Vol. 297 No. 1
asked the Minister for Health if he has recently received a recommendation from Comhairle na nOspidéal on operating and surgical facilities at the county hospital in Nenagh, County Tipperary; and, if so, if he will state his decision on the recommendation.
8.
asked the Minister for Health if he will make a statement on a report (details supplied) concerning recommendations by Comhairle na nOspidéal on the county hospital at Nenagh, County Tipperary.
9.
asked the Minister for Health if he will sanction the appointment of a surgeon and an anaesthetist to maintain effective surgical facilities at the county hospital in Nenagh, County Tipperary.
With the permission of the Ceann Comhairle, I propose to take Questions Nos. 7, 8 and 9 together.
As the Deputy will be aware, the Government's decision in relation to Nenagh hospital, as announced on the 21st October, 1975, is that Nenagh hospital will be retained as an acute general hospital. In making that announcement, I indicated that it was my intention to initiate discussions with the Mid-Western Health Board with a view to instituting joint staffing arrangements between that hospital and one or more of the Limerick city hospitals to ensure that adequate staffing is guaranteed for Nenagh hospital.
During the course of 1976 several efforts were made by officials of the Mid-Western Health Board to work out joint staffing arrangements between Limerick city and Nenagh hospitals. On June 8th last, the chief executive officer of the board informed me that it had not been possible to work out suitable joint staffing arrangements following consultations with the consultant medical staff in the area. Following receipt of that letter, the chief executive officer of the board was asked to consider the matter again with the consultants in the Limerick region. On the 7th October, he reiterated that suitable joint staffing arrangements were not found possible.
On January 4th last, I received a letter from Comhairle na nOspidéal which stated that they had been informed by the Mid-Western Health Board that joint staffing arrangements between Limerick city and Nenagh were not feasible and that the Government's decision to retain Nenagh hospital should be re-examined.
On January 28th, I informed Comhairle na nOspidéal that there would be no change in the Government's decision on Nenagh hospital and that all the agencies involved should continue to seek a suitable solution to the staffing problem there.
The position at the moment, therefore, is that Nenagh hospital will be retained, as announced in the Government's decision of October, 1975, and that the health agencies concerned have been asked to concentrate on finding a suitable staffing solution. I am anxiously awaiting their recommendations on this matter and there will be no delay on my part in approving any suitable solution which they propose.
The comhairle, at a meeting on 18th February, decided to arrange talks with the medical organisations on staffing problems in a number of hospitals, including Nenagh. I do not wish to pre-empt the result of these discussions which, I expect, will take place shortly but, if cover by consultants in Limerick is not practicable, it may be necessary to consider other arrangements, such as the appointment of special additional staff, in order to ensure that the Government's decision to retain Nenagh hospital is made effective.
The Minister will be aware that the Mid-Western Health Board, supported by the staff themselves and by all the people in north Tipperary, have asked that the additional staff be appointed, namely an additional surgeon and an anaesthetist. Would the Minister not accept that in view of the fact that the arrangements with Limerick hospital have not worked, it is vitally necessary to appoint an extra surgeon and an anaesthetist to ensure that the surgical and other facilities at the hospital can be maintained?
First, I should like to point out that the appointment of consultants is a matter for Comhairle na nOspidéal, both in respect of numbers and of locations. I would point out also, though, that the staffing complement at Nenagh hospital is at the same level as has been the case for years.
That is the point. The Minister should be aware that Nenagh and the surrounding area is very much a developing area, as the population structure proves. I take it that the Minister is not saying that the hospital with the same complement of staff as it had some years ago is adequate to cope with present day needs. Will he not recommend, if that is the limit of his power, to Comhairle na nOspidéal that an extra surgeon and anaesthetist be appointed? These appointments have been requested both by the staff at the hospital and by the Mid-Western Health Board. It is obvious that if the request is not complied with we will be ensuring effectively that facilities at the hospital cannot be maintained.
My function is not the same as that of Comhairle na nOspidéal. If the comhairle make a recommendation to me I shall give it my fullest consideration; but, as I have said, the staff complement has not changed for years. I do not know what the Deputy was doing in that regard.
The Minister keeps repeating that.
Will the Deputy accept that the Minister for Health, regardless of who holds that office, cannot appoint consultants?
I accept that but I accept also that the Minister for Health has, as he has acknowledged already, the final responsibility in regard to designations at general hospitals. I am asking him to be honest and at least to recognise that since it has not proved possible to work this arrangement of sharing staff and facilities with Limerick the least that should be done is the guaranteeing of proper surgical facilities and that the only way of doing this is by providing extra staff? Obviously that is a matter that only the Minister can decide.
Brevity, please.
I do not know whether the Deputy was listening but I referred to that in the last paragraph of my reply when I said that:
The comhairle, at a meeting on 18th February, decided to arrange talks with the medical organisations on staffing problems in a number of hospitals, including Nenagh. I do not wish to pre-empt the result of these discussions which, I expect will take place shortly but, if cover by consultants in Limerick is not practicable, it may be necessary to consider other arrangements, such as the appointment of special additional staff, in order to ensure that the Government's decision to retain Nenagh hospital is made effective.
In view of the fact that the comhairle are investigating these problems thoroughly I do not think I should be asked to pre-empt by way of comment any decision they might reach.
I appreciate that but since, as the Minister has acknowledged, the arrangements that were reached some time ago have not worked out and in the meanwhile since Nenagh hospital is suffering considerably——
May we have a question, please?
——would the Minister ensure that these consultations will come to an immediate conclusion so that the extra staff that are required may be appointed?
Question No. 10.
I can assure the Deputy that the discussions will take place shortly.
Might I refer to the fact that Deputy John Ryan is not present to support me on this very important issue? Indeed, he has yet to table a question in this regard.
I have yet to see 143 Deputies in the House.
I have tabled three questions on this issue.
This is quite irrelevant. I have called Question No. 10.
Question No. 10.
The Deputy should confine his local politics to north Tipperary.
The Labour Deputy from North Tipperary might have come here to help me out and to back what he has already said elsewhere in regard to this matter.
Deputy O'Kennedy must allow Question Time to continue in an orderly fashion.
This is a dignified House, that is, when the people on the other side are absent.
