4 May 2021

Dear Fellows and Members,

I hope you will enjoy the May 2021 Surgical Bulletin, which includes links to the National Healthcare Outcomes and Professionalism in a Pandemic conferences, both recently held in the College. The effects of COVID-19 on hospital discharges and waiting lists are stark. Scheduled care has been disproportionately affected as always happens when health service demands exceed capacity. Nevertheless, urgent and critical care needs were met and high quality patient care continued to be provided throughout the pandemic. As I write, only 144 confirmed cases remain in hospital, of whom 40 are in ICU, and close to 25% of the population has received at least a first dose of vaccine. There is a sense that as a society we have done our best and there is renewed trust in the healthcare professions whose members have acted with integrity, putting themselves in harm’s way for the overall good.

There are many lessons to be learned and the risks of complacency are great. Not too many months ago it seemed that India had managed to avoid the worst ravages of the pandemic, only for exponential growth in case numbers to overwhelm the health system in a matter of weeks. Our thoughts are with our many Indian Fellows, Members and Alumni, both in Ireland and abroad, whose families have suffered loss or serious illness. It can only be hoped that public health measures and increased availability of respiratory supports will improve the situation. As Professor Denis Harkin, Chair of Medical Professionalism at RCSI, remarked: "We are duty-bound to emerge more resilient and better prepared." It is time to reboot and re-programme our health care systems. We cannot simply revert to pre-2020 models of practice that tolerated long waiting lists and inequity of access. Strong professional leadership will be needed and sectional interests divested. To quote Lennon: "There are decades where nothing happens, and there are weeks when decades happen." Let us hope that we are at such a time in healthcare delivery.

As society reopens, it will be important to re-establish the collegiality of surgery that so many of us have missed in the past year. Our scientific and College meetings have migrated entirely online. It can only be hoped that such important dates in the surgical calendar as the Freyer, Waterford and O’Halloran meetings will be face-to-face in the next academic year. Given the unprecedented number of delegates (over 4,000 from 56 countries) who attended the Charter Meeting in February, preparations are underway towards a hybrid Charter Meeting incorporating the Millin Meeting from 1–5 February 2022. This format will allow much greater participation from international Fellows and Members who might not otherwise be able to attend. I suspect that this will be the pattern in the future, however for the moment all major meetings remain virtual.

The annual ASGBI Annual Congress this week is virtual. My congratulations to Council Member Mr David Moore who delivered an outstanding Robert Smith Lecture entitled 'Mind the Gap: Massive bone defects – how they are managed and what the future holds'. In his lecture David, presents a state-of-the-art summary of limb salvage following massive bone loss through trauma or tumour excision, and holds out the exciting prospects of tissue engineering, gene-activated scaffolds and 3D printing. The lecture is available to view here

I very much hope that May and June will offer respite from the long and difficult months we have endured, that our friends and colleagues in India will see the tide of disease turn and that by the next newsletter you will have had time with family and friends.

Kind regards,

P. Ronan O’Connell