Four patients due to undergo joint replacement surgery at Letterkenny University Hospital had operations cancelled for the second time in a week because of a protocol designed to reduce emergency department (ED) overcrowding.
Consultant orthopaedic surgeon Peter O’Rourke has been forced to cancel his theatre list each Wednesday for the past three weeks because hospitals are obliged by ministerial directive to cancel elective surgery when ED overcrowding reaches certain levels.
However, even though there were five empty beds on the orthopaedic ward last Wednesday, none could be used to take patients off trolleys because of the high risk of cross-infection to orthopaedic patients, Mr O’Rourke told the Examiner.
In addition to the cancellation of his operating list, orthopaedic colleagues had surgeries cancelled this week. Two general surgeries were also cancelled, Mr O’Rourke said.
The consultant said that management’s hands were “tied by the escalation policy”.
The escalation protocol, issued as a directive to acute hospitals last November by Health Minister Leo Varadkar, makes it compulsory for hospitals to take specific steps to address ED overcrowding when it reaches crisis levels, including cancellation of non-urgent surgery.
Hospitals that do not comply are subject to penalties with resources re-allocated.
Mr O’Rourke has repeatedly criticised the escalation policy which he said was introduced to “appease those working in the ED” without taking cognisance of the knock-on effects on other parts of the hospital.
He said it will lead to longer waiting lists as surgeries are cancelled with increased likelihood of operations being outsourced to private hospitals as waiting lists grow.
Figures obtained by Sinn Féin Donegal South-West TD Pearse Doherty in January showed Letterkenny Hospital had the second highest number of cancellations for elective surgical procedures across the entire Saolta University Health Care Group over the past two years.
It emerged a total of 351 scheduled procedures had been cancelled in 2014 and 2015.
Mr O’Rourke has said he is “sick to death” of hearing about the ED crisis, that it was “the myth that just keeps on giving”.
“There is no crisis in ED’s but there is a shortage of beds. Trying to resolve the effects but not dealing with the cause of a problem is doomed to failure,” he said.
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