Patients with acute tuberculosis in the eastern region should be treated in a new specialist unit at St James's Hospital, Dublin, it has been recommended, writes Dr Muiris Houston, Medical Correspondent
The Working Group on TB Services in the Eastern Region, which was set up last year following controversy over the continuation of TB treatment at Peamount Hospital, Co Dublin, has recommended the transfer of inpatient services to a 10-bed unit at St James's Hospital.
The group, which was chaired by Dr Mick Molloy, senior registrar in emergency medicine at Cork University Hospital, has also recommended the creation of an additional consultant respiratory physician post at St James's to oversee the new unit.
According to the working group's report, acute admissions to the 30 in-patient TB beds at Peamount ceased in April 2004. It acknowledges the need for a special in-patient facility for certain patients.
"These include those with drug-resistant TB and non-compliant patients [ homeless patients, patients with drug or alcohol addiction problems, and patients with a mental illness].
"Having considered the options, the working group agrees with the Comhairle na nOispidéal recommendation that the location of this specialist unit should be on the campus of an acute hospital."
Peamount Hospital had been providing treatment for TB patients from a number of health boards throughout the State since 1916. However, the board of Peamount Hospital, in a five-year strategy published in 2003, had signalled it wished to concentrate on providing services for chronically ill older patients and those with intellectual disability.
In the area of respiratory medicine it said it wished to provide non-acute respiratory services while ceasing to operate an in-patient TB facility.
The working group recommended a minimum of six consultant respiratory physician sessions be provided each week at Peamount; it acknowledges that as an "interim arrangement", a consultant respiratory physician in Tallaght hospital will provide two consultant sessions per week.
In moving TB facilities to St James's, the expert group has called for the National TB Reference Laboratory service, which is to be located on the hospital campus, be made available "as a matter of urgency". It wants the transfer of TB outpatient clinics from Peamount to St James's to be considered "a priority" with the move completed by the end of this month.
And it recommends the new 10-bed in-patient facility at St James's be operational by the end of this year.