Closing hospitals and the ‘ungovernability’ of Roscommon…

The people of Roscommon are a formidably independent bunch. They are under no illusions why they send TDs to Dublin. It is to defend the parish from the cutehoors and Jackeens of Dublin: no more; no less. No one puts the least store in the county council, since Jack Lynch had their teeth removed back in 1977.

Sure there are concerns about the state of nation and the knock on effects that has for the local economy, but their TDs know too that they are permanently on notice to quit if they don’t deliver.

Even their counterculture, cannabis-toking TD Luke ‘Ming’ Flanagan knows the value of a good local interest (aka populist) platform. His protective stance over turf cutting, for instance, does not exactly come with a Friends of the Earth approval tag.

I doubt the decision of Dennis Naughten of Fine Gael to vote with the Opposition (and subsequent loss of his party’s parliamentary whip) against his Minister’s decision to close the Accident and Emergency facility at Roscommon Hospital was taken willingly. But it was probably inevitable in light of his Minister’s rather bizarre (and with hindsight rather foolish) decision to pledge:

…to retain the Emergency, Surgical, Medical and other health services at Roscommon Hospital which are present on the formation of the 31st Dáil. Furthermore, in the event of the A&E being downgraded, we are committed to reinstating a 24/7 service, where feasible.

It should be noted too that the previous government may have been aware that Roscommon County Hospital was on the axing list as early as last September:

While Dr Reilly, who took over as Minister in March of this year, is unlikely to have had sight of this previous safety report, it is not known whether his predecessor, Mary Harney had seen it. The HSE did not make publicly available the September 2010 report, which was released to under FOI.

Now, there is a strong clinical case to be made for the move. Patient outcomes are four times better for a number of acute conditions in Galway A&E. But Fine Gael was not making it before taking two seats out of Roscommon/South Leitrim. Nor, to be fair, was any other party. No one could credibly pitch that one to the voters and stand even a remote chance of getting in.

One of the reasons (and acutely understood by local people) for the differential in outcomes is a lack of investment in specialist staff at the hospital. What’s never cited, the likely outcomes for people living in Roscomon who have to get to Galway in the first place. Time and again people reiterate their fearful mantra of ‘dying on the road to Galway’.

As Peter and I noted back in February, despite the vast improvement in long distance road networks, roads west of the Shannon leave a lot to be desired:

Ten years ago a road-trip around Ireland would have lots of bumpy roads, traffic jams and long journey times, but this around it was all, well, bumpy roads, traffic jams, and long journey times. Ireland’s new motorways don’t help you much if you’re traveling between Cavan, Roscommon and Kilkenny – and these poor travel times are one of the main reasons why local folk would rather be treated in a community hospital, like in Roscommon, than take their chances on the road to a centre of excellence in Galway.

And there is the old county thing too. They are trying to rob us of another key asset (not mention an important centre of good employment where non agriculturally related work is relatively scarce) from Roscommon. First they come for A&E, but what will be next?

Of Fine Gael’s two Roscommon-South Leitrim TDs, Naughten was left holding the short straw on this issue. Roscommon town, where the hospital is based, is very much the centre of his electoral patch. Boyle publican Frank Feighan is removed from the town and so may calculate that his end of the constituency,will not be so keen to punish him for Dr Reilly’s apparent Ministerial fickleness.

Naturally enough, most political correspondents in Dublin are understandably resiling to the politics of Dublin, and more specifically those of Leinster House. But the undeniable fact is that no candidate standing for election in February in Roscommon-South Leitrim was in favour of the kind of expert opinion Minister Reilly is acting upon.

The refusal of the last government to publish last September’s report  has undoubtedly skewed the playing field, both laying a booby trap for the incoming administration and dodging an electoral bullet for their own unsuccessful candidate, Ivan Connaughton.

Such local trumping of the national interest by the local is one serious problem for governments of all stripes. It further underlines the need for the substantial beefing up of local democratically elected power at a time when many fear the resolve of all parties to ‘do-the-right’ on constitutional reform seems to be waning the teeth of the economic crisis and the irresistible urge of the opposition to make make political hay whilst the government’s caught out in a political downpour.


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