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A former Consultant at Daisy Hill Hospital has said he is speechless and can't see a quick solution to what he called a 'monumental disaster' unfolding at Daisy Hill Hospital. Dr Donal Duffin was speaking at a meeting yesterday, 25 May 2023, between the Southern Trust and Newry, Mourne and Down District Council, which Newry.ie attended.
The hospital is in the middle of serious staffing issues with seven consultants leaving in the past six months or so. As a result the Southern Trust has once again removed acute stroke services from Daisy Hill. Respiratory and gastrointestinal inpatient medical provision is also currently at risk.
Dr Duffin who is a member of the Daisy Hill Futures group said that the Daisy Hill Emergency Department is working perfectly and it must not 'under any circumstances' be put at risk. He spoke of his concern though of the facility being 'caught in the crossfire' surrounding other problems at the hospital.
Emergency Department is the Jewel in the Crown of Daisy Hill
Speaking about the Emergency Department Dr Duffin said "Six years ago, we were threatened with closure within a week. The community, the Trust, and the Pathfinder group came together, worked together, solved the problem. An Emergency Department that six years ago couldn't recruit for love nor money, couldn't retain for love nor money is now the jewel in the crown, not of Daisy Hill Hospital, but of this bloody trust, that's how good it is. The staff who work in it now fight to come and work in Daisy Hill. When you try to recruit doctors and nurses to Daisy Hill, they're in there, before they're in anywhere else. If you look at the trainees in emergency medicine coming out, they want to go to Daisy Hill, they don't want to go to the Royal, we all know the Royal's having difficulties at the minute and despite the fact you may have a lot more support around you, you've a much better working environment in Daisy Hill.
"The Emergency Department is currently working perfectly. The Emergency Department in Daisy Hill is sacrosanct. If anything that is done to try and fix another problem impacts on what is now a perfectly functioning Emergency Department that will be a catastrophe. I think it was the chair used that word. It will be catastrophic. The Emergency Department is sacrosanct. It is working perfectly. It is the safety net for this community. It must not under any circumstances be put at risk again."
Speaking on the loss of staff Dr Duffin said "As we all know, we've lost six consultants recently. Well, actually, we've lost seven, and it's not in the last year, It's in the last six or seven months. It's an unprecedented haemorrhage of talent out the front door. These are not locums who came, had a wee look, didn't like the place. These are people who dedicated their careers to Daisy Hill and have now said I can't put up with it anymore.
"I've had multiple emails and multiple WhatsApp messages and multiple complaints from staff who have left or are thinking of leaving and they all say the same thing. Love Daisy Hill, want to stay, it's the Trust. I am not getting supported. I'm not being listened to. I'm not getting what this hospital needs and therefore I'm off. I've banged my head against a brick wall. I've survived COVID, I've brought you all through COVID, but enough, I'm out of here."
Dominoes falling
The former consultant said that no-one should downplay the seriousness of the situation and that it is not just a Daisy Hill problem but a much wider problem. "I've never heard of a unit that lost half its consultant staff in that timeframe anywhere, let alone in Northern Ireland. But everybody thinks this is a Daisy Hill problem. It isn't, this is Northern Ireland problem. We've heard of the issues that you have of funding and how do you provide a health service in a country that has no flaming government, that has no politicians turning up to do their work and has an indicative budget, not a proper budget so you can make any planning. How do you do that? The problem is that all of those problems apply everywhere else and all of Northern Ireland is linked together. So if one domino falls down somewhere in Northern Ireland, the whole thing goes down around our ears. Daisy Hill isn't just the wee hospital out on the periphery, it's a cog in the wheel and if that cog breaks, we really are in trouble and I don't mean we as in the Trust, as in Craigavon, I mean, the Northern Ireland health service, because if a problem takes down Daisy Hill, the next day, the South West Acute and the Causeway panic and they get into just as much trouble, just as quickly. So we are really in a bad place, and we have to do something rapidly." explained Dr Duffin.
Dr Duffin said he had never seen this speed of collapse. "I know what the staff are telling me. I know they said we needed this, we went and spoke to people, they literally didn't listen to us. We bombarded them with emails, they didn't listen to us. The day after we resigned we get an email saying, you remember there was talk of this new service that you thought was a good idea. We think it's a good idea now - The day after they've resigned! The stuff I've heard would make your hair curl. I've gone and I've looked back through Trust briefing notes, agendas, minutes to see when this first came to the fore. The Futures Group picked up on it last summer that Medicine was in trouble. Everybody at that stage was concentrating on Emergency General Surgery but we said something's going on in Medicine too, we're not sure where the details are and it has to be sorted. I can't find anywhere in any Trust communication any discussion of Medicine since then, to now. I mean, somebody had to have seen what was going on, somebody had to have taken some action. What action has been taken? What action has not been taken? Have these staff had exit interviews? I mean, we've six of them now, we should know what's going on. We should have something we can deal with."
Monumental Disaster
He believes an emergency intervention is necessary along with leadership both within the organisation and in political circles but he can't see a quick solution. "For the first time in my life I think I'm speechless. I have no idea. This is such a monumental disaster, that I cannot see a quick solution. But I can say you need two things. You need an emergency intervention now to retain the staff that you've still got. Don't assume the ones that are still here are going to stay. We've heard from multiple sources today they're not happy right across the board, Nursing, Medicine everyone, and your service is your staff. You lose your staff, you fall apart. So there needs to be some sort of staff focused, staff involved, staff listened to emergency intervention from management, to do a lot of listening to what the staff say, this is what we want, this is what we need. And I think they'll tell you what might work.
"I don't know what might work. I recognise the recruitment crisis all across the board. I recognise that there's 3000 short nurses in Northern Ireland. I recognise all of those problems and I can't fix them and until we take our *politicians by the scruff of the neck and say, get up of your backside and do the work you're getting paid for nothing is going to change, because I mean, no matter how good the health care staff are, they don't do miracles without leadership, without a budget, without a government. That must change and it must change maybe in September when it suits one particular political party. It has to change rapidly. The Trust need a rapid intervention, the medium term the politicians need a rapid intervention. I'm delighted to hear that Liz is so up for getting things moving forward, but it has to be done. Now, I'll end by saying what I said at the start, this is not an Emergency Department problem and the Emergency Department is sacrosanct. If in the process of trying to save Medicine, you cause harm to the Emergency Department that will be irretrievable. We will be worse than we were six years ago."
Departments are all Interlinked
Dr Duffin added "But the problem is that they're all interlinked. If there isn't a good Medical Department, where's the Emergency Department going to put the 25 admissions that pitch up at the door every day? They are all interlinked. If there isn't a good Emergency Department in Daisy Hill we all know Craigavon's going to get into major problems. But so's Belfast.
"People from Newry when they can't get service in Newry they don't drive across the bad roads to Craigavon, they drive up a nice straight road to Belfast. And the same will apply to Medical Services as well as Emergency Services. If you can't get medicine in Daisy Hill, you're going to go to Belfast. The Belfast Trust is not going to be a happy bunny if it suddenly finds a significant increase in its workload and that has to be taken into account."
Spelling out graphically how all the services overlap and how one falling down could affect the others Dr Duffin concluded "We spent the last year talking about the Emergency General Surgery issue. The clinicians who provide that surgery say we have to change it, and who are the non clinicians to argue with them. Yes it has to be changed. The upside is that Daisy Hill will now be an elective, overnight surgical centre. Great, we'll be able to do something about the worst NHS waiting list in the United Kingdom great. What happens if we have no Emergency, what happens if we have no Medical Department? Do you think surgeons are going to be happy even doing elective work with no medical backup? No. That's what I mean by everything being interlinked. You can't knock over one domino without the whole thing collapsing and that's the seriousness of the situation. And the politicians need told that in little polite words. If anybody wants them told that in very impolite words, give me a call."
* error in transcript corrected 8.20pm 26/5
