Dáil Éireann - Volume 433 - 08 July, 1993

Ceisteanna — Questions. Oral Answers. - Hospital Summer Service Plans.

10. Mr. Finucane asked the Minister for Health if he has received details of summer service plans in accordance with the reply to parliamentary question No. 75 of 3 June 1993; and if he will make a statement on the matter.

Mr. Howlin: As the Deputy will be aware, seasonal summer closures have been a characteristic of the provision and organisation of hospital services throughout the country for many years. They are generally planned to coincide with annual leave arrangements for staff, at a time [1845] when the level of activity has traditionally decreased. An opportunity is also availed of, during this period, to refurbish wards.

Details of summer service plans have now been received in my Department from hospital and health board authorities. On the basis of the information available to my Department at present, the national average number of beds proposed for closure during June-August is 530, compared with 934 during the same period last year. The proposals regarding summer closures in 1993 should also be viewed in the context of the total of 12,000 acute hospital beds available in this country. In addition, I would emphasise that all emergency and urgent services will continue to be provided. As in other years, my Department will be monitoring the situation regarding seasonal closures and will remain in constant touch with health agencies about this matter.

Mr. Browne (Carlow-Kilkenny): In view of the first priority Question relating to pressure on the number of beds, with 530 beds closing over the summer months, will we not be faced with further difficulties unless we can guarantee that people will not get sick? Can we afford to close 530 beds during the summer?

Mr. Howlin: Like everybody else, hospital staff are entitled to holidays. Traditionally, during the summer period activities in hospitals wind down and they have been slower to wind down this year than in the past.

Mr. Browne (Carlow-Kilkenny): Every year is the same.

Mr. Howlin: Because of the initiative I took in regard to hospital waiting lists and the allocation of an additional £20 million in that area, there was a 43 per cent reduction in bed closures this year. A total of 934 beds closed last year but not all for the full summer period. Hospitals close beds at different times of the year. A hospital in the Deputy's home town closed a ward for refurbishment purposes and that is also taken into [1846] account in the general number of bed closures. Upgrading and redecorating are other reasons for ward closures. I am satisfied that there will be a significant throughput, much greater than in recent years, throughout the summer period and that every emergency and requirement for hospital services will be met.

Mr. Allen: Will the Minister admit that behind the figures he has quoted the reality is that some wards are mixed and public service patients, at a time when they are most vulnerable, are being humiliated and degraded by having to share wards with members of the opposite sex? That is an affront to the dignity and sensitivity of patients at a vulnerable time in their lives. Does the Minister believe that position is acceptable?

Mr. Howlin: That is a separate question but I will address it. Some wards are mixed, for example, intensive care units deal with both sexes at the same time.

Mr. Allen: That has always been the case.

Mr. Howlin: Generally speaking, I do not support the idea of mixed wards. If the Deputy had tabled a separate question on that matter I would have crawled through the country to discover where that is occurring. I am pleased that a couple of health boards will have no bed closures this summer. That is a significant new development. The number of bed closures across the country this year will be insignificant compared with other years and some wards will close for refurbishment purposes.

There is obviously a diminution in throughput during the month of August in particular. We ourselves will not be here in this House in August, and hospital staff are entitled to their holidays the same as everybody else, obviously maintaining an essential level of activity that I have indicated will be provided.

Ms McManus: I certainly hope that none of us will be sick during the month [1847] of August. No ordinary general practice closes down for a couple of weeks in August in the hope that people will be looked after by somebody else. Would the Minister not agree that the best way to prove his seriousness about cutting waiting lists — which have built up dramatically in recent years in part at least due to bed closures during the summer — would be to state that there will be no bed closures this summer? That would be a clear indication of his commitment to reducing the waiting list. Would the Minister not also agree that this closing down in the summer is a recent phenomenon and is not because doctors are on holidays but because they are not replaced when they are on holidays? Lastly, would the Minister indicate how many wards are closed because of refurbishment and how many because of cutbacks?

Mr. Howlin: There is no incidence of ward closures because of cutbacks. The voted amount of money this year is up by 12 per cent and that is before taking into account the additional £30 million added in the budget that provides my £20 million for the hospital waiting list initiative, plus other initiatives on mental handicap services, dental services and so on. It is quite misleading for the Deputy to introduce the notion of cutbacks.

In regard to GP practices, no GP works 52 weeks of the year either. If one looks for one's GP on some weekend or long holiday one may find that there will be somebody else covering for them or one may have to go somewhere else.

Ms McManus: That is my point. Get the locums into the hospitals.

Mr. Howlin: Similarly, not every bed will be open for the duration of the year but there will be sufficient beds in the country for anyone who needs hospitalisation. It is quite alarmist and quite wrong of the Deputy to say she hopes nobody gets sick in August. Let me make it clear that anybody who requires hospitalisation in August, January or September [1848] will be provided with it. Obviously elective patients will not be called while the hospital is operating at its lowest level during the summer months. That is the way hospitals have traditionally operated. There should be some appreciation of the fact that this year we will have the lowest level of bed closures in many years, a diminution of 43 per cent on last year which was not a bad year when one considers what happened from 1977 and 1988 onwards. Bed closures are not a recent phenomenon. There will be extremely good cover and many hospitals will be working flat out in many health board areas on the throughput of an additional 17,200 extra procedures which I have funded on top of the normal 1992 input, thanks to the availability of £20 million for the waiting list initiative. That should be applauded on all sides of the House.

Mr. Browne (Carlow-Kilkenny): Let me compliment the Minister on his efforts, lest he thinks we are completely against him. However, I have to say the Minister is being carried away by “lies, damned lies and statistics”. He gave a lovely figure there, 43 per cent, and since both of us spend years teaching sums, I will not argue about the accuracy of it. However, if 934 beds too many were closed last year, any bed closed this year is still too many. Saying that things are only half as bad as last year is like the difference between saying a glass is half empty or half full. If I get sick in August — the fact that I am out of here does not mean I will not get sick — it is no consolation to me to know that the staff who are entitled to their holidays are not being replaced by locums.

Mr. Howlin: I suggest to the Deputy that if he does get sick in August he will be well looked after in his hospital in Kilkenny which is currently being extended at great cost to the State, or in the new regional hospital in Waterford which is now a state-of-the-art flagship hospital. The Deputy need have no fears about his health throughout the summer or at any other time of the year.

[1849] Ms McManus: Particularly if he goes private.