Retired surgeon may head Cavan unit

A retired surgeon has been approached to take over as head of the troubled surgical unit at Cavan General Hospital

A retired surgeon has been approached to take over as head of the troubled surgical unit at Cavan General Hospital. Eithne Donnellan, Health Correspondent, reports.

The move to appoint Joe Johnston, who retired from practice at Mayo General Hospital some time ago, comes in the wake of a number of critical reports on the unit at Cavan hospital, one of which described it as "dysfunctional".

An absence of surgical leadership at the unit was identified in a report by the former North Eastern Health Board's medical adviser Finbarr Lennon over a year ago after he examined some 15 adverse clinical incidents at the unit between September and December 2003.

A Royal College of Surgeons in Ireland (RCSI) report last December, following its inspection of the unit, also criticised the ongoing lack of surgical leadership in the department.

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The unit has been run mainly by locum consultants since the suspension in August 2003 of two of its three permanent surgeons, William Joyce and Pawan Rajpal, over so-called "interpersonal difficulties".

While their suspensions were lifted last December by Minister for Health Mary Harney, neither have yet returned to work. Mr Joyce is challenging in court the conditions which the Health Service Executive (HSE) wishes to impose on him prior to his returning to work and Mr Rajpal is awaiting the outcome of a Supreme Court case in which he appealed the decision to suspend him in the first place.

The RCSI report of late last year also called for more resources, including dedicated surgical beds, to be provided immediately at Cavan hospital. This hasn't happened and Prof Arthur Tanner, director of surgical affairs at the RCSI, said yesterday he was "very disappointed" at the failure to provide ringfenced surgical beds at the hospital.

He added that a person who had agreed to be the new head of the surgical department would not take up the post until there was a "cast iron guarantee" that all infrastructural recommendations for change in the RCSI's report would be put in place. These included ringfenced beds and adequate finances to support the running of the unit.

These beds also needed to be put in place before the appointment of three permanent consultant surgeons to the unit, something which had also been recommended in the RCSI report. The HSE north east region interviewed for these posts recently.

Prof Tanner said the HSE was concerned if something was put in place in Cavan every other hospital would want similar treatment. But he said a special case had to be made for Cavan hospital. "Our case is that Cavan is not every hospital in Ireland. It requires additional help to put it back to a position where it can deliver safe surgical care."

Staff at the hospital have been informed by e-mail of the proposal to appoint Mr Johnston. The message stated negotiations with him about the appointment were ongoing. It is understood Mr Johnston has already visited the hospital and met some staff.

Meanwhile, it has emerged that the RCSI has told the HSE it will not give permission for surgical training for junior doctors at Cavan hospital from July 1st. But it has said when the three new surgeons have taken up their posts later in the year it will reconsider this decision.

The surgical unit at Cavan hospital has been at the centre of controversy since the suspension of the two surgeons and the death in February 2004 of Frances Sheridan (9) from Cootehill, three weeks after an appendix operation at the hospital. A post-mortem found she died from complications of recent surgery.