HEALTH TRUST MEDICAL DIRECTOR HAILS ACUTE SERVICES REVIEW AS AN EXCELLENT IDEA
Health trust medical director hails acute services review as 'an excellent idea'
THE ongoing appraisal of acute services in the west of the Province has been hailed as 'an excellent idea' by Sperrin Lakeland Health and Social Care Trust's medical director.
Dr. Clive Russell was speaking on the resumption of the Western Health Board's review in the wake of the Omagh bombing, which had brought about its suspension, and responding to Mr. Joe Byrne, a member of Omagh District Council and a West Tyrone Assembly member.
Mr. Byrne said the review was exercising the minds of many communities in Omagh and Fermanagh, but the public at large wanted more information.
"I think it is fair to say that it is very important that there is a viable level of acute services retained at the Tyrone County and Erne hospitals. In the regional strategy there is a lot of concern that there is too much emphasis on the big hospitals, the Golden Six," said the councillor.
He argued, too, that the Western Board had not engaged in what he regarded as proper consultation.
"In fact, I think there has been a democratic deficit in relation to the consultation process, and I hope that it will be addressed," Mr. Byrne added.
The exchanges came at last Thursday's second annual public meeting of the Trust Board at Tyrone and Fermanagh Hospital's Great Hall in Omagh.
Mr. Byrne queried the lack of consultation, and claimed the public wanted more information on just what was going on.
But Dr. Russell said: "We welcome the acute services review, and we also welcome the fact that we have had a change to make an input to it through involvement in many of the groups.
'Excellent idea'
He added "I don't think this review should be stopped. It is an excellent idea. All boards have statutory requirements to produce an acute services review. We cannot stand still, and have the County Hospital that we had 20 years ago, and I would be really worried if that's what the people of Omagh wanted."
The director said it was necessary to move with the times, to keep abreast of modern technology.
"That's not about closure, but about keeping up to date investment, and revitalisation. I don't want people going past the County Hospital to other hospitals for services," warned Dr. Russell. "I want us to be able to provide a certain level of service and I think that it has to be determined in an acute services review, which has to be Board wide."
He said the one lesson to be learned from the Omagh bomb was that Sperrin Lakeland could not exist alone.
"The Erne and Tyrone County hospitals are very good at what they do, but there are some things that we just cannot do. We relied very heavily on other hospitals.
"I don't subscribe to the concept of the Golden Six, but I do accept there are certain services, we cannot provide, some not determined by money, but determined by the fact that the Royal College of Surgeons no longer allows people to be trained like Mr (Dominic) Pinto.
"Thus we cannot look after accidents, people with broken bones, if you are a general surgeon, when Mr. Pinto and his colleagues like him, retire we don't have anyone else to replace them, so orthopaedics and trauma have to go to the centre in Derry."
"That doesn't mean to say we cannot replace the general surgeons, and we have done that with a recent appointment, but that general surgeon is not trained or skilled in dealing with some of the more specialised things that the general public would be expecting if they actually broke a bone and needed that treatment."
Dr. Russell said the same was true of paediatric scene, and that there was a need there, too, to move with the times.
My junior doctors, medical senior house officers, are currently providing a paediatric service in Omagh. I don't think that is correct, I never thought it was correct. I was the paediatrician, with my colleague, Dr. Blair, for nearly 17 years. That wasn't correct.
"I totally disagree with people who say we have to preserve services at all costs - at your cost?, your children's cost?, Whose cost? We have to keep up, but it does not mean to say the closure of Tyrone County Hospital, or the closure of the Erne."
"There are certain services which we will continue to provide and, indeed, increase. The renal dialysis services has doubled and trebled in size in the past two or three years, and many of the people who benefit from that are Omagh and Fermanagh people.
"In addition we provide a service as far as Derry, and we, the local people, have to accept we cannot stand in isolation, but we have to become part of a much larger unit, which, I believe, is the whole of Northern Ireland."
"I'm optimistic about the acute services review. I think it is a challenge, an opportunity. We learned a lot of lessons following August 15th, and I hope the people in the centre, in Belfast and in Derry, learned a few lessons as well."
Mr. Eugene Fee, director of acute hospital services for the Trust, endorsed Dr. Russell's response, and said a sub-group, led by a member of the Western Health and Social Services Council, was looking at the consultation question.
And Mr. Stanley Millar, chief officer of the council, said: "I echo what Mr. Fee has said. The Health council has had, and will continue to have a very active role in this review. We have already voiced comment that we believe it is appropriate that is should continue. There is a danger that where there is a vacuum the bureaucrats will make and impose decisions.
"While Mr. Byrne is correct in that the public have had very little opportunity to date to voice an opinion, I can assure him that within the next month, or so specific plans have been laid to allow the population throughout the Western area to engage both in research and in focus groups.
"There will be opportunities to put forward the points of view of communities, which are a very essential and key part of the exercise."
Sensitivities
Mr. Hugh Mills, the Trust's chief executive said, "In discussions I have had with the Board there was a recognition of the sensitivities that are now involved, and the very practical issue of trying to engage the public at this time in this area while so many people are grieving."
"We hope there will be an active response from the local community, and participation in the workshop opportunities that Mr. Millar has outlined. I want to add my word of encouragement to it to participate. It will be their opportunity to convey what they feel about the services they need."
Mr. Richard Scott, Trust Board chairman, said Mr. Bob Nicholl, who was leading the Board review, was very keen not only to consult, but to be seen to consult very widely, and said he would welcome suggestions as to how the consultation process could be deepened or widened.
He went on: "It is always assumed, especially here in the Western area, that these things are money-driven, that they are purely money considerations, that some where someone is trying to save money, and it is asked, why we should be at the brunt of the savings?"
"I think one thing I have observed since coming into this job two and a half years ago, is an awareness that is not the motive. There are limited resources and changes in services are not driven purely by financial considerations."
"There are difficulties with the quality considerations of the Royal Colleges and their perceptions that teams need to be formed, and that rules have to be appropriate to the maintenance of those teams."
THE ongoing appraisal of acute services in the west of the Province has been hailed as 'an excellent idea' by Sperrin Lakeland Health and Social Care Trust's medical director.
Dr. Clive Russell was speaking on the resumption of the Western Health Board's review in the wake of the Omagh bombing, which had brought about its suspension, and responding to Mr. Joe Byrne, a member of Omagh District Council and a West Tyrone Assembly member.
Mr. Byrne said the review was exercising the minds of many communities in Omagh and Fermanagh, but the public at large wanted more information.
"I think it is fair to say that it is very important that there is a viable level of acute services retained at the Tyrone County and Erne hospitals. In the regional strategy there is a lot of concern that there is too much emphasis on the big hospitals, the Golden Six," said the councillor.
He argued, too, that the Western Board had not engaged in what he regarded as proper consultation.
"In fact, I think there has been a democratic deficit in relation to the consultation process, and I hope that it will be addressed," Mr. Byrne added.
The exchanges came at last Thursday's second annual public meeting of the Trust Board at Tyrone and Fermanagh Hospital's Great Hall in Omagh.
Mr. Byrne queried the lack of consultation, and claimed the public wanted more information on just what was going on.
But Dr. Russell said: "We welcome the acute services review, and we also welcome the fact that we have had a change to make an input to it through involvement in many of the groups.
'Excellent idea'
He added "I don't think this review should be stopped. It is an excellent idea. All boards have statutory requirements to produce an acute services review. We cannot stand still, and have the County Hospital that we had 20 years ago, and I would be really worried if that's what the people of Omagh wanted."
The director said it was necessary to move with the times, to keep abreast of modern technology.
"That's not about closure, but about keeping up to date investment, and revitalisation. I don't want people going past the County Hospital to other hospitals for services," warned Dr. Russell. "I want us to be able to provide a certain level of service and I think that it has to be determined in an acute services review, which has to be Board wide."
He said the one lesson to be learned from the Omagh bomb was that Sperrin Lakeland could not exist alone.
"The Erne and Tyrone County hospitals are very good at what they do, but there are some things that we just cannot do. We relied very heavily on other hospitals.
"I don't subscribe to the concept of the Golden Six, but I do accept there are certain services, we cannot provide, some not determined by money, but determined by the fact that the Royal College of Surgeons no longer allows people to be trained like Mr (Dominic) Pinto.
"Thus we cannot look after accidents, people with broken bones, if you are a general surgeon, when Mr. Pinto and his colleagues like him, retire we don't have anyone else to replace them, so orthopaedics and trauma have to go to the centre in Derry."
"That doesn't mean to say we cannot replace the general surgeons, and we have done that with a recent appointment, but that general surgeon is not trained or skilled in dealing with some of the more specialised things that the general public would be expecting if they actually broke a bone and needed that treatment."
Dr. Russell said the same was true of paediatric scene, and that there was a need there, too, to move with the times.
My junior doctors, medical senior house officers, are currently providing a paediatric service in Omagh. I don't think that is correct, I never thought it was correct. I was the paediatrician, with my colleague, Dr. Blair, for nearly 17 years. That wasn't correct.
"I totally disagree with people who say we have to preserve services at all costs - at your cost?, your children's cost?, Whose cost? We have to keep up, but it does not mean to say the closure of Tyrone County Hospital, or the closure of the Erne."
"There are certain services which we will continue to provide and, indeed, increase. The renal dialysis services has doubled and trebled in size in the past two or three years, and many of the people who benefit from that are Omagh and Fermanagh people.
"In addition we provide a service as far as Derry, and we, the local people, have to accept we cannot stand in isolation, but we have to become part of a much larger unit, which, I believe, is the whole of Northern Ireland."
"I'm optimistic about the acute services review. I think it is a challenge, an opportunity. We learned a lot of lessons following August 15th, and I hope the people in the centre, in Belfast and in Derry, learned a few lessons as well."
Mr. Eugene Fee, director of acute hospital services for the Trust, endorsed Dr. Russell's response, and said a sub-group, led by a member of the Western Health and Social Services Council, was looking at the consultation question.
And Mr. Stanley Millar, chief officer of the council, said: "I echo what Mr. Fee has said. The Health council has had, and will continue to have a very active role in this review. We have already voiced comment that we believe it is appropriate that is should continue. There is a danger that where there is a vacuum the bureaucrats will make and impose decisions.
"While Mr. Byrne is correct in that the public have had very little opportunity to date to voice an opinion, I can assure him that within the next month, or so specific plans have been laid to allow the population throughout the Western area to engage both in research and in focus groups.
"There will be opportunities to put forward the points of view of communities, which are a very essential and key part of the exercise."
Sensitivities
Mr. Hugh Mills, the Trust's chief executive said, "In discussions I have had with the Board there was a recognition of the sensitivities that are now involved, and the very practical issue of trying to engage the public at this time in this area while so many people are grieving."
"We hope there will be an active response from the local community, and participation in the workshop opportunities that Mr. Millar has outlined. I want to add my word of encouragement to it to participate. It will be their opportunity to convey what they feel about the services they need."
Mr. Richard Scott, Trust Board chairman, said Mr. Bob Nicholl, who was leading the Board review, was very keen not only to consult, but to be seen to consult very widely, and said he would welcome suggestions as to how the consultation process could be deepened or widened.
He went on: "It is always assumed, especially here in the Western area, that these things are money-driven, that they are purely money considerations, that some where someone is trying to save money, and it is asked, why we should be at the brunt of the savings?"
"I think one thing I have observed since coming into this job two and a half years ago, is an awareness that is not the motive. There are limited resources and changes in services are not driven purely by financial considerations."
"There are difficulties with the quality considerations of the Royal Colleges and their perceptions that teams need to be formed, and that rules have to be appropriate to the maintenance of those teams."
Further Information
Publisher: TYRONE CONSTITUTION
Ref: TC/1255
Published Date: 01-Oct-98
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