detailed funding disparities between LUH and other hospitals.
Calls for equitable access to elective care
The clinicians' letter said LUH has the "longest waiting times when compared to other model 3 hospitals".
The clinicians previously wrote to the minister on 28 April regarding the future of surgical services at Letterkenny University Hospital.
In the letter sent to Minister Carroll MacNeill yesterday, the clinicians said a delegation remains available to meet in Donegal or Dublin.
They reiterated call for equitable access to elective care for all. Dr McGuinness said the matter "isn't just about a building or a budget line".
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