I move:
That Dáil Éireann calls on the Minister for Health to fully implement the arrangements for a federation as negotiated between the Western Health Board and the management of Portiuncula hospital in regard to the Roscommon County hospital, thereby ensuring a full scale maternity unit in the County and, to this end, to take whatever steps to ensure that such appointments of professional staff as are necessary to honour the agreement, be made without further delay.
The agreement referred to was freely negotiated and entered into by the health board and the authorities of Portiuncula Hospital in the interests of providing the very best in patient care. It sought to provide full medical, surgical and maternity services at Roscommon County Hospital. Members are aware of the impasse that has arisen in relation to the implementation of the full terms of this agreement due to the decision of Comhairle na nOspidéal not to ratify the creation of the post of consultant obstetrician-gynaecologist for Roscommon County Hospital, an appointment advocated by both parties to the agreement. Members are also aware of Comhairle na nOspidéal proposal for a third consultant based in Portincula, an appointment sought neither by the Portiuncula hospital authorities nor the Western Health Board.
I agree with the views of Comhairle na nOspidéal that there is a need for a third consultant but the person appointed should be based at Roscommon County Hospital. I should now like to give the House some relevant facts in relation to this matter. The Portiuncula Hospital authorities and the Western Health Board agree that the appointment should be to Roscommon County Hospital. The major centres of population in our country are Roscommon town, Castlerea, Cortober, Boyle, Ballaghaderreen, Frenchpark, Elphin, Strokestown, Ballyleague, Keadue, Arigna and Roosky. The route to Portiuncula Hospital is through Roscommon town which is 45 minutes journey from Ballinasloe over very inferior quality roads.
Roscommon has approximately 60 miles of national primary roads, Tarmonbarry-Ballaghaderreen, Boyle-Carrick-on-Shannon, and Athlone-Ballinasloe. The remaining roads, almost 2,500 miles, although well maintained by our council are of inferior quality and will remain so by national policy. The national primary routes referred to are of no significance in linking the centres of population in Roscommon with Ballinasloe. The route from Roscommon town to Ballinasloe runs in the main, over very poor ground, boggy and wet. It runs through the catchment area of the river Suck. This route is notorious for fog and frost during the autumn and winter months. Does this time factor and potential travelling difficulties make for good patient care?
Roscommon County Hospital has already a new maternity unit, consisting of 25 beds and a modern labour ward, an admission ward, waiting rooms, a nursery, and isolation rooms with incubators. That unit was provided less than ten years ago. Is it not financial suicide to let this building lie idle simply because we cannot afford the salary of an obstetrician-gynaecologist? Roscommon, as a centre, is ideally situated to serve the centres of population of Lanesboro, County Longford, and Ballygar, County Galway. Those towns are within a 15-minute journey of the hospital. In matters of this kind we are often inclined to forget the visiting of patients. Suffice to say that Roscommon as a centre is within easy reach of all towns in the county. Visiting patients is now recognised as an integral part of patient care and that should be borne in mind.
The Roscommon hospital is a modern cut-stone building on approximately eight acres of ground. It was opened in the early 1940s and in 1968 a modern maternity unit consisting of 25 beds was added which brought the total number of beds to 137. The hospital also has a modern surgical unit. The maternity unit lacks consultative staff, an obstetrician-gynaecologist and a paediatrician. The hospital has full x-ray and laboratory services also. The original federation agreement with Portiuncula Hospital in 1974 provided for the appointment of an obstetrician-gynaecologist at Roscommon County Hospital. A letter, dated 21 August 1975, from Comhairle na nOspidéal states that the Portiuncula Hospital authorities would not agree to the appointment of an obstetrician-gynaecologist at Roscommon County Hospital. The Western Health Board have applied for such an appointment and unanimously agreed not to fund a third obstetrician-gynaecologist at Portiuncula Hospital until Roscommon County Hospital obtains such a specialist.
Roscommon County Hospital is a public hospital administered by the Western Health Board while Portiuncula is a voluntary private hospital. It is funded but not administered by the Western Health Board. The Roscommon hospital is situated in the centre of a very large catchment area of the Shannon basin and is linked by road, rail or bus service to every corner of the county. Portiuncula Hospital, on the other hand, is on the perimeter of the Western Health Board area and is connected to Roscommon county at large only by second and third class roads.
That hospital is on the main Dublin-Galway road and it would appear that it would be better if its services were used to relieve the great pressure of maternity services at Galway Regional Hospital.
It as been satisfactorily established that, for the first time since the Famine, the population of County Roscommon has stabilised and may be increasing. The marriage age has been lowered drastically. The Department of Education figures reveal a boom in the number of four year old children attending primary school.
The IDA reports for the years 1973-1977 show Roscommon at the top of the other mainland counties—Laois, Longford, Offaly, Roscommon, Westmeath—in new industries. The number of industrial jobs, 1,319 in 1973 increased to 2,316 in 1977, by almost 1,000 jobs. In the 1978-1980 period further jobs for the area are estimated at 1,200—Ballaghaderreen 250, Roscommon 250, and Clondra/Tarmonbarry 700. Further advance factories under construction in Boyle, Castlerea and Carrick-on-Shannon will ensure 600 to 800 jobs in the near future. Developments proposed by the ESB and Bord na Móna at Lanesboro, Shannonbridge and Ballyforan will give an unknown but substantial number of jobs. Increased industrial activities in east Galway, within 20 and 30 miles of Roscommon, will also have its effect.
The hospital services—acute, general and maternity—are one of the most important infrastructures in any area for industrialisation. When industrialisation is considered a major factor in the improvement of the economy in the west and the midlands, why should a Government Department try to withdraw such an infrastructure?
Capital input has already been spent at a new maternity unit at Roscommon. In a speech in Mullingar on 10 October 1978 the Minister for Health stated that the complexities of modern medical services were not easily understood by laymen. He went on to say that these included the realisation of limited resources and the fact that everything could not be provided everywhere. The structure, fittings and so on are already provided at Roscommon. The only extra cost involved is the salary of two consultants.
