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Stabilize emergency health care

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    An ambulance raced to the scene of a fatal traffic accident on Kunia Road in January 2011.

The current turmoil in Oahu’s emergency-services and overall medical care system has underscored with sharp clarity just how crucial, and vulnerable to economic shifts, these services are.

The city’s Emergency Medical Services office issued a startling report that six of the island’s hospitals turned away ambulances carrying noncritical patients on Tuesday, signaling just how thin health services have been spread in recent months.

The reason is plain to all: The closure of the Hawaii Medical Centers’ two hospitals has dealt a blow to emergency-care capacity especially.

The hope is that new ownership for HMC-West will ultimately close the gap, and that a plan to assimilate HMC-East into the state’s Hawaii Health Systems Corp. will fill a persistent need for long-term-care beds.

But in the meantime, the state must provide a kind of bridge back to stability, and legislation proposed to accomplish that deserves a renewed push from the public.

Two of the measures come up for a hearing at 1:30 p.m. today before the Senate Committee on Health, room 229:

» House Bill 1953 would allot unspecified grants to boost the on-call availability of emergency medical and ambulance services on the Leeward Coast and in Ewa, and to support emergency-room services at Wahiawa General Hospital, which has been put under particular pressure in the current crisis.

» HB 609 would appropriate funds to enable the HHSC to hire staff for a repurposed Liliha facility formerly operated by HMC.

Across the State Capitol, in a 9:30 a.m. hearing before the counterpart House committee, comments will be taken on two other related measures:

» Senate Bill 2939 would provide the backing for renovating HMC-East by authorizing up to $80 million in special-purpose revenue bonds. The bond authorization is for St. Francis Healthcare System, which proposes to partner with HHSC on the long-term facility.

» SB 2958 would appropriate funds to implement a new bone marrow transplantation program, replacing the one that had been operated at HMC-East. This is a necessary adjunct to the fledgling replacement organ transplant program, services also interrupted by the HMC closure.

On that front, there is some good news. Last month Gov. Neil Abercrombie signed HB 608, a $1.5 million appropriation enabling The Queen’s Medical Center to restart the organ transplant program. And yesterday, the medical center staff hosted a celebration for the program’s first two liver transplant patients. Dr. Linda Wong, formerly of HMC, performed the surgeries with Drs. Makoto Ogihara and Hiroji Noguchi of Queen’s.

It’s encouraging to see that in a matter of a few months, the service can be operationally up and running in its new home, although everyone acknowledges that there’s much more work to be done. For example, applications to perform kidney, pancreas and heart transplants are still under review by the United Network for Organ Sharing, the national approval organization for organ transplantation.

The same kind of focused attention must now be brought to bear on other initiatives aimed at restoring stability to Oahu’s health services network. It’s clear that an island state, in the most remote location on Earth, can rely on nobody else for the basic care of its citizens.

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