Sligo Today Editorial

By Eugene McGloin

PUBLIC INTEREST might best be served if the HSE removal of mammography services from Sligo Regional Hospital was the subject of a formal written complaint to the Office of the Ombudsman.

The magnitude of, the importance of, and the possible permanence of the recent HSE decision are reasons why it should be independently evaluated.

No Criteria

There are numerous reasons why the HSE decision on Sligo should be independently scrutinised:-

1. The HSE published no announcement suggesting that such a (final) decision was under consideration.

2. The HSE's publicly stated position was the 100% opposite, they were working to re-commission the follow-up service in Sligo, they said publicly.

3. Neither did the HSE invite submissions from interest parties and the general public before its recent reconfiguration excluded the return of mammography follow-ups in Sligo.

4. No criteria, even yet, have been published by the HSE setting out how its position came to be wholly reversed (b) how the swift timeframe for implementation was decided and who was consulted and over what period.

5. The HSE also failed (c) to state whether it's recent decision was open to an internally conducted appeal (d) or whether its decision was in a sense intended to be forever or whether it can/will be reviewed in a service delivery context.

Who would have input into any such review? There is a world of difference between 'advisory/consultative' and 'partnership/stakeholder' frameworks.

6. No qualitative evidence was offered by the HSE as to how the consumers of the current service, the 'clients' of the service as the HSE jargon has it, evaluate it.

Yet the HSE itself often requires such evidence to be actively sought from bodies, little and large, with whom it has a contractual relationship, eg per Service Agreements.

That is as it should be....but WHY should the HSE then exempt its own performance and decision-making from similar rigour and scrutiny.

An appeal to the Office of the Ombudsman would facilitate a scrutiny of the various relevant consultant posts in place in the region.

A consultant post does not have to be delivered in one location alone.

The sessional commitment in the approval for such post can set out two locations.

The representation of the (Sligo) public interest -- and whether, or not, that interest was sufficiently reflected in final consultant post outcomes -- deserves to be scrutinised by the Office of the Ombudsman.

Still Unravelled

The public record deserves some independent scrutiny of what (precise) approvals were originally sought in the components of consultant post specifications.

Such independent scrutiny might also assist us to learn how/why these requirements still unravelled, to the detriment of Sligo.

The HSE made its recent decision without (a) notifying its intention or (b) inviting submissions on the fragmentation and hardship its new decision would cause.

The HSE dressed its recent decision in the decent clothes of avoiding 'fragmentation' in delivery of the service.

How noble the idea and with one bound our HSE heroes are free.

What about the fragmentation of families where a mother, carer, partner is absent for the equivalent of a full working day?

What metrics did the HSE use to quantify that prior to its recent decision?

On The Road

What model of 'best practice' or what model of primary care would have such a person facing long stressful journeys, physically far from their families, after receiving 'bad' news?

In an age when homes in every Irish village can Skype and Message across the globe its defies logic to ignore solutions like 'conference' technology.

The HSE could have facilitated a better service than travelling on the road for a whole day for a review that takes place in 15 to 20 minutes.

Scrutiny by the Office of the Ombudsman would also permit us to see what, if any, reconfigurations were proposed recently by the HSE for Letterkenny.

The logical reconfigurations, in the post-Border age, would be to have north Donegal in a relationship with Derry....and not paired with Galway, a galaxy away in geographic terms.

North Donegal paired with Derry would then leave Sligo on the periphery and fuller entitled to the satellite status it should have been granted in all HSE configurations from Day One.

Fine Gael TD Frank Feighan was quoted recently in the Derry & Donegal News newspaper about the need for co-operation across border counties in the delivery of cancer services.

Where's the beef, where is the beef, to quote another Fine Gael TD from an earlier era when looking for answers.

The outflow from the Good Friday Agreement (GFA) intended something of more substance than the short-changing of Sligo, however inadvertent.

Posted on 17/12/14 : 07:33:35