HSE CHIEF Executive Paul Reid has said the HSE will press ahead with plans to downgrade the Emergency Department (ED) at Our Lady’s Hospital in Navan, Co Meath, despite an instruction from the Health Minister not to proceed.

Under the plan the ED at the hospital is to be converted to a 24-hour medical assessment unit. Patients attending this new unit would need a GP referral and critically ill patients would be diverted away from Navan to other hospitals such as Our Lady of Lourdes in Drogheda.

This reconfiguration of the ED is to begin from the end of this month.

Clinicians and politicians have raised concerns about the safety of patients – in particular plans to send patients who are critical to other hospitals.

Last week Health Minister Stephen Donnelly told the Dáil that the government is not satisfied with the plans and that he had instructed the HSE not to proceed.

“Legitimate questions have been raised by members of the Oireachtas regarding issues including access to the medical assessment unit, the capacity of the National Ambulance Service, local access to GPs, emergency and other resources in Drogheda and other hospitals, the use of injury units and more,” he said.

He said senior clinicians at Our Lady of Lourdes Hospital in Drogheda had told him they do not currently have the resources required to cater for the additional patients who would have to go through their Emergency Department.

“I want to be very clear on this. For the reasons I have raised and members of the government have raised, and indeed for reasons raised this evening, the government position is absolutely clear. I have instructed the HSE not to proceed with what it had intended to do on 30 June,” the minister said.

Speaking to RTÉ’s This Week today, Reid said the HSE is now “at the final steps of a whole set of processes”, which he said would ultimately result in an increase in services provided at the hospital.

He said he has been made aware of “very significant risks” and concerns raised by clinical medical staff about the plan and that the board had met over the course of last week to discuss them.

When asked whether, after the minister’s instruction not to proceed with plans, those plans were now on hold, Reid said:

No, we’re progressing the actions both in Navan but also in terms of Our Lady of Lourdes hospital and that’s a range of actions in terms of putting more ICU capacity in Our Lady of Lourdes…

He acknowledged the minister’s concerns and said they will be addressed over the coming weeks, but “ultimately we have to do this” because of patient safety.

“People in the Navan and Meath area are really at risk of poorer health outcomes and indeed death if we don’t address these actions,” he said.

“The minister ultimately can determine, through Section 10 of the Health Act, and direct us not to do it but I hope we don’t get there and I think that would be a mistake.”

Covid cases

Reid also spoke about the current pressure at hospitals due to a rise in Covid cases.

He said about 50% of patients in hospital with Covid are in hospital because of their symptoms while the other half came into hospital with another illness and subsequently tested positive.

“It still impacts to the same extent on us and on capacity, the infection prevention and control meausures that we have to take, so it’s a very significant impact,” he said.

We are striving to keep other services going, but there’s no doubt about it with the increased demands that we are having, along with that at our emergency departments the numbers are up – in some cases up 20% on where they were in 2019 and particularly older persons presenting at some hospitals, about 35% up. So we are operating at a very significant hot base at the moment

He said the health service is “very hopeful” that Covid figures will peak over the coming weeks and they do not continue at current growth levels.

Reid encouraged people to come forward for their vaccine, whether that is initial doses or booster jabs for those who are eligible.