STATE LOOKS TO KERRY AS EXEMPLAR OF HOSPITALS’ MERGER
NOWHERE has the merger of private and public healthcare worked more effectively than in Kerry.
That’s according to Bon Secours Hospital Tralee manager TJ O’Connor, speaking to The Kerryman this week of the extraordinary period since the HSE takeover of 20 private hospitals at the start of April.
The move marked the greatest experiment in the history of Irish healthcare, in response to its gravest threat – the new coronavirus then ravaging parts of Italy and New York.
The Bon Secours went public overnight, merging with University Hospital Kerry in a manner unthinkable just weeks beforehand.
A handful of the hospital’s independent, self-employed consultants notably resisted the move initially. While nine of them last week flagged their resignation from the new public contract by the end of July (see right), their contribution to the fight against COVID in Kerry made all the difference in the optimal response mounted by both hospitals, Mr O’Connor said.
“The transition wasn’t that chaotic to be honest about it,” he told The Kerryman this week. “It had been well flagged and, in fairness, we have always had a very good working relationship with UHK. Our single biggest thing was ‘what was our community going to need from us in the fight against this disease?’.
“We needed to prepare however we could for what was coming and to be in a position to take as much of the essential work as possible from UHK so that when the surge did come, we would be there with the support UHK vitally needed.”
The nation held its breath as the daily figures began sky-rocketing from early April (peaking on the 14th on 1,068 daily confirmed cases), and hospitals braced for the very worst. Though not on the initial front-line, staff at the Bon Secours were anticipating frantic scenes within a matter of weeks.
“There was a plan to have COVID patients here all along. In phase one, we were to have been non- COVID, but once the surge continued in the way predicted on the basis of the experience in other countries like Italy, it was projected that both UHK and the Bon Secours would then have COVID patients. Thank God that never materialised and that the curve was flattened.”
The Bon Secours did experience the disease, in a number of patients transferred from UHK and in a handful of staff members. But the virus was kept in check by an ever-vigilant system put in place by all staff.
“The arrangement was that if we had suspicions of COVID in any of the hundreds of public patients we took in, and if they tested positive, they were transferred back to UHK. UHK were brilliant, anytime we have had a COVID patient they were taken back straightaway.”
Sticking to protocols and following PPE guidelines to the letter kept the COVID in check, Mr O’Connor said. He said there had been little problem with PPE from the outset: “Everybody struggled to maintain their store of PPE, but our procurement people through the Bons Secour Group did a fantastic job, so we’ve been well stocked with PPE throughout.”
One of the greatest health concerns through the crisis has been the effect on chronic non- COVID patients, either previously within the care of the private system or those becoming ill during the pandemic.
“The professional guidance at the moment is that only urgent essential work should be pursued. We cannot have patients who are clinically compromised, and we always rely on consultants using their clinical judgement to decide when a case is urgent.”
In the case of consultants’ erstwhile private patients, they would have been admitted since April as public patients to the hospital alongside its work in supporting UHK in its essential care, all the time in as COVID-free an environment as was possible to achieve.
“We would have been actively trying to keep ourselves clear of COVID so we could take the excess from UHK. They were brilliant in taking the few COVID patients, which meant we could get on with doing, for instance, the urgent cancer diagnostics, all of their infusions, all of their urgent, essential work that needed to be done could be done in a safe, COVID-free environment,” Mr O’Connor added.
Far from lying idle under a flattened curve, Tralee’s ‘Bons’ has had the highest occupancy rate (86 per cent) of any of the HSE’s 20 new hospitals. Though he would not be drawn on the concerns surrounding consultant contracts, Mr O’Connor said that but for the consultants of the Bons Secours, its success in the face of the virus would not have been so great.
That includes the establishment of Kerry’s first-ever surgical assessment unit there, a powerful tool for both hospitals at a time when surgeons are sharing the same roster. “All our staff should be so proud of themselves, coming in to face into this every morning. We could not have done what we have done without our consultants; they have been the difference between us and every other private hospital. From day one, they were always saying to us ‘just tell us what you need from us’, and getting stuck in in every way possible. The fact we are being told that, nationally, we are the best example of how this model can work says everything about the work of all the staff and consultants here. It’s been quite humbling to see it, really,” Mr O’Connor said.