THE HEALTH Service Executive (HSE) has said that protocols were in place which would have allowed for the admission of the late Dan McDonnell (59) to Ennis General Hospital when the hospital’s A&E unit was closed earlier this month.
The Kilkee father of three died after suffering a heart attack in an ambulance on Limerick’s Dock Road after the ambulance had bypassed the closed A&E unit at Ennis General in the early hours of Sunday, April 19th.
Mr McDonnell’s wife, Marie, said her husband’s life “might have been saved if the A&E unit at Ennis was open at the time”.
Mr McDonnell had been complaining of breathlessness when emergency services were called.
Twenty-four hour A&E services ceased at Ennis and Nenagh hospitals on April 6th with the A&E closed at both hospitals from 8pm to 8am each day.
However, the national director with the HSE, John O’Brien, says that a protocol issued to the out-of-hours GP service Shannondoc and to all GPs on April 6th stated that “the vast majority of acute medical conditions can be admitted to Ennis General at any hour of the day with the proviso that after 8pm, the referral must come from the patient’s GP”.
He states that in the protocol, “a list of medical conditions treatable at Ennis General Hospital was also provided which includes “acute breathlessness and/or chest pain”.
Mr O’Brien says: “For the record, I understand the clinical decision in the particular case in question was made in good faith by the GP on call.”
Mr O’Brien’s remarks are contained in a letter to the chairman of the Clare branch of the Irish College of General Practitioners, Dr Michael Harty.
Dr Harty said last week that Mr McDonnell would have had a better chance of survival if the A&E was open, pointing out that HSE protocols prevented Mr McDonnell being admitted to Ennis General by a GP due to the high level of support he required.
Dr Harty added that the protocols gave no option to the ambulance crew but to transfer Mr McDonnell directly to the Mid-West Regional Hospital in Limerick.
In his letter to Dr Harty, Mr O’Brien states: “These comments indicate either a lack of awareness or a total disregard of several communications and clarifications provided by the HSE to GPs in relation to the changes in the A&E and other services which commenced with a meeting as far back as last November.”
Mr O’Brien states that the Health Information and Quality Authority report on services at Ennis General concludes that “change for safety must happen”.
Mr O’Brien tells Dr Harty: “Your stated position of opposing the changes must also be interpreted as opposition to the Hiqa report. I wish to state in the strongest possible terms that in light of this and earlier reports, the HSE is obliged to act on those findings and recommendations. This is the compelling and only reason for the current programme of ‘reconfiguration’.”
