The campaign for a neuro-surgery unit in the west of Ireland has been boosted by a promise of up to $4 million from abroad. The Minister for Health, Mr Martin, has been told that if he funds the capital cost of building a specialised unit at University College Hospital, Galway (UCHG), supporters in the US will buy the equipment.
The Minister was given details of the US offer at a meeting late last week with Ms Pat O'Dwyer, representing Prof Patrick Kelly, professor and chair of the neuro-surgery department at New York University Medical School. The Western Health Board has already given its backing to the West of Ireland Neurosurgery campaign, which is backed by Prof Kelly, one of the world's leading neuro-surgeons.
Current national policy provides for this specialist treatment at two locations only - Beaumont Hospital in Dublin and Cork University Hospital. While the international norm is to centralise such services in units serving catchment populations of a million people or more, patients with serious road traffic injuries or brain haemorrhage require rapid access.
"We are asking the Minister to sanction the building of an extra floor during the current construction work at UCHG," Ms O'Dwyer said. "Phase two of this work has already started, so we are appealing for this capital support while there is still time to alter the plans. Dr Kelly has undertaken to raise between $3.5 million and $4 million for the equipment." Patients "from Donegal to Leitrim and further south" stand to benefit from location of this unit in Galway, she said.
"If your government is going to build fabulous dual carriageways and have people careening down them, then there needs to be far quicker access to neurosurgery. Most neurosurgery cases involve emergency treatment, and trauma is the leading cause of death in people aged under 45 years," she said.
"It is the third major cause of premature death in Ireland. Time is always the critical factor."
In 1999, there were over 1,000 hospital patients from the Western Health Board area of Galway, Mayo and Roscommon with a discharge diagnosis of "fractured skull and vertebrae", and 285 with a diagnosis of "injury to spine and trunk". Also in the region, there is an average of over 40 cases of primary tumours of the brain or tissues covering the brain, the health board was told last month.
As Dr Sheelah Ryan, chief executive officer of the health board, explained in her response, there can be difficulties in the transfer of such patients from a local hospital to either of the designated national centres. These difficulties include geographical distance, delayed access to senior decision-making in the centres, and consequent delays in diagnosis and treatment.
"Safe inter-hospital transfer is crucial to good outcome," she said. "Secondary problems can arise in patients during transfer." Staff sent to accompany patients can also be absent for prolonged periods, putting pressure on their colleagues."
Mayo General Hospital and Portiuncula Hospital in Ballinasloe, Co Galway, have an ISDN link to Beaumont in Dublin, and a similar link is being installed in UCHG so that images, such as CAT scans, can be transferred directly.
This technology has the potential to reduce unnecessary transfers by up to 20 per cent, and improve diagnostic accuracy. However, most patients still need to be seen and treated by a neuro-surgical team.
The additional trauma associated with transfer of a patient involved in a road accident or other emergency is one of the central planks of the helicopter emergency medical service campaign spearheaded by Mayo GP Dr Gerry Cowley.
However, with an election looming and a Government commitment to improving health services, the campaign is hoping for a positive response to its efforts.
"A helicopter will help, but the west needs more than that," said Ms Pam Fleming, chair of the campaign.
