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Dáil Éireann debate -
Tuesday, 14 Jun 1988

Vol. 382 No. 1

Adjournment Debate. - Meath Hospital (Dublin) Facilities.

At this late stage of the evening I am grateful to you, Sir, for allowing me to raise this matter, the subject of a Private Notice Question I tabled today. I tabled it because I felt an unprecedented warning had been sounded by senior medical staff in one of the most important hospitals in the country and I was a little dismayed when that Private Notice Question was ruled out of order on the grounds of lack of urgency.

Last night the hospital manager of the Meath Hospital, Mr. Eddie Thornhill, admitted that 23 people were being cared for on steel trollies in that hospital yesterday as a result of the health cuts imposed by this Government. Last week 43 beds were closed in that hospital and a further seven beds, according to the hospital administrator, are due to close in the near future. I think the comments of the senior medical staff in the Meath Hospital are worth reading into the record of this House. They are not the comments of a partisan politician or somebody trying to make political capital of an issue. They are a cry from the heart from over-burdened and stressed medical staff who have come to the end of their tether and can cope no more in a hospital system deprived of urgently needed resources. I want to quote from today's Irish Independent:

Senior Registrar Dr. John Manson complained bitterly that so many beds had been closed down because of health spending cuts. He said that lives were being put at risk because of the measure: "We have patients who had emergency operations during the night being put back on trollies."

Another senior registrar, Dr. John Black said that elderly patients could be in danger of a fall from a trolley, or developing bed sores on the hard surface.

Dr. Manson confirmed: "It is an unfortunate position that people could die. We have already had a number of near misses with patients, being recognised to be very seriously ill having to lie on a trolley with major bleedings problems and no beds available."

Dr. Manson said that the problems had increased in the past few months. "We kept on working under these conditions because we were under the mistaken impression that somebody or the Government would see what was happening and do something about it. But nothing is being done."

Dr. Manson added: "There is a lack of realisation as to what the health cuts actually mean in the hospitals. We are not being allowed to treat our patients properly."

They are the comments of the senior medical staff charged with the responsibility of providing health care in an important national hospital. Unfortunately, the problem is not confined to one hospital. The entire health service is on the verge of collapse and the Government, and the Minister in particular, have nothing on offer but the prospect of more cuts and further closures.

Since Fianna Fáil came to office, between full hospital closures and bed closures in those hospitals that Fianna Fáil have not closed something approaching a staggering 4,000 beds have now been taken out of service. There has been a consequent job loss for people engaged in the health services numbering at least 2,000 at the latest count.

One must ask: what does it take, what evidence needs to be provided, who needs to make the appeal before the Minister realises the extent of the crisis in the health services? When will he change course? My words of exhortation are ignored, but can the Minister continue to ignore the senior medical staff? As a society we have had some difficult decisions to make. We are faced with a financial crisis, but the question we must now address is: who is to pay for the financial crisis we have? Surely the answer cannot be that we resolve our financial difficulties on the backs of the weakest, the most vulnerable and the sick.

All the cutters in this House, be they on the Government benches or on the Opposition benches in Fine Gael or the Progressive Democrats, have now got to answer this dilemma. They have put forward as a virtue the notion of cost-cutting, the notion of savaging our health budgets and have exhorted the Minister to sterner and further cuts in the future. They now must examine their consciences, as the Minister must because he is the person with ultimate responsibility for the health and well-being of the people of the nation.

I should like to put one simple and direct question to the Minister: what is he going to do to save our health services? Like Nero of old, is he going to stand idly by and, in the words of the medical people at risk and allow some people to people at rick and allow some people to die and be forgotten? The crisis now must be recognised by the Minister and I exhort him to look at the problem in the Meath Hospital because that is a reflection of the real crisis that exists in every major hospital here.

I should explain that the accident and emergency service for south Dublin is at present being provided by St. Vincent's Hospital, St. James's Hospital and the Meath Hospital. The Meath Hospital have a transfer arrangement with the Adelaide Hospital.

The MANCH — Meath, Adelaide, National Childrens Hospital — agreed in mid-1987 to accept additional responsibility for accident and emergency services previously provided at Dr. Steevens Hospital and also to accommodate orthopaedic services from Dr. Steevens Hospital. To accommodate these additional services provision was made for urgent upgrading of the accident and emergency department at the Meath Hospital and the building of additional theatre facilities and recovery areas in both the Meath and Adelaide Hospitals. This work was completed on schedule and has greatly improved the facilities available to the medical and nursing staff in both hospitals.

I would however accept that the facilities are not ideal, but it must be appreciated that it is an interim arrangement. The fact is that in a few years the Meath Hospital with the MANCH hospitals will transfer to Tallaght. In this regard I am pushing on with the completion of the design of Tallaght Hospital with all possible speed — I recently approved stage 4 planning which is the penultimate stage of design. There will be no delay as far as I am concerned in the building of Tallaght Hospital.

I am very concerned at the allegations made by the doctors involved. The Meath Hospital's revenue allocation, for example, was increased from £8 million in 1987 to £9.45 million in 1988, an amount of money which should clearly enable them with proper management of their resources to provide an adequate service to meet essential needs. The Adelaide Hospital budget was increased from £5 million in 1987 to £6.25 million in 1988.

The amount of taxpayers' moneys provided in both hospitals certainly does not warrant a hospital surgeon going on radio to advocate that patients that can go private should do so because they could not be catered for.

In this respect I have instructed the chief medical officer of my Department and an Assistant Secretary of my Department in charge of acute hospitals to make contact with the management of the Meath Hospital to undertake an immediate examination of the use of resources and the manner in which co-ordination of activity between the Meath and the Adelaide hospitals is working particularly at the consultant level. It has been suggested to me that when there were patients on trolleys in the Meath Hospital there were the same number of vacant beds available in the Adelaide Hospital. I am also having this aspect of the matter inquired into and also the level of consultant staffing available in the accident and emergency services unit of the hospital.

In addition, I am also having the allegation that patients developed bed sores at the casualty department investigated and also how this could have arisen. I have also asked the officers concerned to find out could there be any basis for the statement by one of the doctors involved that patients should seek private treatment in circumstances in which the combined allocation of the Meath and Adelaide hospitals is £15.7 million in 1988 an increase of £2.73 million in that year over the year 1987. When I receive a report on the examination I will consider what action it is necessary for me to take.

I should say also that no attempt was made to use the normal channels of communication which exist within the hospital and with my Department to discuss the problems which were arising. There are and have been regular formal and informal contacts with me and with officers of my Department on a variety of issues which have arisen from time to time, particularly since the transfer of services from Dr. Steevens Hospital.

I am confident if the normal procedures had been used in this instance they would have, as in the past, resulted in the resolution of the problem and avoided the unnecessary distress caused to patients and their relatives. Such distress caused to patients and their relatives is out of character with the fine tradition over the years of these two excellent hospitals.

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