Meadhbh Monahan spoke to Deputy Chief Executive of the Western Trust Joe Lusby ahead of the implementation of up to £30 million in cuts to health services across Fermanagh, Omagh and Londonderry.

MM: What is the reality facing health in the area with these unprecedented cuts of £30 million?

JL: “We’ve put forward a plan to the Commissioner and it really is for the Commissioner to decide what way they want to go ahead with it. But in anybody’s language, £30 million of cuts are huge, huge; you would have to stop certain services.” MM: Can you reveal which services?

JL: “I can’t because the Commissioner must make those decisions. I’m told that the Commissioner will take the decision next week in conjunction with the Minister.” MM: Is that what was discussed with staff [last Thursday] morning?

JL: “Yes. Staff are really concerned about this, as everybody is.” MM: You mentioned a shortage of middle grade doctors; what impact is that having?

JL: “We have the rotas all filled so there is no rota that isn’t filled; that isn’t safe. However, we are reliant on agency staff for a large proportion of them.” MM: Is that the situation in maternity ward?

JL: “That’s a different thing. The PHA have brought out increased standards. For all the right reasons, they are saying that, for example, there’s a higher risk for mums that are obese, so mums with a BMI over 40 can’t be cared for in a hospital like SWAH. They need the neo-natal intensive care back up and all of that. Fortunately they are relatively small numbers. It’s the same with mums that are expecting twins, they are at a higher risk. That’s nothing to do with the staffing.” MM: There are concerns that SWAH maternity ward is under pressure and that it will move to Altnagelvin.

JL: “That’s not one of the proposals, I can tell you that for certain.” MM: The public are demanding more Cancer services at SWAH while the Trust have to make cuts to existing services. Is it fair that Fermanagh patients have to travel to Belfast or Altnagelvin for Cancer treatment and palliative care?

JL: “And people are getting older. I think it’s important to hang onto the fact that we do provide a very extensive range of services.” MM: They are not extensive enough for sick people who have to travel to Belfast or Derry.

JL: “I don’t think we’ll ever get to the stage where we’ll meet everybody’s needs locally; you can’t do that. However, in terms of patients in chemotherapy, we have a pilot service in Omagh for the past year and a half.

“Up until a couple of years ago, all of the chemotherapy patients had to go to Belfast or Altnagelvin. For these patients that it is safe to administer the chemotherapy in a local setting we have a pilot running in Omagh and it’s really proving its worth.

“If we can justify that it’s really meeting the need and there’s enough of a volume of patients that are able to access it, our plan is to make the case to the Commissioner and see if we can get funding. If we can prove it in Omagh, we will make the case to bring it to Enniskillen.

“All chemotherapy drugs are very potent and not all patients can be treated in a local hospital without the regional back-up; that’s why it’s often based in Belfast or Altnagelvin. But there is a cohort of patients on which it is safe to do it locally and that’s what we are trying to prove in Omagh.

“It’s up to the Commissioner. He’s the funder at the end of the day.”