Council Minutes

Health Care Committee - 03/09/2009

3rd September 2009

Minutes of the proceedings of a Meeting of the HEALTH CARE COMMITTEE held in the Council Chamber, Council Offices,The Grange, Mountjoy Road, Omagh on
THURSDAY, 3 SEPTEMBER 2009 at 7.03 pm


Presiding Chairman: Councillor J McLaughlin

Other Members: Councillors:

S Clarke P J McDonnell
J Deehan S O’Brien
F Donnelly A Quinn
A M Fitzgerald A G Rainey MBE
M McColgan

In Attendance: Clerk and Chief Executive
Policy Officer
Committee Administrator
Mr L McIvor ) Northern Ireland
Mr B McNeill ) Ambulance Service

Mr J Doherty ) Western Health
Dr M Parker ) Social Care Trust

Apologies: Councillors:

S Begley P J McGowan MBE
R Hussey S Shields


AT THE OUTSET: the Chairman, Councillor McLaughlin, advised that following the announcement the previous day of the temporary suspension of Gynaecological services at the Tyrone County and Erne Hospitals, the Chief Executive of the Western Trust had agreed with Council staff that Trust representatives would attend the meeting to advise Councillors of the situation. He added that the representatives would be received later in the meeting.



WELCOME: was extended by the Chairman to Mr Liam McIvor, Chief Executive and Mr Brian McNeil, Director of Operations, Northern Ireland Ambulance Service.

IN HIS OPENING: remarks, Mr McNeil advised that the Trust had been lobbying for some time for additional funding and it had secured more funding from the Comprehensive Spending Review investment than that required to be released through efficiency savings. He added that the CSR investment was specifically designed to improve ambulance response and support service development. In relation to current provision, he advised that one 24/7 A&E vehicle was provided in Limavady and another in Castlederg with an additional A&E vehicle being provided in both Enniskillen and in Omagh. He added that a deployment point had also been provided in Irvinestown. In relation to Omagh, he advised that three night shifts were currently provided Monday to Friday, four on Saturday and Sunday, and that four day shifts were provided in all of the areas seven days per week.

IN ADDITION: Mr McNeil reported that CPR cover had also been increased and, in terms of capital investment, that 24 new vehicles had been purchased 7 of which had gone to the Western Trust area and included the additional A&E vehicles allocated to Omagh and another to Enniskillen. He added that the condition of all vehicles was currently under review in an attempt to ensure that the vehicles covering the most mileage, for example, the Omagh district, were in good condition.

Councillor Deehan entered the meeting at this juncture.

DISCUSSION: ensued, during which concern was expressed by members regarding the NIAS HSC Trust’s proposals for efficiency savings and comprehensive spending review investment and Mr McNeil and Mr McIvor answered members’ queries in relation to the matter. In acknowledging the possibility of longer travelling times for patients being transported to an A&E department, Mr McIvor spoke of the proposals to reduce unnecessary demands on emergency ambulances and to maximise resources in a planned way across Northern Ireland through the assistance of a transport co-ordinator. Mr McNeil confirmed that some additional Intermediate Care Vehicles (ICV) were planned for immediate provision and that more vehicles would be provided as resources became available.

ADVISED: by Mr McIvor, that, due to the funding which had been secured and the work of all involved in delivering the service, response times had improved across all of Northern Ireland, particularly Omagh. He reported that 76% of ‘Category A’ calls in Omagh were reached within 8 minutes while the target for Northern Ireland was 72.5% within 8 minutes with a minimum of 65% for each local area. He paid tribute to the work of the NIAS Management Team in securing the funding to modernise the ambulance service making it more effective and efficient. He advised that a number of road shows had already been staged as a means of engaging with staff regarding the proposals and that it was intended to seek their views as the changes were implemented. He further indicated that he would work with ambulance crews in an effort to develop improvements to assist in alleviating pressures where possible.

HIGHLIGHTED: by Councillor Deehan, the fact that there was a greater reliance on the ambulance service in the West Tyrone area due to the geography and demographics of the area and also the fact that when acute services were removed from the Tyrone County Hospital, an assurance had been given by the Minister for Health, Michael McGimpsey MLA, to provide additional ambulance services in the Omagh district. She voiced concern about emergency response vehicles being called away from Omagh to travel long distances and the length of time patients in the Omagh area would have to wait to be transported to an A&E department. In this regard, she felt that the unique circumstances which existed in Omagh should have resulted in the Minister and the NIAS making a special case for Omagh as the area was totally reliant on the ambulance service. Making reference to the Mobile Coronary Care Team and the Cardiology Assessment Unit which remains at the Tyrone County Hospital, Councillor Deehan felt that it would be to a patient’s advantage to ring for a cardiac ambulance directly. However, she explained that as the call would bypass the Tyrone County Hospital at present, this procedure should change in order that the excellent service which operated at this hospital would be fully utilised. During further related comments by Councillor Deehan, she was informed by Mr McIvor that patients who were authorised to call out a cardiac ambulance were identified to the NIAS by the Western Trust.

Councillor McDonnell left the meeting at this juncture.

INDICATED: by Mr McIvor that the NIAS was aware of the concerns which had been raised about the potential impact of the proposals on rural areas and that this had been reflected back to the Minister. He advised that the NIAS would continue to work to deliver the responsibility of care to the people of Omagh and would assess the impact of the proposals and convey them to the resource providers. In relation to a query concerning destination protocols, he advised of the establishment of a review group, to which Dr Deeny MLA had been appointed to provide GP representation, and he explained that when the NIAS could be assured of paramedics safely identifying the condition of patients, they would be taken to the Tyrone County Hospital. However, he added that an expectation that paramedics should make an assessment could place an additional burden on them when the necessary equipment which would identify the condition was available in acute hospitals. Following an enquiry by Councillor McColgan, Mr McIvor undertook to provide the Council with a NIAS definition of the ‘Golden Hour’. In conclusion, Councillor McLaughlin advised of complaints which he had received concerning three elderly people who had been transported from Tyrone County Hospital to the Erne Hospital for treatment and had to pay for a taxi home.

Mr McIvor and Mr McNeil were thanked for attending and they left the meeting at this juncture.


WELCOME: was extended by the Chairman to Mr John Doherty, Director of Women’s and Children’s Services and Executive Director of Social Work and Dr Michael Parker, Clinical Director of Obstetrics and Gynaecology, Western Trust.

IN HIS OPENING: remarks Mr Doherty explained how it had been necessary for the Trust to take a decision to suspend temporarily some gynaecology services the previous day, in order to maintain safe acute maternity services at the Erne Hospital, as a result of five of the six junior doctors appointed by the Trust failing to take up their posts. He apologised for the way in which the matter had come to the attention of the Council and recognised that it should have been informed of the situation at an earlier stage.

DISCUSSION: ensued, during which members voiced concern at developments and the Trust representatives answered members’ queries in relation to the matter. Mr Doherty and Dr Parker provided a detailed description of the events which had led to the suspension of services and they provided details on the process of the appointment of junior doctors, the effect of a new Government requirement for appointment and certain recruitment difficulties. They assured members that every effort was being made to restore the gynaecology services as soon as possible and Dr Parker envisaged that these would be reintroduced within the next 2 – 4 weeks. He informed members that the situation was not unique to the Western Trust area and advised that all Trusts were affected at various times in different specialities. Councillor Deehan provided information on a constituent who, following recent cancellation of her appointment, wrote to the Minister who informed her that the matter was the responsibility of the Western Trust. She spoke of her dissatisfaction with the Minister’s response and felt it unacceptable for him to absolve himself from responsibility. Furthermore, she voiced concern in relation to the current arrangement for the appointment of junior doctors through the Northern Ireland Medical and Dental Training Agency (NIMDTA) and the inability to ensure that the necessary provision was available in hospitals to provide for the needs of the population. Dr Parker advised that all of the Trusts in Northern Ireland were dissatisfied with the current practice.

IN CONCLUSION: Dr Parker assured members that it was the aim of the Western Trust to restore services and to provide the best health care possible for the people of the area. Mr Doherty indicated that it was now intended to explore different models for the filling of posts in an effort to ensure planning with some certainty for the delivery of services into the future. Dr Parker spoke of a need to make vacant posts attractive to junior doctors and he sought the support of Councillors in both Omagh and Fermanagh in assisting the Trust to fill hospital positions by ensuring positive publicity.

IN CONCLUSION: Mr Doherty undertook to keep the Council informed of developments.

Mr Doherty and Dr Parker were thanked for attending and they left the meeting at this juncture.


3.1 Request to Meet Councillors to Discuss New Hospital in Omagh (VB/23/1)

SUBMITTED: letter dated 9 January 2009 from Mr Kevin Taylor, Western Innovations Network, requesting an opportunity to attend a meeting to discuss the way forward on the proposed new hospital in Omagh.

RECOMMENDED: after brief discussion, on the proposal of Councillor Deehan, seconded by Councillor Rainey, that the Chief Executive offer to meet Mr Taylor or, alternatively, invite him to make a written submission, whichever was preferred by Mr Taylor.

3.2 Local Government (Miscellaneous Provision) Bill - Public Consultation (VB/23/1, CL/5)

SUBMITTED: email dated 17 August 2009 from Mr Sean McCann, Assistant Committee Clerk to the Environment Committee, Parliament Buildings, advising that the Committee would now commence oral evidence sessions and inviting a maximum of five Councillors and Council officials to attend a meeting to be held on Thursday 24 September 2009.

RECOMMENDED: that approval in principle be granted for the Chief Executive/Policy Officer and four party nominees to attend the oral evidence session to be held in Parliament Buildings, Stormont, on Thursday 24 September 2009.


4.1 Special Council Meeting with Minister for DARD

REFERENCE: was made by Councillor Rainey to Councillors having been informed earlier in the day of the cancellation of a meeting with the Minister for Agriculture and Rural Development, Michelle Gildernew MP MLA, on 9 September owing to diary commitments and also the pre-meeting which had been arranged to take place earlier this evening. He expressed disappointment at developments and hoped that both meetings could be rearranged in the near future.

RECOMMENDED: that a new date be obtained for the Minister’s visit and, in preparation for a meeting, a pre-meeting be arranged to take place as soon as possible.

The meeting concluded at 9.20 pm.


CHAIRMAN ______________________

CLERK AND CHIEF EXECUTIVE ______________________

DATE 6 October 2009

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