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Not many gatherings would see the presence of two MP's, 5 MLA's and a Councillor but the emotive issue that is Daisy Hill Hospital ensured that the political representatives all descended on the Thinklab at WIN Business Park, Newry this morning.
These representatives plus a member of the Bengoa Expert Panel, representatives from Daisy Hill Pathfinder Group, Newry Chamber of Commerce and Newry and Mourne Enterprise Agency all form part of the new Daisy Hill Future group who today set out their vision for Daisy Hill Hospital at a Press Conference at the Thinklab.
Vision
The vision is that 'Daisy Hill will be a major acute healthcare hub providing safe accessible services for citizens in the east border region.'
The new group spelt out six aims:
- To secure a reliable ambulance service for the Greater Newry Area
- An electrical supply upgrade at the hospital with the provision of an MRI suite
- Staff contracts need to be Trust wide and not site specific
- Newry, Mourne and Down Council need to transfer the present Council Offices at Monaghan Row to the Trust to enable the hospital's development and expansion
- Elective surgery hub status confirmed for Daisy Hill
- Specialist workforce need to be recruited
Equality
Daisy Hill Future Group, Chair, Conor Patterson explained the background to the group and pointed out that this area makes a disproportionately positive contribution to the Northern Ireland economy.
"Newry urban area alone notwithstanding the size of the hinterland which we've talked about, represents about 2.5% of the population of Northern Ireland and this Newry urban area contributes 10% to the private sector economy in Northern Ireland. We're not saying we want 10% necessarily of the budget - which would be £2.1bn for Newry. What we are saying is, it should be understood in Belfast the extent to which per capita, arguably we provide three times the contribution to the Northern Ireland economy than other areas of Northern Ireland do."
Patterson continued "Forty percent of the ED caseload in the Southern Trust is handled by Daisy Hill Hospital. Every citizen in Northern Ireland has a right to the same expectation of safe accessible, acute healthcare and a key principle underpinning the delivery of services in Northern Ireland is what's called Section 75. It underpins the equality provisions in the Good Friday Agreement. Temporarily moving services to avoid a section 75 audit is not acceptable, it's the principle of section 75 counts not the practice. So the principle should be - every citizen has a right to the same provision of service in this jurisdiction, because we know there are intra regional disparities, not just in income, but also in access to services, and in health outcomes.
"A male for example, living in parts of North Down will live nine years longer than a male living in west Newry. That's a reality, that's a big metric. And all of this relates to the future access of people disadvantaged currently within the health service, arguably if this is about 'the greater good' and we are lectured about the greater good, arguably the intervention should be to address those health service disparities not to reinforce the pre existing advantage that certain citizens in this jurisdiction have over others."
Patterson explained in detail the aims of the group "Our first priority is to secure a reliable ambulance service for the greater Newry area. Everything else that can happen is within the restructuring, which we acknowledge is necessary to bring 21st century medical opportunity to citizens in this community. All of that is predicated on the availability of a reliable ambulance service to citizens in this community.
"The electrical supply upgrade must be prioritized and the development of an MRI suite at the site.
"All staff contracts must be Trust wide not site specific. It is not defensible, that staff can insist that they only work at one site. If they are recruited into the Southern Trust and it is a campus offer to citizens and to employees. That needs to be underpinned in the staff contracts that those employees are required to sign up to.
"We are working with the Newry, Mourne and Down Council and other stakeholders to enable a transfer of the Monaghan Row site as quickly as possible to the Southern Trust and in fact that can enable redeployment of staff from the current site at Daisy Hill into the pre existing office facilities in Monaghan Row in those buildings, and that frees up significant space within the current Daisy Hill site. to enable for example, the redeployment of elective surgery into new suites at the current Daisy Hill site."
Patterson said their aspiration is for elective surgery hub status to be confirmed for Daisy Hill.
"And when that is worked out, we are then in a position to sell Daisy Hill Hospital as an attractive option for clinicians, not just from this jurisdiction, but from abroad, to be attracted to work in the Southern Trust and specifically to do some of their work at Daisy Hill Hospital. Daisy Hill is a teaching hospital already. But that teaching hospital position needs to be reinforced, it needs to be attractive to medical students and that depends on dynamic senior clinicians being available to oversee, mentor and give support to those students at the Daisy Hill site, but not just exclusively Daisy Hill, but within the campus structure, also including Craigavon. And then that the full range of surgery can again be available on site at Daisy Hill Hospital.
"We accept that emergency surgery is no longer a general discipline, that emergency surgeries that are required will depend on the type of emergency that presents and that those emergency surgeries may need to be carried out at specific acute hospitals within Northern Ireland. Our argument is that Daisy Hill should be one of those acute hospitals that can service some specific emergencies that may present, that those can be handled by specialists that are on site at Daisy Hill. So that's our aspiration in the longer term."
Concluding the Chair said "We recognize that this is multi-annual plan, that these challenges have been long in the making, they're not exclusive to Daisy Hill but the steps this development pathway have put together recognizes that, step by step we can put back in place a service that will be admired across this island and internationally and that is possible."
Great admiration for Daisy Hill
Bengoa Expert Panel member Mairead McAlinden spoke of her involvement in setting up a Nightingale Hospital in Exeter during the pandemic and the challenges in the sector at the moment.
"One of the main challenges we face at the minute as a health service is that our emergency demand is outstripping our ability to provide timely elective care, timely planned care. I've been working in south west England looking at what's called protected elective capacity. I was very involved in the setting up of the Nightingale Hospital in Exeter which was the COVID Hospital for that area. When that was stood down, we actually bought the facility in south west and we've turned it into protected elective capacity phase one. So it is now providing a wide range of orthopedic interventions, ophthalmology, and those two specialties were selected because they have the longest waiting times in Devon for elective care.
"And I have to say I have been absolutely amazed at the innovation that the teams who are working in that facility are delivering. I think it's something like 60% is done on the same day of hip surgery. We have fast streaming, fast diagnosis for ophthalmology procedures, and those teams are coming from elsewhere. So some of the teams are coming from Exeter, some of them are coming from Torbay and they pick their sessions and they work there and they work in a very different way than they work in their own hospitals, because they are uninterrupted by emergency demand. Beside that there is a suite of diagnostic capacity and that includes MRI, and CT. It's basically a one stop shop and the feedback from patients has been amazing. I mean, there was one chap who I think had waited almost three years for his hip surgery and walked out of Nightingale Exeter on the same day."
McAlinden explained that the Nightingale hospital doesn't have an HDU or an ICU high dependency unit but is able to carry out so many procedures without this.
"Imagine what Daisy Hill could do with a fantastic High Dependency Unit, which was developed during my time as Chief Executive and I'm not sure if it's still working that way but there was a robot link to the ICU unit in Craigavon. So there's absolutely no reason if we say that Daisy Hill has a potential to be a protected elective capacity centre, that it can't be driven at pace because actually, we did that in the Nightingale. We transferred it from a COVID hospital to a protected elective capacity in eight months. So it's very doable and doable at pace." she said.
Pointing out the importance of the electrical infrastructure in Daisy Hill McAlinden said "This is a major hospital, it provides renal services, maternity services, huge range of diagnostics and 24/7 emergency department and we cannot let it be vulnerable to something as fundamental as a good electricity supply. So I think the plan that has been set out is the right plan.
"The Bengoa expert panel was always focused on 90 to 95% of what local people need is delivered locally and that's your GP services, it's your diagnostic services, it's your medicine services. It's a good ED. So actually Daisy Hill which I have the greatest admiration for in terms of infrastructure and staff, just needs that little bit of support to take the next move in its development journey. It's already a fantastic hospital but I think the panel here is really committed to help them take the next steps, and I'm absolutely part of that journey."
McAlinden spoke on how Daisy Hill should be seen not as a problem but as an asset. "It's a huge asset. There's been new theatres, there has been a really good investment in HDU Department. There's all sorts of innovation happening there. And yes, we have lost some of the really strong clinicians who basically held services together. But if we make this an attractive offer, and you're talking about workforce people will want to come here. There's huge assets in Daisy Hill and in the outline area, education, housing, everything to attract new consultants, but we have to lift the doomsday scenario from Daisy Hill. We have to say there are positive things happening here. We have to say that this is an interesting place to work where you can develop your skills and interests. We have to say if you come here you can do your work and that is I think, the key message behind this plan."
A timely campaign
Panel member, Finance Minister, Conor Murphy MLA said he believed the new groups emergence was timely with concern over service provision growing, the Health Minister Robin Swann moving on post Covid and the potential of the Council's Monaghan Row site for the hospital.
"This is timely for probably two reasons. One, the level of concern about the lack of service is growing. We had an experience in Newry just a couple of months back which shocked everyone. The other thing is that the Health Minister is now moving ahead post COVID with the redevelopment of services and he's made announcements in the last number of days so I think it's timely that a group like this has come together and we've been doing some work for some time now over the last number of months and I want to thank Conor for convening that and bringing us all together. As he has said, this is not just a group that's cross party, but it's also people with a clinical background, people like Mairead with an administrative background, ordinary citizens who are concerned about the future of the hospital.
"Previously we have come together with a lot of people from the Pathfinder group and they have done excellent work but their focus and remit was limited. It's specifically around stroke services so we tend to come out and get a degree of angst when a service is under threat or when the service is removed. This is a different approach. This is about actually charting what does the hospital need in the longer term, not just what's the next threat, what does it need in the long term. How will we work through and we've brought it right back to the electricity supply being the most basic thing, and let's work our way forward from there."
Mr Murphy concluded "I think it's an important development that this group comes together not just for a specific service or to respond to some loss or threat to service but to take a holistic view of the hospital and what it needs going forward for the for the next generations."
A huge asset
Emma Mullen-Marmion from Newry Chamber of Commerce spoke of the hospital as a huge asset "We've been selling Daisy Hill as an asset, a huge asset for this area. As things stand currently, with 98% employment, and we still have 1200 vacancies within this area. A lot of businesses within this area are selling this as a place to live, work and do business.
"The border in a business world doesn't exist because we have to attract talent from across the border, from anywhere that we can get it really. A huge market is our returner market. So we have to sell Newry as a place to want to live, our education system, our health system, all of those things are hugely important. and you only have to look at the brochures that go out to potential employees, they're phenomenal, they're beautiful but one of the things that they touch on is our health system and that is one of the questions that is asked, What are your Schools like and can you ensure the health of us whenever we leave whatever country that we're in to come and actually live here?"
All hands to the pump
MLA Justin McNulty saw the consensus present on the future of Daisy Hill Hospital as extraordinarily positive. "I think it sends out a very strong message the broad basis of what we have here today. You'll all know that I've been banging the drum on this for quite some time. I've been accused of parish pump politics by the media, I've been accused of electioneering by the Health Minister. But take a look around. We have a plan to enhance Daisy Hill hospital to meet the needs of the people of Newry, to meet the needs of the people in South Armagh to meet the needs of people of South Down and isn't it fantastic to have all hands to the pump. I think it's a really positive day and let's really focus on building Daisy Hill Hospital for the future."
Incredible opportunities
Séana Grant spoke on behalf of the Daisy Hill Hospital Pathfinder Group "What people are really concerned about the increased travel times is not so much the concern for specialist treatment, but it's for emergency treatment, and as surgery plans were launched yesterday for elective surgery, we noticed that some of the key requirements for the elective surgery standards were, access to imaging services, which of course surgeons in the 21st Century are going to want access to, which is why the upgrade for the electrical system, which I think people will be shocked. I think the public generally aren't aware of how bad the electrical infrastructure is in Daisy Hill. And I think that would be a shock to most people in this day and age to not have access to good electricity supply for an acute hospital.
"I think in the Southern Trust we have incredible opportunities. We have incredible advantages and we plan to use that momentum to move Daisy Hill and services for everybody in the Southern Trust in line with modernisation and think that the plans, we work collaboratively with the Department of Health with the Southern Trust and with all the other Trusts actually because providing care all across Northern Ireland is something that we all want to improve and we think that Daisy Hill can really be a part of that."
A sustainable first class hospital facility
Slieve Gullion Councillor David Taylor spoke of the need for the local population to have proper health provision. "Daisy Hill belongs to all of us. We've all benefited from care and treatment from the hospital as have our family members and it's because we care about the hospital and we care about the area, it's the reason we're here today because that's what the focus is, It's about caring about our population and a growing population and that's what we want to do here.
"Even if we weren't elected representatives, we would want to play our part but as elected representatives we obviously have a role within the community to deliver the best services for our people.
Cllr Taylor concluded "As a resident of the area I want what's best for everybody here and I think what we see here today would ensure that we have a future sustainable first class hospital facility. We already have first class staff, a great asset as it is but we want to develop that further to ensure that our population has the best health delivery outcomes that we can"
Potential
MLA Liz Kimmins spoke of the potential of our entire area. "We want to do away with this perception or this view from others that Daisy Hill is a small hospital. No matter the size, it's the innovation, it's the potential, It's actually the work that's ongoing and that's what we want those potential staff, surgeons, clinicians to hear.
And again, in addition to that, the wider aspect of what Newry and surrounding areas have to offer. We attended a conference last week in the Canal Court and Newry's a very exciting place and I think we have a lot coming and that all feeds into it, you're talking about education, and facilities and all of that. We we do have so much exciting things happening. So that will all feed into it and I think that as elected reps, that's where we can come in in terms of engaging with the departments as well to ensure it is now underway. And we see that particularly for the ambulance service."
Ms Kimmins concluded "Workforce and the infrastructure are two of the key issues that we have to deal with here. And I think with this group collectively that's something that we can push on with and make sure that the decision making bodies who make the decisions in terms of this will see that we're not going away. We know what we're talking about, and that we will be pursuing this to the bitter end."
Positivity
Mickey Brady MP spoke of the great asset that Daisy Hill is "Daisy Hill is an asset, it's not a problem. It's an asset and the purpose of this group is to make sure that that asset remains and is expanded to its full potential."
The MP added "To me the great aspect of this group is the positivity surrounding Daisy Hill and to promote that and to continue that and therein lies the solution to the problem."
Need for collaboration
MLA Patrick Brown spoke of the need for collaboration between both hospitals in the district. "I would be keen to see as much collaboration as possible with the Downe Hospital and Downe Health Committee in terms of making sure that we're not potentially competing for elective care services, but that we are collaborating and trying to think together how we can maximize services across both hospitals. I appreciate they are different trust areas, but I think that's definitely the way forward, we're in a unique position here in South Down with two hospitals that have fantastic potential, great facilities, but are constantly coming under threat of losing services."
Future role for North South Ministerial Council
South Down MP Chris Hazzard also thought colloboration between both hospitals should be a priority. "I think it's no accident that if you look at Newry, Mourne and Down district that you have two hospitals in Daisy Hill and even the Downe at the other end, that very often ambulances are going past to go outside of the district and then get sucked in and stay and can't get away because patients aren't being offloaded off the ambulances and into ED's because they're worried about the figures in those other ED's.
"So that's part of the problem as well. We then have an opportunity I think through the Shared Island Unit and if you look at the Peace Plus Programs, there's billions of pounds available to work with collaboration, looking at pilots. This particular around Daisy Hill especially for ambulance response, that's something that should be looked at, here's no doubt about it. I think that's a future role for likes of the North South Ministerial Council"
Wasting time 'firefighting'
MLA Sinead Ennis thought that spending so much time firefighting, and constantly dealing with those individual issues made it difficult for progress and thought the groups approach was the right one. Sehe also thought there was an equality issue too. "It's an equality issue the issues around Daisy Hill and while we're still seen on the periphery of the North we're never gonna get anywhere. As long as Daisy Hill is constantly peripheralised, then it's going to be a downward spiral. So we need to break away from that and that cross border east border region, aspect we're trying to put on this I think will be very beneficial."
The work is just beginning for the Daisy Hill Future group with a suggestion that they may need to take the campaign to Belfast following the no show from the Belfast press.
