The Chief Executive of the Western Health and Social Care Trust, Neil Guckian, has hit out at those criticising the handling of the South West Acute Hospital (SWAH) emergency surgery crisis.

He was leading a medical and management panel in a special meeting convened by Fermanagh and Omagh District Council for members to seek answers, which was held within hours of the announcement of the temporary withdrawal of emergency surgery, although it’s understood that wasn’t known when the meeting was scheduled.

Criticism

Mr. Guckian was scathing of criticism received as the situation unfolded, and began by explaining he was addressing members as Chief Executive and Accounting Officer, meaning he is accountable for safe service delivery.

“Despite what has been said in the media, I’m proud of engagement between the Trust and the Council.

“We had a long session on October 18 on our concerns around the fragility of emergency surgery in the SWAH.

“Over three hours, my senior team and I fully answered all questions posed in an open and honest manner,” he said.

Mr. Guckian highlighted the Council’s Health and Social Care Committee as “the established engagement platform between our organisations”.

He continued: “I explained there was a possibility of legal and governance information and data protection issues which ordinarily require confidential discussion. This was agreed before the meeting, and the Chair made the decision to go into confidential session.”

Referring to correspondence recently received from the Council, including a letter on a Motion referring to the absence of consultation, an equality impact assessment, rural-proofing or consideration of any likely adverse impact on public health and human rights, Mr Guckian said: “I am somewhat surprised ... given our very detailed briefing.”

“Until today [November 17] we had no approved proposal to consult on. We’ve been highlighting the fragility of our services, not that we have a proposal to change.

“We also require Ministerial or Permanent Secretary approval. We have, however, attempted to have pre-consultation engagement with many stakeholders, including the Council.

“Now we have a proposal, we will enter into consultation, and I hope that includes consideration of an overnight elective care centre, for which we will look [for] support from [the] Council.”

‘Misinformation’

Mr. Guckian advised concerns around public health would be addressed “which is extremely important, given the misinformation in the media and [from some of the] Council”.

He added: “These changes, while disappointing to many, will improve outcomes for patients.”

Mr. Guckian referred to a second Council letter on a Motion calling for the Trust Board to resign, and for the Department of Health to put the region into special measures.

“In 25 years as a Trust Board Director and a Chief Executive, this was unprecedented. We are dealing with a very difficult situation.  We are working our way through this.

“Such Motions attack the structure of health and social care locally, and are as damaging to everyone in the Trust as they are to senior managers.

“Such a Motion can also really hinder us from working together to advocate for services,” said Mr. Guckian.

He drew attention to comments by local councillors and in the media, one of whom stated union representatives had advised that Altnagelvin Hospital has six surgeons who are “more than willing” to rota cover at the SWAH.

“I will ignore the emotive language used thereafter,” Mr Guckian said. “I can assure this is completely false information.

“While the union quoted has many members, not one is medical. Altnagelvin has five, not six general surgeons. Emergency rotas require residency within 30 minutes of the SWAH.

“You cannot cover from Altnagelvin safely, due to distance and the time required.

“Two surgeons have assisted to cover the SWAH rota, but this requires careful management and can only be a top-up due to their existing on-call commitments in Altnagelvin.”

Concluding, Mr. Guckian remarked: “I note a councillor’s comment on television – and I highlight my disappointment at the language used – to describe an elective care centre as ‘a glorified hotel’ was bordering on insulting.

“An overnight elective centre is seen by my senior clinicians as the final piece in our strategy for addressing this issue, particularly if we can focus on general surgery, given the rurality of the SWAH.”