THE EMERGENCY DEPARTMENT in Our Lady’s Hospital Navan is to be replaced with a 24-hour Medical Assessment Unit, following years of uncertainty about its future.

The HSE has insisted that it is “incorrect to state that the emergency department will close”, and the new MAU will see roughly 80% of the current number of patients who present every day.

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.

The hospital’s clinical director Gerry McEntee said today that there are currently a number of risks for patients presenting to the emergency department in Navan, including difficulties attracting consultants to the hospital. There is also no emergency surgery in the hospital.

The MAU will treat patients who are deemed stable and not likely to deteriorate or require resuscitation

The hospital “does not have a number of this specialty services that are necessary to provide a comprehensive ED service”, he said, such as neurology for stroke patients and interventional cardiology for heart attacks.

An average of five to six unstable patients per day are currently brought to the hospital by ambulance but cannot be managed there. These patients will now be brought directly to an appropriate 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”.

The HSE has said that the transition to a MAU will not affect the level of activity within the hospital – it is predicted to become busier as a result of recent and ongoing investment.

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.

Meath TD and Aontú leader Peadar Tóibín said existing problems in the health service meant that the move was a dangerous one. He said:

Their proposed MAU replacement for the A&E is dependent on GP referrals. GPs are impossible to get for new patients and existing GP patients are waiting up to 10 days for an appointment. There is no way the majority of people with an emergency health issue are going to wait 5, 6 or 7 days to go to a GP to get referred to an MAU. Also out of hours patients in an emergency situation will not wait. They will all go straight to overcrowded Drogheda A&E.

He said people are already waiting 12 hours for admission in Drogheda A&E. 

“Tens of thousands of extra patients from Meath may now have to join them. When hospitals are overcrowded they stop elective produces  that make up the bulk of their hospital waiting lists. The HSE plan will increase the length of hospital waiting lists,” he said.

The HSE says an additional emergency ambulance, as well as an additional advanced paramedic, will be put in place to deal with the extra patients in the emergency department in Drogheda.