Dr. Colm Henry:

To clarify, the smaller hospital framework document clearly outlines the kind of services one would provide in model 2 hospitals, which have what we call differentiated presentations. Given the health care expectations that people have in 2024, we expect optimum outcomes for stroke, heart attack and other surgical treatments which involve specialised care. The fact is that a fully staffed, 24-7 emergency department requires a critical level of expertise from a range of disciplines, including surgery, neurology, ICU and all the support structures that people expect in order to have the best possible outcomes corresponding to the level of care that we need in 2024.

That said, the model of care that we have for model 2 hospitals envisages, and has seen in practice, medical assessment units that involve a high level of differentiated medical presentations coming to such hospitals. They are adequately and very capably dealt with in those hospitals, and include exacerbation of chronic bronchitis, heart failure and a range of medical presentations. What we have seen in those hospitals is a high level of activity in the medical assessment units and also in the local injuries units, which has the effect of displacing activity away from what is clearly an overburdened model 4 hospital in UHL.