Dáil Éireann - Volume 633 - 20 March, 2007
Adjournment Debate. - Hospital Services.
Ms Burton Ms Burton
Ms Burton: I thank the Ceann Comhairle for the opportunity to raise this important issue. I was disturbed and shocked to learn that the waiting list in the urology unit at Connolly Hospital in Blanchardstown, Dublin 15, now exceeds two years and that the unit plans to close its doors to all but emergency cases. This is a shocking state of affairs. It is of particular concern at a time  when such prominence is given to men’s health and the provision of health services for men through public advertising to encourage them to avail of regular screening for the detection of prostate cancer.
On the one hand, the HSE is encouraging men to seek early diagnosis and assistance through screening programmes. On the other hand, however, those men who need to avail of urology services at Connolly Hospital will find it is unable to cope with the extra demand. The Taoiseach said today that there is an easy solution to such problems because those with private health insurance will be able to avail of new private hospital facilities. Under the Fianna Fáil model of health provision, it seems patients will be instructed to turn one way for the public service, only to find no service is available, and the other for private hospital services, if they are appropriately insured.
Patients in Dublin 15 will have to go elsewhere for urology services, most likely to the Mater or Beaumont. Last year, there were 1,200 trips by inpatients in Blanchardstown to Beaumont and the Mater for diagnosis and screening, including MRI and CT scans, at an average cost per patient of more than €400. It seems the same will now happen with urology services. The round trip to the Mater from Blanchardstown, assuming that the traffic is relatively good, is at least two hours. This does not take into account the time spent at the hospital.
This situation underlines yet again the Government’s lack of commitment to the long-term development of Connolly Hospital. The sole policy in regard to the hospital seems to be to promote the development of a private hospital by selling or leasing off some of the grounds of the public hospital. While I was Minister of State in the rainbow coalition, €72 million was set aside in 1996 for Connolly Hospital and left as a dowry to the incoming Government. Ten years later, however, only phase 1 has been developed. Phase 2 was commenced only because the general election is on its way. The hospital does not even have a CT or MRI scanner even though it serves a very large population across the Dublin 15 area, Cabra, Finglas and a significant part of Meath.
The long-serving and hard-working staff in Connolly Hospital provide excellent care to patients but it is difficult to see how they will not be demoralised. Although several additional consultants have been appointed, they lack the facilities and equipment to do their job. The hospital has put forward a request for additional urology consultants to be appointed but nothing has been done so far.
I raise this as a matter of urgency. As with education and policing, as far as this Government is concerned, Dublin West is far down the list of priorities. Connolly Hospital seems to be further down the list than most issues.
Ms Hanafin Ms Hanafin
 Ms Hanafin: I will take this Adjournment matter on behalf of the Minister for Health and Children, Deputy Harney. Services at Connolly Hospital are provided by the Health Service Executive. The hospital is one of three providers of adult urology services on the north side of the city, the others being Beaumont and the Mater.
The HSE has advised that the current urology service at Connolly Hospital is provided by one consultant urologist with a four session commitment each week. It further advises that all emergency and follow-up outpatient services are provided. Urgent prostate referrals are seen within one to two weeks. Due to an increase in clinical workload, no routine first-visit outpatient appointments are being allocated at present. The HSE will ensure there is no interruption to urgent urology services and that any reduction in routine services will be in the short term only.
The Department of Health and Children is advised that in light of these urology service pressures, Connolly Hospital plans, in conjunction with Beaumont Hospital, to recruit an additional consultant urologist. The intention is to provide the service by way of locum cover pending the filling of the post on a permanent basis. The Department is advised by the HSE that the necessary funding is available for this post and that it is expected to be filled within a matter of months.
Mr. O’Dowd Mr. O’Dowd
Mr. O’Dowd: There has been systematic neglect of the acute hospital system in the north east. Louth County Hospital and Our Lady of Lourdes Hospital are under extreme pressure for funding and staff. One year ago, Chris Lyons, hospitals network manager for the north east, said there was inadequate support in the budget for the increase in service demands experienced in 2005 and 2006. Grave concern has been expressed by local managers in this regard. There is unparalleled growth in the region’s population, which increased by 13% since 1996. There is the possibility of significant closures of services, major patient safety issues, increased clinical risk and longer waiting lists. What did the HSE decide in its wisdom? It decided, because of its budgetary cutbacks, that with immediate effect all pending and new development posts would be put on hold in order to bring a reduction in recruitment costs of approximately €100,000. Patrick Kinder, head of the maternity services taskforce, wrote about Our Lady of Lourdes Hospital in October last year. He said a serious risk obtained in the maternity unit there due to the increased levels of overtime, that the working of overtime at the levels indicated was not sustainable for any length of time and there was a critical need to review the recruitment process to avoid unnecessary delays in filling posts.
An advertisement from the HSE will appear in tomorrow’s newspapers seeking to fill 25 new midwifery posts approved for the hospital, but the reality is these posts were needed a year ago.  Due to lack of funding from the Government, the hospital is in a state of crisis. It is unacceptable that expectant mothers must wait for up to 20 weeks for their first appointment with their consultant. This is a shame and an utter disgrace. I call on the HSE and the Minister to publish the correspondence on the matter, particularly that between Mr. Patrick Kinder and the HSE.
The number of unfunded posts in the northern area HSE was 322, or 9% of all of those employed, in April 2006. Some 92% of the unfunded staff are employed in frontline services. The accident and emergency unit in Drogheda currently has 30 unfunded posts. The advertisement in tomorrow’s newspapers states that a new 25-bay emergency department in Our Lady of Lourdes Hospital will be up and running in early 2008.
The facts, as illustrated by the response I received to a freedom of information request, show that the accident and emergency unit was due to commence in autumn 2006 and be ready in 2007 and that any delay in that schedule would compromise patient safety based on the known risks. The accident and emergency unit in the hospital at that time was overrun and it was essential the new unit would begin as soon as possible to ensure continuity of services.
We have a HSE in crisis, a hospital system which is totally underfunded and problems with regard to anaesthetists in the hospital. Advertisements for three new anaesthetist posts have been placed, but these probably will not be filled for six months. These are serious issues of concern. I call on the Minister and the HSE to publish the truth about the issues surrounding anaesthetists in the hospital.
I am also deeply concerned about cancer care. Patients should and are entitled to receive chemotherapy in the hospital. However, I know a patient who had to travel from Drogheda by taxi to a Dublin hospital yesterday and return in the evening only to have to get up again at 6 a.m. this morning to get to the hospital by 8 a.m. for another session of chemotherapy.
The acute hospital system is in crisis, but the Government is doing nothing about it. We do not accept the Minister deserves to be in office. She should be run out of office for the shameful way in which she runs Our Lady of Lourdes Hospital and the Louth County Hospital. There is no excuse for the situation. Never was there so much money available in the country to look after our sick and elderly, but never did a Government do so little. Never were administrators, nurses, midwives and consultants so up in arms over the lack of funding and resources. They are entitled to these resources because of population increases in the region.
The Minister stands condemned in the court of public opinion. She has run these hospitals into the ground. It appears from what the Taoiseach said today with regard to not being able to keep hospitals open, that all the Minister seems to have  on her mind is the closure of acute hospitals in the north east.
Ms Hanafin Ms Hanafin
Ms Hanafin: I will take this Adjournment matter on behalf of my colleague, the Minister for Health and Children.
Both the Government and the Health Service Executive are committed to continuing to improve and expand services at Our Lady of Lourdes Hospital and Louth County Hospital in the short and medium term. In the longer term, a new state-of-the-art regional hospital will be built in the north east.
Over the past five years, the level of revenue funding allocated to both Our Lady of Lourdes Hospital and Louth County Hospital has increased significantly. The current revenue funding for Our Lady of Lourdes Hospital has increased from €36 million to €115 million, an increase of 219%, and in the case of Louth County Hospital, from €10 million to €28 million, an increase of 180%. Over the same period, staffing numbers across the two hospitals have increased by 225.
In the case of Our Lady of Lourdes Hospital, a new three-storey development approved by the HSE is scheduled to be fully completed by April 2009. This development will allow for a 25-bed accident and emergency assessment area and a further two floors will be utilised to provide some additional facilities and space for critical care, general medicine and general surgical departments. The 25-bay accident and emergency facility is scheduled by the HSE to be fully operational by April of next year.
With regard to maternity services at Our Lady of Lourdes Hospital, the HSE has advised that it has approved 22 new midwife posts and two specialist nurse posts as well as three new consultant anaesthetist posts. The HSE will continue to monitor staffing levels within the maternity services unit at the hospital relative to demand.
Urgent care facilities will be developed at Dundalk. It is intended when the new regional hospital is established, that Louth County Hospital will retain this urgent care service providing a significant service to a large proportion of patients from Dundalk. Extensive electrical work has been carried out at the hospital to facilitate the installation of a new CT scanner which will be operational next month. Two new modular theatres are also due to open next month. Investment in Louth County Hospital will continue in order to provide the best and most appropriate service to the people of the area.
Since October 2005, Our Lady of Lourdes Hospital and Louth County Hospital have been managed under a single general management structure. These close working arrangements have facilitated a reduction in patient waiting times and have resulted in improved care and clinical outcomes for patients. In advance of the development of the new regional hospital, ambul ance and emergency services will be developed to a high standard in the north east. This will include the training of advanced paramedics and nurse practitioners.
It should be emphasised that the HSE has given the Minister for Health and Children an assurance that in progressing the reorganisation of services in the north east, there will be no discontinuation of existing services until suitable alternative arrangements have been put in place.
Dáil Éireann 633 Adjournment Debate. Hospital Services.