Alleged promises, alleged betrayals, resignations, protests, concerned citizens and demonised politicians. The closure of Roscommon’s A&E service in 2011 would have made for one hell of a drama series.

Politicians that left were martyrs; the one that stayed was vilified. In one of the most heated episodes of 2011, the Irish Country Living looks at how the closure of Roscommon’s A&E has impacted the county five years on.

Sequence of events

A breakdown of what happened at Roscommon:

  • December 2010 and January 2011: A meeting took place between the Hospital Action Committee and Minister James Reilly in Dail Eireann, where an agreement was reached to continue to provide the A&E services in Roscommon.
  • February 2011: Enda Kenny makes “a promise” to keep Roscommon A&E open. The general election takes place. Roscommon elect Denis Naughten and Frank Feighan, both of Fine Gael as TD’S for the constituency.
  • March 2011: Enda Kenny becomes Taoiseach.
  • April 2011: The Mallow HIQA report is published which reports on the Quality and Safety of Services in smaller hospitals. This would have a major bearing on the future of the A&E.
  • June 2011: Rumours emerge that the A&E service in Roscommon hospital was to close. They were initially denied.
  • July 2011: It is announced that Roscommon A&E is to close to be replaced by an “Urgent Care Centre”. Mass protests begin in Roscommon in an attempt to keep the services open.
  • July 6th 2011: The decision to close the A&E is passed by 96:46 votes in the Dáil. Denis Naughten votes against the closure. Frank Feighan votes in favour of the government.
  • Naughten is expelled from Fine Gael.
  • Fine Gael councillors Dominick Connolly and Lawrence Fallon resigned over the decision.
  • Frank Feighan stays in Fine Gael.
  • Fear and division

    The hangover from the fallout is ever present.

    While rumours and innuendo of the A&E’s closure clouded the region back in 2011, the impact of what may occur after the A&E service ended left many uneasy. Fearing the unknown became an issue.

    Five years on and the impact leaves as many divided as the initial closure did.

    According to John Mc Dermott, one the main voices against the downgrade of the service, the region remains at a major disadvantage due to the closure.

    “The reality is we do not have adequate emergency services in the region for people with life threatening conditions such as heart attacks, strokes or major traumas,” he said. “Yes, there is an air ambulance and it is a fantastic service, but it covers the entire country and is totally inadequate. The lack of ambulances has also made closing the A&E even more harmful because of the extended length of time it takes to get to the nearest A&E.

    “People lives are in jeopardy now,” Mc Dermott continued.

    When you are told by experts that something is unsafe you would be showing tremendous negligence to continue doing it

    This is something that is refuted, however, by people on the other side of the coin. Frank Feighan, former Fine Gael TD until earlier this year, remains defiant the right decision was made.

    “The simple fact is patient safety was a major issue in Roscommon A&E. There was no cardiac consultant there; there was no paediatric consultant there,” he said. I wouldn’t forgive myself if people died in the old system that operated in Roscommon hospital.

    “Not one person has died since on account of the A&E closing down in Roscommon five years ago,” he clarified.

    In terms of individuals caught up in the events, few have been impacted as much as Feighan. When he voted in favour of the closure, he faced the wrath of his constituency. To this day that wrath is still felt; however Feighan does not regret his decision.

    “The right decision for patient safety was made. For that I have no regrets. A letter recently appeared in the local newspaper from a medical experts who vindicated me for my decision. I feel history will see that we made the correct decision,” Feighan said.

    A new €6 million Endoscopy unit opened its door in recent weeks in Roscommon hospital. It comes 12 months after it was announced that the hospital would receive €7.85 million for the development of a Rehabilitation Unit. Many would say the funding is badly needed and would have been given anyway. Others would say it is hush money to silence the protestors. Few dismiss either claim as nonsense.

    I believed I could make it work but I was wrong

    Similar to Feighan, the former Minister for Health James Reilly stands by his decision.

    “I tried my best to keep it open but the findings of the HIQA reports meant it just was not possible. I even met with HIQA to find a compromise. I believed I could make it work but I was wrong,” Reilly said. “I am a doctor by profession and when you are told by experts that something is unsafe you would be showing tremendous negligence to continue doing it.”

    The services that have developed since have been highly beneficial to the hospital according to Reilly. Services such as a rheumatology, a vascular and a plastic surgery service are now all available says the former Minister for Health.

    Dramatic changes

    Many of the same arguments made back in 2011 are still being used today. Those in favour of the closure believed the catchment of people using the service in the surrounding area is far too small to merit an A&E service. Those against the closure argue that this should not matter. Those in favour believed Roscommon A&E was unsafe for use. Those against believed it was perfectly safe. Those in favour believe Fine Gael did all they could have done within their power to save the service, those against firmly believe they did little and certainly not enough.

    The political scene has now dramatically changed in Roscommon. No Fine Gael TD was elected in the constituency in the last general election. Frank Feighan chose not to run and Denis Naughten became an Independent. In the local election, four Fine Gael Councillors lost their seats while two resigned and were re-elected as Independents.

    Of the 18 seats in Roscommon County Council, only three are now held by Fine Gael. While many results of the closure of the A&E remain ambiguous, the political shift comprehensively shows how unpopular the closure remains among the people of Roscommon, despite the fact that five years have passed.

    Half a decade later, there are still occasional protests outside Roscommon hospital over the issue. Time may have passed, but emotions still remain high.

    It can be argued that closing the A&E did not result in the negative impact the protestor’s claim it would have had. Similarly, it did not have the benefits that the government suggested it would.

    Like so many things, the truth probably lies somewhere in between.