Frank Feighan (Sligo-Leitrim, Fine Gael) | Oireachtas source

I thank Senator Cassells for raising the matter of the plans to reconfigure services at Navan hospital’s emergency department. Navan is one of nine hospitals that were designated as model 2 hospitals under the smaller hospitals framework, which was approved by the Government in 2013. Navan is the last of these nine hospitals to undergo transition to a model 2 hospital. Currently, Navan is a model 3 acute general hospital with a 24-hour emergency department service to which patients may self-present or be brought by ambulance. It also provides a range of inpatient and outpatient general medical, elective surgical and orthopaedic services. Ambulances currently bypass the emergency department for certain conditions that cannot be catered for at Navan. These are STEMI heart attacks, strokes and traumas, as well as paediatrics and obstetrics. Patients who present to the emergency department who require surgery are transferred to Our Lady of Lourdes Hospital in Drogheda. The HSE has advised that the current acute model of care at Navan holds significant risks from a governance and clinical care perspective.

In 2013, the smaller hospitals framework described the evolution of healthcare delivery, including the shift to day surgery and ambulatory care, and the consolidation of complex care in larger volume centres. There is a recognition that there is a link between volume and outcomes. This in no way means we must only provide care in larger hospitals. Less complex care, which is the majority of hospital care, can be and is provided safely in smaller hospitals.Other hospitals in the smaller hospitals framework that have already transitioned to becoming model 2 hospitals provide excellent examples of how these hospitals can be even busier than before.

As the Senator mentioned, elected representatives from the Navan area met the HSE operational and clinical leads on 13 June. At that meeting, the HSE described clearly the patient safety rationale for the proposed change to a model 2 hospital so that critically ill and unstable patients could have the best chance of survival. Let us ensure that these issues of survival and patient safety are at the forefront of discussions on this matter.

There would be a 24-7 medical assessment unit, which would continue to cater for the vast majority of medically unwell patients who currently come into Navan hospital through its emergency department. There has been considerable capital investment in Navan hospital, with the opening of a new second general theatre, a new day ward, an expanded recovery room, a new laboratory, a new rehab unit and a new psychiatric day ward. There are other future development plans. The future vision for Navan hospital is that, with the expansion and development of services, it will be busier.

It is important to note that Navan hospital is not closing or being downsized. However, while recognising the real clinical concerns, the Government is clear that several important issues, including additional capacity in other hospitals impacted and the continued ability of people in the Navan area to access emergency and urgent care, would need to be fully addressed before any proposed transition by the HSE could be considered.