03/06/2025
Please share - this will affect the services Letterkenny Hosiptal will be able to provide for years to come. Thank you
Letterkenny University Hospital, Letterkenny Co. Donegal
F92 AE81
Telephone: (074) 9125888
RE: Surgical Hub Location, HSE West and North West
Dear Minister Carroll MacNeill
We wrote to you on April 28th, highlighting serious concerns regarding the future of surgical services at Letterkenny University Hospital (LUH). We asked for a meeting during your visit to the hospital on May 1st to outline our patient safety concerns, but this was not facilitated; however, a copy of our concerns was hand-delivered on your visit to the campus. We hope you have had time to consider its contents and are asking for an urgent meeting in Donegal or Dublin to discuss our concerns regarding the hospital's current and future surgical services.
As you know, the HSE is currently presenting options for placing a surgical hub in the North West. We understand that the decision has been taken to present Sligo University Hospital (SUH) only as the preferred option for the hub, with no consideration being given to placement in LUH. Disappointingly, regional management has dismissed a business case for this.
When challenged about why SUH was chosen as the only option, Tony Canavan (REO of HSE West and North West) articulated that SUH was chosen on population grounds. The numbers do not stack up; the
population of Sligo/Leitrim/ South Donegal and Cavan combined is 114,459. The population of Donegal is 159,227. The people of Sligo,Leitrim and Cavan have access to Mayo, Roscommon, Galway and Cavan University Hospital. The population of Donegal only has access to LUH, and the distance to other hospitals is prohibitive. For example, the travel time from the Inishowen Peninsula to Sligo is 2 hours and 30 minutes— similar for North Donegal or West Donegal. So, geographic location, the other reason cited by the HSE, has no factual basis. If LUH were chosen as the base for such a surgical hub, no patient from Donegal, Sligo, or Leitrim would be more than 90 minutes from a surgical hub.
For many years, HSE West and North West neglected Letterkenny University Hospital in favour of hospitals closer to Model 4 in Galway. The figures are stark.
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SUH receives twice the funding per patient, as LUH does.
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LUH has the longest waiting times when compared to other model 3 hospitals.
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While funding for LUH has increased in line with other HSE hospitals, it has not addressed the legacy capital shortfall arising from historic block grant underinvestment.
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In the HSE Capital Programme 2025, LUH is allocated only 9% of what it should receive based on patient throughput, equating to only 0.3% of the total 2025 national capital budget.
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The National Cancer Registry Ireland report showed Donegal had the highest deprivation index and a higher incidence and a later presentation of all cancers, with a significantly poorer five-year survival.
We know HSE West and North West propose an ambulatory care centre for LUH. While any investment in LUH is welcome, this proposal lacks the ring-fenced funding, defined scope, staffing allocations, and delivery timeline associated with the surgical hub model. We fear it is being used to deflect from the pressing need for LUH to be considered equitably in the current surgical hub decision.
Your department aims to ensure equitable access to elective care across the country by developing surgical hubs. We ask, what other population base in Ireland is expected to travel five hours round-trip to access such care? To bypass LUH in this decision would be to disregard this equity objective and perpetuate health inequality on a profound scale. Patient safety us at the heart of what we do on a daily basis, and all we are asking for is safe, equitable delivery of care in the appropriate location.
We are united with our GP colleagues, whose support is noted below, and we respectfully urge you to commission an independent review of the evidence supporting the location of the surgical hub in the North West. We are ready to present data showing that LUH is a more appropriate and equitable location. We are also concerned that failure to secure the hub at LUH will hinder our ability to recruit and retain surgical staff, jeopardising the future of general surgery in Donegal. The consequences for patient safety would be severe.
We have no agenda beyond ensuring LUH remains a viable Model 3 hospital and improving patient outcomes and waiting times.
We respectfully request one hour of your time to present the evidence in person and for your department to defer any decision regarding the location of the surgical hub until a fair, evidence-based comparison of LUH and SUH is conducted. We also urge you to await the findings of Mr. Michael Sugrue's forthcoming Letterkenny University Hospital Model 3 Clinical Care Report and Plan, which will further support our position.
A delegation is available to meet with you at your earliest convenience, ideally within the next month. The people of Donegal deserve no less.
Yours faithfully,
