Dáil Éireann - Volume 638 - 26 September, 2007

Adjournment Debate. - Hospital Services.

  Deputy John Perry:In their pre-election promises the Taoiseach and Minister for Health and Children said no health cuts would be made and that more than 4,000 health workers would be recruited in the post-election period. The recent health cuts have completely undermined any credibility the new Government might have had. We cannot believe a word it says. The Minister of State at the Department of Health and Children, Deputy Devins, promised two weeks ago that there would be no cutbacks at Sligo General Hospital. We learn now that he is uncomfortable about the cutbacks which have been made. It is two weeks since he told The Sligo Champion that patient care should not be hit in any way by cutbacks being implemented at Sligo General Hospital. The promises of the Minister and Minister of State that such measures would not reduce services were plainly inaccurate. Today’s developments on critical services and the roll out of BreastCheck and radiotherapy are very disappointing. Delivery will depend on the capacity of services in Belfast to take patients from the region. It is appalling.

Sligo General Hospital has lost four consultants and 30 nurses. The scale of the cuts at the hospital exceeds anything proposed for any other location nationally. The cutting of the consultant posts will be especially disappointing for women in the north west with the loss of a consultant obstetrician gynaecologist and a general surgeon with special expertise in breast surgery. Other specialties affected are orthopaedics and ear, nose and throat services, which are also critical. These extensive cutbacks in front-line staff will adversely affect the quality and availability of patient care. The IMO president, Dr. Paula Gilvarry, has said the decision will cause outpatient appointments and clinics to be cancelled and result in longer waiting lists. The IMO president would not make such a statement without specific knowledge. The chairman of Sligo General [154] Hospital medical board, Dr. Niall Considine, has said that breast operations will be reduced by 50%, while there are over 360 placed patients on the waiting list for surgery for more than 12 months. These major cutbacks will result in longer waiting times for outpatient appointments and the cancellation of clinics leading to greater hardship and stress for patients. There is no arguing with these facts.

I am very disappointed that the Minister, Deputy Harney, is not present to deal directly with this matter. She is trying to defend cuts which are doing grievous damage to patient care. It is the responsibility of the Minister for Health and Children to ensure the standards of care and access to the service are maintained. I call on the Minister, Deputy Harney, to urgently address these serious concerns.

The budget is the responsibility of the HSE but the Minister has ultimate responsibility. Look at the scale of the cutbacks. The staff in the north-west region cover a huge area. It is most disappointing to hear the Minister, as late as today, briefly allude to this and offer a feeble excuse. There is huge unrest about this issue, as my colleague Deputy Scanlan will agree. No spin will alter the fact of the cutbacks in this area, while up to €13 billion is being spent on health care services.

Before the general election we were promised the roll out of BreastCheck in 2007, in addition to radiotherapy and other oncology services. However, the IMO president, Dr. Paula Gilvarry, has said this decision will cause outpatient appointments and clinics to be cancelled, as well as longer waiting lists for patients. The most eminent consultant in Sligo, Dr. Niall Considine, in a letter to The Irish Times said that breast operations will be reduced by 50%. The Minister, Deputy Harney, should reply not just to me but also to Dr. Considine, who knows his business.

This relates to the oncology service. People are dying in the north west because they do not have services. They feel the cutbacks and the lack of BreastCheck and radiotherapy services. A doctor who provides breast surgery is being removed. Dr. Niall Considine has stated as much. I demand quality health care. With no disrespect to the Minister of State, Deputy Hoctor, I am disappointed that the Minister, Deputy Harney, who knew this issue was to be discussed and mentioned it earlier, would not wait to reply to the debate. It clearly indicates what she thinks of the roll out of services in Sligo General Hospital.

  Deputy Máire Hoctor:I am replying on behalf of my colleague, Deputy Harney, Minister for Health and Children. The provision of services at Sligo General Hospital is the responsibility of the Health Service Executive. The Health Service Executive has informed the Department that Sligo General Hospital is reducing temporary staff in some nursing, medical and [155] catering posts. This does not involve any withdrawal of the core services provided by the hospital. The circumstances are specific to each staff category and I will explain these for each.

With regard to nursing staff, as in previous years, in the summer months additional temporary staff were employed, mainly to cover annual and other leave. A total of 30 people were employed on a temporary basis for this reason. This compares with a total permanent nursing staff of over 700 at Sligo General in whole time equivalent terms. As in every organisation, small or large, public sector or private sector, when permanent staff have returned from their summer holidays, the temporary cover staff are no longer needed. This is what happened at Sligo General Hospital. In no organisation could this arrangement be described as a cutback in staffing.

Four temporary consultant posts, which were contracted for specific temporary purposes and time periods, have recently come to the end of their contracts. These posts were in addition to the permanent consultant complement of the hospital, which is not affected and remains the same. In orthopaedics, one of the three permanent consultants was a member of the Medical Council until his recent retirement. To maintain full orthopaedic services a locum was employed while this consultant was away on Medical Council business. Following his retirement, a new permanent consultant was appointed and has taken up full-time duty in Sligo General Hospital. There was therefore no requirement to maintain the locum position.

In obstetrics/gynaecology, one of the three permanent consultants retired in July, his replacement having taken up duty prior to this. To ensure a smooth transition, the retiring consultant was contracted on a short-term locum basis following his retirement. This arrangement can now be discontinued, and the specialty has its full complement of three consultants. In surgery and ENT, a temporary additional consultant was employed in both these specialties during 2006 to help reduce waiting lists. They were not intended as permanent appointments. The hospital has had the benefit of these temporary appointments in reducing waiting lists and seeing more patients. However, within its overall funding the hospital has to make choices about which service pressures most need to be addressed from time to time, and it was decided at this time to discontinue these temporary contracts, to allow the funds to be used for other service priorities. The recently opened new neonatal intensive care unit, for example, which provides a much better facility for newborns, required and received more nurses to staff it.

With regard to the Deputy’s reference to patients waiting over 12 months, the Minister understands that to date this year, 207 inpatients have been referred to the National Treatment Purchase Fund, NTPF. Patients waiting longer [156] than three months are entitled to apply for treatment through the NTPF. I hope Sligo General Hospital would make every effort to reduce its waiting lists by referring appropriate patients to the fund.

Overall consultant staffing has been significantly enhanced at Sligo General Hospital. An additional appointment has been made in paediatrics and radiology. Further consultants in emergency medicine, pathology and radiology have been approved and a consultant neurologist will take up post in January 2008.

It is clear that these measures do not entail a reduction in the hospital’s core services, nor will they adversely affect the quality and safety of patient care. Every effort is being made to ensure the hospital’s resources are managed in an efficient and effective manner to protect core services and activity, and to deal with emerging service pressures. This year, our health services are seeing significant increases in funding, staffing and patient services. That is the record so far and will be the overall outcome at the end of the year.

The Government is clearly committed to the provision of services at Sligo General Hospital. The HSE is fully aware that it must remain within the employment ceiling negotiated with the Department of Finance. The Minister is confident that the measures taken by the HSE with regard to Sligo General Hospital will assist the hospital to manage its services within budget.