A woman from Alderney has called for the island to get its own dialysis machines for the first time in a decade.
Kelly Main said her 71-year-old mother, Julie Main, has stage 4 chronic kidney disease and is likely to need dialysis in the near future.
Mrs Main said she had approached the States of Guernsey about putting in new dialysis machines, however she had been told that experts “don’t recommend to do it”.
Without the machines her mum would have to move to Guernsey or the UK when the time comes, as dialysis needs to be done several times a week.
“Mum’s been here 50 years and dad’s from Alderney – they rebuilt the island after the war.
“It’s their home, they don’t want to move somewhere – they don’t know anyone.”
Deputy George Oswald, President of Health and Social Care, said the committee was “not considering” providing dialysis in Alderney at the moment for “a number of reasons”, including “supply chain risks” and staffing.
Alderney States Member Alex Snowdon said it was important to “continue to examine every realistic option” for on-island dialysis on Alderney.
Alderney currently had three potential dialysis patients that she was aware of, Mrs Main said.
Her mum had also put off having a knee replacement for the last four years, as there was a risk that her kidneys could fail if there were complications, meaning she would “need dialysis straight away – so she’s chosen not to have it”.
As house prices are more expensive in Guernsey, her parents couldn’t afford to live there, Mrs Main said, while her 73-year-old father, Jack, could not move his haulage business off the island.
Mrs Main said her mum found the situation “frustrating”, adding that she was “pretty adamant that she doesn’t want to leave her home”.
“There was a gentleman that actually could have done with [dialysis] about two years ago,” she said, but “he died recently, as he didn’t want to move to Guernsey”.
Can’t do it or won’t do it?
Mrs Main said she has spoken to Health and Social Care in Guernsey, but has been told that Guy’s and St Thomas’ Hospital, which advises HSC and provides staff, does not recommend Alderney gets its own dialysis machines.
However, she said the reasons why hadn’t been fully explained to her, so she wanted further information.
She said: “Is it just a matter of cost? Because as soon as we know that, that’s when we can start to do something about it.
“There’s a difference between you can’t do it and you won’t do it.”
Mrs Main said the NHS provided satellite dialysis units to Lerwick, in the Shetland Islands, “which I would argue is as remote as Alderney, if not more so”.
She said: “Everybody in the UK gets the choice, so do people in Guernsey.
“We are part of the Bailiwick, but we feel like we’re not really treated as such in this situation.”
What is kidney dialysis?
Your kidneys are the main way your body filters things like waste products and toxins.
People’s kidneys can fail as a result of conditions like diabetes, high blood pressure, or kidney infections – as well as traumatic injuries.
Kidney dialysis is a treatment for people with stage 5 kidney failure, which filters waste products, toxins and excess liquid from the blood.
Without dialysis or a kidney transplant people with kidney failure would die.
Risks
Deputy Oswald said HSC “appreciates that all individuals would like to receive all their healthcare and support closer to home”, but dialysis was not provided in Alderney for “a number of reasons”.
He said the reasons included:
- Supply chain
“Alderney has known additional supply chain risks as the island is even more exposed to delivery delays caused by adverse weather.” - Equipment
“If equipment fails in Guernsey, there is a technical team to hand that can assist in a timely manner. Alderney does not have the infrastructure to provide that backup.” - Clinical support and patient safety
“The Guernsey renal unit is staffed by employees of Guy’s and St Thomas’ NHS Foundation Trust who are trained specifically in care for renal patients. While Alderney staff could be trained to some extent, they would never have the level of expertise and knowledge as the clinicians who continuously work with renal patients, and this could lead to clinical risks for the service users.”
Deputy Oswald said that people in the UK “often must travel long distances to regional centres to access dialysis”.
“This is reflective of the specialist nature of renal dialysis and is why not all hospitals provide this service in their local area.”
Deputy Oswald said HSC was “not considering the provision of renal dialysis in Alderney at this time as there are too many risk factors that could compromise patient care and ultimately lead to a poor outcome”.
However, the committee would “continue to monitor the island’s situation, should it become feasible to introduce it in the future”.
Significant challenges
Mr Snowdon said he recognised there were “significant clinical, staffing and operational considerations involved in providing dialysis services safely on a small island such as Alderney”.
However, he said it was important to “continue to examine every realistic option that could improve quality of life for islanders and reduce the burden of off-island travel”.
A recent Rule 14 question from Mr Snowdon revealed there had previously been an on-island dialysis machine in 2016, but this had since been removed.
He said the prospect of having to relocate to Guernsey or the UK could “significantly disrupt the lives of people who have lived and worked in Alderney all their lives and contributed to the system over many years”.
He added: “With the increasing number of people likely to require dialysis treatment in the near future, the case for exploring treatment options in Alderney is becoming stronger.
“Ultimately, everyone involved shares the same goal, ensuring Alderney residents receive safe, high-quality and compassionate care as close to home as possible.”
Guernsey decision
A spokesperson for Guy’s and St Thomas’ NHS Foundation Trust said: “When requested, we provide clinical and operational advice to help commissioners understand the implications of options for healthcare.
“Decisions about the configuration of health and care services provided in Alderney are made by the States of Guernsey, through the Committee for Health and Social Care, based on expert advice as appropriate, as healthcare is a transferred service.”
