Fears of 12-hour A&E at Portiuncula

There are fears this week that a 12-hour emergency department service could be implemented at Portiuncula Hospital in Ballinasloe due to a major funding shortfall at the hospital. This comes amid news that the Department of Health is currently tendering for a private management company to run University Hospital Galway, which is under the same management structure as Portiuncula and Roscommon County Hospital. And the chaos in Portiuncula has prompted veteran consultant Dr John Barton to consider emigrating. A spokesman for Health Minister James Reilly confirmed to the Westmeath Independent yesterday (Tuesday) that the department is tendering for a new management tier outside of the HSE which he said would be used to grow the skills of the management team in Galway and the tendering process is due to conclude this week. And while a new management team is due to be appointed, the Minister has reiterated his directive that all hospitals in the country must operate within budget this year, something which IMPACT's Padraig Mulligan says is an impossibility at Portiuncula Hospital in Ballinasloe, which had gone over budget to the tune of €4.2m at the end of August. Mr Mulligan said forcing the hospital to remain within budget would be a catastrophe for health services in the west and would result in a 12 hour emergency department at Portiuncula, the curtailment of cancer services and a significant increase in waiting times for all services. "UHG is turning away people, it is at capacity, it can take no more, the trolleys are full. If you put Portiuncula on 12-hour shifts you're talking about a third world health service. That is not acceptable to me, it's not acceptable to the people providing the service and it's not acceptable to the people in the west." He added: "There is no room at the inn. The message from the HSE is 'Don't get sick this winter, we're breaking even and we've reached our patient targets'. This is totally unacceptable." He added that it is an impossibility for the hospital to run within budget. "I have spoken to senior managers in all areas of the HSE and they are saying it's an impossibility unless you seriously curtail services and directly affect patients," he said. Despite the hospital having spent significantly over budget in the first eight of the months of the year, meaning an additional €1.6m per month is needed to run the hospital for the remainder of the year if services are to maintained at the same level, Health Minister James Reilly is holding firm on hospitals operating within budget. A spokesman for the Minister yesterday (Tuesday) told the Westmeath Independent: "The Minister has not departed from his very clear message that they (hospitals) have to be managed within budget."On Monday the HSE released the latest performance report, which provided details of how much money was spent at Portiuncula between January and August this year and what the hospital is left with for the final four months of the year. For the first eight months of the year it cost €3.95m per month to run the hospital, but for the final four months of the year hospital management has just €2.35m per month to run the hospital, a shortfall of €1.6m per month. The report shows that Portiuncula Hospital was over budget to the tune of €4.2m by the end of August, or had overspent by 15.38%. The hospital has been allocated €41.1m for the entire year and up until the end of August it had spent €31.6m of this allocation, or €3.95m per month. This leaves hospital management with just €9.4m to spend for the final four months of the year, or €2.35m per month. However, Health Minister James Reilly says there is simply no more money available to hospitals, with his spokesman pointing out yesterday that the department had started the year €70m in the red and in the first few months of the year hospitals had spent more than they had been allocated. He said there would be less money available next year and less the year after and the department had to resolve the problem. He said in that context a new management source would be installed in Galway and Limerick and this would 'upskill all around it'. He added that the winning tender would sign a contract with the HSE and would be answerable to the HSE. But, at a time when hospitals could be facing serious curtailment of services due to lack of funds, IMPACT's Padraig Mulligan has questioned the use of money for such a move. "Where are they getting the money and surely it could be put to better use by opening the beds that are closed," he said. He said it could be used to fully utilise Roscommon County Hospital, where beds are lying empty and the money could be used to buy equipment for this hospital and ensure it is used as a diagnostic centre for the west. Mr Mulligan said a private management company would be unable to tackle the budget deficit by the end of the year and said appointing the management company was unprecedented in the public service. "Who are they? What experience have they got? Who will they be accountable to? Private companies are only accountable to themselves, they won't be accountable to the HSE forum, the HSE forum doesn't count as far as this Minister is concerned," he said. "This is the worst we've ever seen, particularly when the capacity is there but the beds are closed down." Local Independent TD Denis Naughten has also said this week that the only way that the hospital can make those budget cuts is to have a 12 hour emergency department. "There is no other way to do it," he told the Westmeath Independent yesterday afternoon. "It's more than a fear, that's the only cost cutting they can make. Once Roscommon went, Portiuncula was going to go." In relation to the appointment of a new management, Deputy Naughten said his concern was that Portiuncula and Roscommon would carry the can for the appointment of a new management structure at UHG and said he feared their operating budgets would be impacted as a result.