Ireland's only child chronic pain specialist leaving but position not yet advertised
The country’s only paediatric chronic pain specialist is to leave his post at the end of this month, but the HSE will not advertise the post until the new year.
Dr Kevin McCarthy is a consultant anaesthetist who runs the children’s chronic pain clinic in both Crumlin Children’s Hospital and Temple Street Hospital. Seventy children every year are new patients.
He is one of only 20 such specialists in the world and is leaving Ireland to return to Canada where he completed some of his training.
Dr McCarthy told RTÉ radio’s Today with Séan O’Rourke show that he felt he had to step down from his position because he cannot run the pain unit without sufficient funding and staff.
“It's been a challenge to try and consistently deliver quality care, we've had some incredible successes. Within the international paediatric pain community, me and the other nurse practitioners that I work with, speak at meetings in other countries, Spain are setting up such a service this year, we were cited as an example of what they wanted to emulate.
“The difficulty has been doing it consistently, it’s not unlike a radio show there is a whole team behind it.
“It has been overwhelming, there is a lot of emotional distress when dealing with pain.”
When asked about his decision to leave, he said it had been “a very difficult decision, as the service has expanded as the complexity increased as well, I've felt like I'm not able to deliver care of sufficient quality, that instead of being able to give any one of them 100 per cent of what they need it's dropping from 70 per cent to 50 per cent, 30 per cent of what they actually need.
“At some point if you're only giving somebody 10 per cent of their needs then you might as well not have a service at all.”
Dr McCarthy said that he is working on solutions for his existing patients, as he will be leaving at the end of this month. “A lot of them have improved and can be discharged from the service, some will be transitioned to other consultants at CHI, some to adult pain clinics.”
The paediatric pain management clinic has been in operation for the past four years, prior to that many children would have been treated by adult pain specialists and others were sent to UK.
Dr McCarthy explained that the major difference (between the Irish service and international best practice) is “the team we have to deliver this care, which involves physiotherapists, psychologists, Occupational Therapists, social workers, specialist nurses. All of them, for any involved in this care, in this clinic, they all have other roles, it's their other roles that are funded, the pain is something that is done out of good will. Because there is a need there. “
Dr McCarthy said he believed the process has started to find his replacement. “The challenge is people with this level of training are relatively thin on the ground, there are probably only 20 people in the world with this level of expertise, who have undertaken all this additional training. Trained as an anaesthetist, then fellowship as a paediatric anaesthetist, fellowship in pain medicine, and then another fellowship in paediatric pain medicine. "
When asked how long Children’s Hospital Ireland (CHI) have known about his impending departure, Dr McCarthy said they would have been aware since earlier this year.
He warned that it will take time to find a replacement. “Originally when I came back from Scotland where I had been working as a consultant, there was another consultant paediatric pain specialist appointed here, but he made the decision to stay in Australia, we've remained in touch, when I spoke to him about 18 months ago about how we were running things here, he said he would not consider returning to Ireland unless the rest of the multidisciplinary team were in place.
“You need a team in place in order to run a service like this. It takes a village, you need a team in place ready to start from day one.”
