One of the things which has characterized the struggle with the health board over the future of the hospital has been the manner in which stories have appeared in the papers purporting to speak of a bright future for the hospital, when the evidence on the ground suggests otherwise. This has lead to a lot of confusion as to what exactly is the state of play with the hospital. The Alliance in an effort to clarify this mess has published this list of questions and answers which are frequently posed. If you have any other questions, just submit them and we will add them to the list.
 
Is Monaghan Hospital going to Close?
We accept that the Hospital is not going to ‘CLOSE’ but the Minister for Health, Health Board, and the CEO intend to change the configuration of the hospital as an integral part of the Cavan/Monaghan Hospital – i.e. Have minor surgery on a 9 to 5 basis, with out-patients clinics, but no emergency admissions either medical or surgical. An in-patient geriatric unit would be available.
 
Why was Monaghan Hospital taken off call?
Due to a lack of investment over the past number of years and, due to the withdrawal of services like Maternity, Gynaecology and Paediatrics, the conditions laid down by the College of Anaesthetists could not be met and Junior Doctors in Anaesthesia were not appointed to the hospital from July 1st. The hospital was therefore unable to provide safe, viable, sustainable 24hour services. The Health Board knew that this situation was going to arise but did not take the necessary steps to intervene beforehand.
 
What is the present position?
The Executive of the Health Board and the College of Anaesthetists are proposing a system whereby Monaghan will have minor surgery on a 9 to 5 basis five days per week. This would not give the people of Monaghan emergency cover 24 hours per day nor would it allow any kind of acute services to return to the hospital. In the meantime 300+ staff are being paid and the hospital maintained for less than 15 patients, while other hospitals are overflowing and waiting lists grow by the hour.
 
Is Monaghan the only hospital experiencing these difficulties
Other small hospitals did have problems but many of these are still fully functional. This has been brought about by the granting of reprieves, the placement of fully registered doctors or the employment of locums, but the main factor was the will of the Department of Health and the Health Board to keep that hospital fully operational. In Monaghan’s case, the Health Board is using the problem to force a new configuration on the people of Monaghan but blaming other bodies.
 
Why does the CEO not appoint additional Consultants to the Hospital?
Why does the Health Board not ensure that existing posts are filled and in place and why is the Board, due to the difficulties in the hospital at present, not urging Comhairle na n-Ospidéal to make an immediate decision, regarding a Consultant post as a replacement for the late Mr. Moore? Why has the Board not appointed temporary fully registered Anaesthetists to get the Hospital back ON Emergency Call and what efforts have they made to attract applications for these and other posts in Monaghan?
 
What is Comhairle na n-Ospidéal and the Medical Council?
Statutory Regulatory bodies looking after our welfare regarding Hospitals and Doctors. Was it poor management or by design that the North Eastern Health Board downgraded Monaghan General Hospital so that it could not fulfil the requirements of these statutory bodies. Had services been maintained and proper resources invested in the hospital, these bodies would have been very happy with Monaghan Hospital.
 
What is the Cavan/Monaghan Group Hospital?
It is an amalgamation of two hospitals – One (Cavan) is overcrowded and unable to cope and the other (Monaghan) is empty awaiting the Health Board’s clearance to admit patients.
 
Who is responsible?
Surely Mr. Michael Martin TD, as Minister of Health and Children, must accept full responsibility for the Health Care Services of this country and this county.
 
What is the future for Monaghan Hospital?
The NEHB informs us that General Medicine and General Surgery will be among the range of services offered at Monaghan. If a surgeon removes ONE Toe-nail during a Month then that is termed – General Surgery. Before July 2nd Monaghan had emergency, major, major complex and elective surgery. The return of these to Monaghan is not planned by the Health Board. If that happens then emergency medicine will also go, so that heart attacks etc will not be admitted to the hospital.
What is needed:
1. Three (3) Obstetric/Gynaecology Consultants and New Maternity Unit.
2. Three (3) Paediatric Consultants and New Paediatric Unit.
3. Three (3) Consultant Surgeons and a Second Theatre.
4. Three (3) Consultant Anaesthetists.
5. Fully equipped and staffed A & E Department including CAT scanner.
6. New Male Medical Ward and Separate Ward for Female Surgical patients.
7. More Medical Registrars.
8. Immediate provision of new ICU/Coronary Care Unit.
9. Facilities for Post Mortems.
10. New Management Structures at the Hospital, as proposed by the Minister earlier this year.
11. New Boiler Heating provision.
12. Installation of new Electrical supply to Hospital.
13. General Refurbishment of Hospital.
 
Has there been any capital investment in Monaghan over the last number of years?
In the past three years the Health Board claims that _4.081m has been spent on the hospital. That figure is at variance with the figure of _19.5m quoted by Dr. Rory O’Hanlon TD, Ceann Comhairle and former Minister of Health. How can we reconcile the two figures. It would be of assistance if the Board published a detailed break-down of this expenditure.
We are told that a Design Team has been appointed to prepare a Development Control Plan for the Monaghan Site. Is this to facilitate the new designs, which the Health Board has for the hospital or to facilitate the return of services? How long will it take this team to come up with proposals and how long after that will it be before they are acted on? The Health Board states that the developments will be in line with Board Policies – i.e. the downgraded Hospital, which means that the Design Team has already been instructed as to the proposals they can make.
 
What happens next?
The Health Board is committed to the future of Monaghan Hospital only in so far as it fits in with their plan which is not acceptable to the people of Monaghan and is not in keeping with the ‘Horizontal Principles’ laid down for all Public Bodies – ‘All Public Bodies are required to proof their plans to ensure that the actions contained therein take proper cognisance of the Government’s commitment to the following:
• Eliminating inequality in our society
• Eliminating poverty and social exclusion in Ireland
• Promoting development in Rural areas
• Promoting sustainable development practices
Proofing is necessary to ensure that the strategy does not have any unintended detrimental effects.
Policies should not lead to further decline in marginalized rural areas.
Policies should ensure that women have equal access to opportunities.
Policies should ensure that those least able to speak for themselves have the right to equal access to all services.
Policies should ensure that decisions taken today do not impair the future of the area.’
The plans of the Health Board for the diminution of services at Monaghan General Hospital fall down on every count.
The situation will not change unless anaesthetists are appointed to the Hospital. Fully registered anaesthetists can be appointed thereby removing the requirement for training conditions for Junior Doctors.
As to the future – work it out for yourself -
• If you are involved in an accident at work, on the road or on the farm, where will they take you?
• If there is an emergency in the area, is there an adequate response available?
• If your child shows symptoms of meningitis, what will you do?
• If you are in business, how will the change of configuration at the hospital effect your insurance?
• If your child is injured at a sporting fixture, to which hospital will he/she be taken?
• If you take suddenly ill, where will you go or where will you be taken?
• Can you afford to travel to Cavan or Drogheda to visit and be with your sick child or parent?
Issued by the County Monaghan Community Alliance on behalf of People Who Care.