CMO: Beds for cancer patients can’t be ring-fenced during Covid pandemic

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The chief medical officer (CMO) has defended the postponement of urgent cancer and other surgeries during the latest spike in Covid-19 cases.

With the number of Covid patients in Northern Ireland’s hospitals expected to double over the next two weeks Dr Michael McBride said the health service does “not have the luxury” of being able to ring-fence a certain number of beds for specific conditions when it has been “maxed out” due to Covid pressures.

“What we need to do is ensure that we manage the risks associated with complex surgery, so if we can delay and postpone it, and reduce the harm to individual patients, and then reschedule it for a time when we can safely do that, then that is the right thing to do,” he said.

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“The trust will not continue that for a day longer than is absolutely necessary, I can assure you of that,” Dr McBride told the Nolan Show on Monday.

CMO Dr Michael McBrideCMO Dr Michael McBride
CMO Dr Michael McBride

When asked to explain exactly why it was necessary to cancel all cancer operations, the CMO said: “Let’s be clear here: we prioritise care for all based on clinical need and clinical priorities and that has always been the case and what we are doing at this moment in time, what are trusts are doing, is ensuring through their surge plans that they have the capacity, that they have the beds, the intensive care beds to provide as much treatment as they possibly can for people with Covid and those without Covid.

“Those are very, very, very difficult choices. what we can’t have is our system overwhelmed, we can’t have our systems and our hospitals fall over, so we need to plan and prepare in advance and that means sadly and unfortunately, but you know, these are not easy decisions – there are huge moral dilemma associated with staff making these decisions – that does need that planned surgery, even urgent planned surgery, that can be postponed is postponed, so that we can provide the capacity to deal...”

When pressed on why all operations for every cancer patient had been cancelled by, for example, the Belfast Trust, Dr McBride said: “Those are operational decisions that the trust made based on the pressures that were coming at it.

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“What we have been doing throughout, our response to this pandemic is actually retaining regional resources for elective surgery – both in the run-up to surge, and also during surge, so that we can maintain surgical activity”.

Dr McBride also said that the NHS has approached the private healthcare sector in an effort to increase capacity.

“We have been working with the private sector ... to free up some of their capacity to support the health service for instance, but we need to bear in mind that really, really complex surgery, complex cancer surgery, requires significant demands, and significant support from intensive care, and therein lies the heart of the problem,” he said.

“It is about the skilled, trained staff to ensure that we are able to provide the level of treatment and care safely for those people who are waiting for cancer surgery. It isn’t a matter of ring-fencing beds.”

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