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LAST UPDATE | 14 Jun 2022
THE GOVERNMENT HAS not sanctioned the closing of the emergency department in Navan, according to Tánaiste Leo Varadkar.
His comments come as Health Minister Stephen Donnelly issued a statement saying that “no decision” has been taken on the replacement of emergency department in Navan with ‘medical assessment unit’.
The HSE outlined plans yesterday for a 24-hour Medical Assessment Unit to replace the emergency department in Our Lady’s Hospital Navan.
The HSE insisted that the new MAU will still be able to see around 80% of the current number of patients who present to ED every day.
However, it has been confirmed that the planned MAU will be GP referral 24 hours a day, 7 days a week, while the proposed injury unit will be walk-in.
Donnelly said that the transition has yet to be signed off on by the Government.
The Journal asked Varadkar today if the Department of Health and HSE are at odds with one another over the hospital.
Varadkar said there “are a lot of questions to be asked” about whether it is “wise” to close the ED in Navan.
“I worked in Navan hospital for a time, it provided a lot of good care to a lot of people particularly those with pneumonia, with minor injuries, UTIs, it provided very good care,” he said.
“I fully appreciate it is not a major specialist centre for people with major trauma who have a heart attack or a stroke, it is better that they are taken elsewhere, and that is generally done by the ambulance service.
“But I think if there are to be any changes to services at Navan, we would need a lot of assurances around the ability of the ambulance service,” he said.
Assurances would also need to be given regarding whether Drogheda or Connolly Hospital can take the additional patient load, he added.
The health minister, as well as ministers that sit at the Cabinet table from Meath, Justice Minister Helen McEntee and Minister of State Damien English, “are not satisfied with the HSE’s responses to those very straightforward and reasonable questions”, said Varadkar.
In his statement today, the health minister said “several important issues” must be addressed before any transition can take place, including ensuring people in the Navan area can still access urgent care.
He said while he accepts the concerns of clinicians in Navan over safety issues for operating a “small emergency Department”, he has also listened to clinicians at other hospitals who fear overcrowding if the transition occurs soon.
He said: “No decision regarding the HSE’s proposal for the transition of the Emergency Department at Our Lady’s Hospital Navan (OLHN) has been agreed by this government.”
The minister noted that the HSE has clinical concerns about the safety of the Emergency Department at Navan and said the HSE met with local representatives to to outline those concerns.
“I have heard clearly the concerns of clinicians in Navan as to the ongoing safety concerns of operating a small Emergency Department,” he added.
“I have also heard the concerns of clinicians at other hospitals that would be impacted at a time when all health services are under such pressure.
“Several important issues, including additional capacity in other hospitals impacted, as well as 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 takes place.”
To address extra patients expected in the emergency department in Our Lady of Lourdes Hospital Drogheda, the HSE says an additional emergency ambulance, as well as an additional advanced paramedic, will be put in place.
The replacement of the emergency department with a MAU is the final step in the transition of the hospital to a “model 2” hospital, which does not provide emergency or unscheduled procedures.
Navan is the last hospital to complete such a transition, and the HSE have said that the change will make the hospital safer, allow it to provide a higher quality of care and increased activity.
The MAU will treat patients who are deemed stable and not likely to deteriorate or require resuscitation.
A Local Injury Unit will be opened alongside the MAU, which will treat minor injuries during the day.
The hospital’s ICU will close, and will be replaced by a new system of acute care.
There is also no emergency surgery in the hospital.
Additionally, Navan’s ICU is the smallest in the country, and there is national and international research showing a correlation between low numbers of critically ill patients and “poor outcomes”.
Chief Clinical Officer of the HSE, Colm Henry, told RTÉ’s Morning Ireland programme that the transition plan is not a downgrading for Navan hospital.
Speaking before the minister’s intervention, Henry said: “There is no downgrading. To be very clear about this, what’s happening here is - as we planned with other hospitals that we successfully implemented what are called model two hospitals, it expanded their services.
“They continued to see acutely ill medical patients through the medical assessment unit.”
He added that there will continue to be active, busy local injury units.
“What we’re looking at here is a small proportion of patients who come to emergency departments,” he said.
“And for a small proportion of patients their needs are best served by bringing them to the right place first time. This is the latest in a series of steps that have already taken place at Navan Hospital where patients with heart attack or stroke bypass the hospital.”
Speaking in the Seanad this afternoon, Fianna Fáil Meath Senator Shane Cassells said after a meeting yesterday with the HSE, Meath representatives were handed out a document stating that the phasing out of the emergency department would begin on 30 June.
“The last time I checked, the HSE did not run this country. The Cabinet, the Government, is responsible for the running of the country. The HSE was reminded of that fact very forcefully by the Minister for Health last night and again this morning. He reminded it who runs the health service.
“Ultimately, responsibility rests with the Minister for Health. These people who think they are a law unto themselves and can bypass Cabinet and elected Members got a reminder today,” he said.
“The HSE should remember that, if it wants to have an honest and frank discussion with the political leaders of the country, it must start by showing respect for those leaders and not with what was attempted yesterday,” said the senator
With additional reporting by Christina Finn
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Proper order, It can’t be one rule for some and another for others…all the kids were entered into a lottery style selection process, you can’t get any fairer than that.
@Jimmy Farrell: Read the article carefully and you’ll note that not all the children were included in the lottery. A system of privileged access exists favouring certain categories of applicants. Under this system, while the school is publicly funded, not all children are afforded equal access. This is immoral and should be illegal. The obvious solution in cases such as this, where a school is significantly over-subscribed, is to either build a bigger school and to bus the excess numbers to the nearest suitable school with sufficient accommodation in the interim, or to bus the excess indefinitely if building a school is not a financially viable option. The admission policies of school should be standardised nationally with possible exemption only in exceptional cases. We are supposed to be a democracy after all.
@Tomasz Irlandczik Krótki: why would siblings not get a place in the same school I don’t see a problem with they’re enrolment policy leftover places are a lottery this child’s name was in the lottery but his wasn’t chosen. It’s the same with most schools. The parents wanted a special accommodation for him because a previous principal verbally told them to move him to a feeder school and they took this as a guarantee of a place which was wrong.
@Tomasz Irlandczik Krótki: I did read it all, the children which aren’t included in the lottery are those whom have siblings already enrolled in the school for obvious reasons. For example imagine being a parent of 4 children and they’re all attending different secondary schools. Would be a nightmare trying to pick them up! All different uniforms, no handmedowns, different start and end times..
@Jimmy Farrell: So, get one in – and they’re all in! Wrong – privilidged access is unfair, and unacceptable.
@Fank Pulman: Its not privildeged if the siblings rules applies for all families!…What on earth is there to be gained from splitting up and separating a child from going to school with her brothers and sisters??
@Jimmy Farrell: and what about children of past pupils? Do you agree with that in a schools funded by the state?
@Paul Fahey: yep generally keeps the riff raff out!
@Paul Fahey: Yes, why not? Everyones parents went to school somewhere..if they want to go to that school let them
@Jimmy Farrell: All families!!? Except new ones¡¡¡
@Fank Pulman: This is our school – all my family came here, so my children get priority over everbody else! Can you not see anything wrong with that ‘logic’…¿?
@Fank Pulman: No i dont see anything wrong with that logic, once the rule applies for every school! If your first child starts in a new school (ie. New family as you say) at least their brothers and sisters are guaranteed a place their too!
@Jimmy Farrell: to be fair. If your other children are going there then yes preference should be for those children. But this nonsense of my brother or father used to go here so I should be a shoe in is ridiculous. That should not be allowed.
@Jimmy Farrell: So if I am forced (for work) to move to Mayo, my children – in your view, have to wait for a place; and, say, an excellent academic record is irrelevant. As well as everything else!?
@Jimmy Farrell: so say a family, say like mine, move to an area in Dublin and live there and contribute to the local society for years. A young couple move back to the area after years in Dubai, but because they have a parental link to the school, but my parents went to school in Tipperary, their children get priority over mine. You think this is quotable and justifiable?
@Paul Fahey: Ok its not like your child wont get a place in a school! Everyone just wants a school on their door step. I had to get a 50min bus to school everyday for 5 years! And had to walk 2 miles on a main road in the middle of nowhere with lorrys and cars flying past to get the bus and the same home again, the same in the pitch black of winter i might add! But I’m not complaining i didnt get the local school, mine was in the next town!
@Paul Fahey: so most schools not have catchment areas they service first? That said the number of students taking the trains in the mornings is ridiculous
@Paul Fahey: Yes Paul. Schools are communities and past pupils contribute enormously to the identity and culture of that community.
@Fank Pulman: you don’t have kids do you ?
@Tomasz Irlandczik Krótki: These parents werent worried about a fair lottery when they wrongly assumed their child would get into the school. They’re only bothered now because they’re “we no important people” attitude didnt work
@Thomas McGilly: what identity and culture is it you talk of? Do you mean largely white and catholic only I cannot think of any other.
@Paul Fahey: There is more to a identity and culture than colour and creed. Businesses, sports clubs etc have identities and cultures while potentially having a multitude of different races and world views. It’s a way of doing things that are dear to the school as a community that past pupils know and understand. They (past pupils) also helped create that culture. Having that commitment to a school adds huge value to a school.
@Thomas McGilly: and yet you have failed to identify the “identity and culture”, odd that. Also, companies are subject to equality laws, but religious schools are not fully.
So what is this identity and culture? How is it different for people who have lived in Dublin all their lives, but their parents went to school in Tipperary?
@Jimmy Farrell: you and those supporting you are the reason that disabled children are consistently victimised and denyed entry to schools. No one wants our children because of the extra time and effort involved, and they refuse to apply their own principle of siblings getting preferred entry if the sibling is disabled.
This country is the only one not to have signed the UN Convention of the rights of people with disabilities, and it is because of people like you that they are allowed to get away with it. Mucsavages rule us, and people like you facilitate it. No one should in the 21st century be supporting school entry policies that marginalise and exclude children who don’t have the right parents/siblings or ability.
Either you have deliberately ignored the entry policy of the school above, or you can’t read. Either way it helps to understand how the Irish meekly took on EU bank debt, and hung it round the neck of your children and grandchildren. We are not the fighting Irish, we are the spineless Irish.
@Paul Fahey: Each school, including those with no religious identity, has an identity i.e. what makes them unique, and a culture, i.e. the way they do things and why they do things that way. It varies from school to school. It could be for example, one school places emphasis on academic achievement, exam results, does not have LCA. Relationships in that school could be very formal with students having to make appointments to see teachers. Another school might place emphasis on personal development with an emphasis on wellbeing, has LCA and relationships are less formal. That is their culture and identity. Equality legislation has nothing to do with this particular case. Finally, in practical terms, the Tipp parents example is not a realistic one unless the parents moved to Tipp.
@Jimmy Farrell: they do it to families who have a disabled sibling all the time. Are you ok with that?
@Thomas McGilly: nonsense, you seem to be suggesting that a school striving for academic excellence is a local phenomenon. The Tipp scenario is actually mine; I moved to London and now live in Dalkey, but my parents still reside in Tipp and went to school in Tipp. After 15 years in Dalkey, why should any other family take precedence over mine?
Excellent, the PC lot wont be happy.
@Paul: don’t know how you arrived there, the details in the article are vague and scant
The problem here is not a flawed enrolment policy. It is that the Dept. of Education will not supply enough classrooms to accommodate all the pupils who apply. The Minister then trying to railroad a school into not adhering to its stated enrolment criteria is entirely disingenuous.
@Micheal S. O’ Ceilleachair:
Is there any kid in the entire country who can’t attend school because no places are available? No.
The issue is that certain schools are oversubscribed and certain schools are undersubscribed, which could be for geographical reasons, reputational reasons, convenience reasons etc. etc. etc..
I wonder is there more to this story that we are not being told ?
@David Conroy: I bet there’s a believing in the right fairies angle to it that is not being shared.
@David Conroy: probably not. Just a tale of a parent, a school and its admission policies and a court.
So 100 more pupils apply to a school than available places. Dept. provides 4 extra classrooms and normal increase in staff as necessary. Problem solved.
The legal fees in this case would have provided the resources for above simple solution.
The Dept. of education is a complete farce.
@Liam McGowan: but people are enroling to multiple schools. A proper state or council controled enrolment system should be put in place.
The real story here as any teacher knows is that the Dept of Education are terrified of Joe Duffy and always side with the parents in these situations. Fair play to the school for standing up for their enrolment policy. It may (or may not) be flawed but it’s a policy. There are (usually) other schools in the locality.
One of our local schools insists that the teaching of all subjects is done in Irish (even English!) – a total waste for those of us who chose to work abroad.
@Fank Pulman: You mean it’s a GaelCholáiste? Which obviously isn’t a waste for those who want their children educated through Irish. I will also presume there is a demand for it, otherwise it wouldn’t be there.
@Fank Pulman: One of your local schools? So there’s a choice there? What is the relevance to this article except to release some of your constant, pent up hatred for a language. Go away there and have a good ould self-flagellation for yourself!
@Fank Pulman: equally to teach them in English is futile if you are going to work abroad in a non-English speaking country.
@sean o’dhubhghaill: Aww calm down chaps¡ In my opinion – it is very important to travel in life, and to live in different cultures, countries and environments. I have worked in NYC, Sydney, London and several EU countries; NOWHERE was my gaeilge any help – but if parents want their childten to learn it, fine. But mine won’t – except if they want yo, when they get older.
@Fank Pulman: look at you, claiming to know about schools… Almost fooling us that you went to one!
@Brown Boots: I did BB…to a school where I was forced to speak Irish, play hurling and be a catholic. Now I have nothing to do with the three…
@Fank Pulman: Well done. And I too have worked in a range of countries on 2 different continents. But I found Irish invaluable with some of my colleagues as a language we could converse freely in knowing NOBODY else knew what we were talking about. Apart from one unfortunate incident in a restuarant in Lisbon!!!
@Fank Pulman: frank are you a special needs person
@sean o’dhubhghaill: Just a bit of a laugh then – no good for work! Yet we insist that EU documentation is translated into Irish – and then shredded, unread by anyone…
@Paul O Faolain: are you O¿
@Fank Pulman: did you learn any other language in school you went on to use for work?
@Fank Pulman: So English is taught through Irish!!? Ha ha! You are an idiot.
@Fank Pulman: That’s no reason why your children wouldn’t be capable of learning another language. You might as well say that you had a bully of a teacher for maths so your children are obliged to skip geometry. It’s just eccentric, sorry.
The grammar alone will stand to them. English just doesn’t have the tenses to compare with other languages, so any new language they learn as adults will be easier for them. Hundreds of thousands of Americans speak it fluently, by the way. It’s taught differently now.
@Fank Pulman: also Frank, studies have shown that children who are bilingual from an early age pick up additional languages far more readily later on..
Though I agree that boots family didn’t have a car, how much did all this legal action cost and what budget did it come from?
Good
Nuts
Our Constitution states that all children are treated equally
Did the judges not read the constitution before the made the Judgment
@pat seery:
Tell that to the parent who has to be in four different places at once to collect four children from four schools.
For heaven sake if his friends are there he should be allowed .its so important to have your friends from primary school with you and that’s only one reason .
have your say