asked the Minister for Health if he is aware of the anxiety in the Dungarvan and West Waterford areas as a result of the proposed closure of the maternity unit in Dungarvan, County Waterford; and if he will make a statement on the matter.
15.
Ceisteanna—Questions. Oral Answers. - Dungarvan (Waterford) Maternity Unit Closure.
14.
asked the Minister for Health if, in view of the public outcry in the Dungarvan area, County Waterford at the suggested closure of the maternity unit there, he will request the South Eastern Health Board to keep the unit open.
16.
asked the Minister for Health if he is aware of the serious hardship likely to be caused to the people of West Waterford by the decision to close the maternity unit at Saint Vincent's Hospital, Dungarvan, County Waterford; and if he will request the South-Eastern Health Board to rescind its decision on the matter.
I propose to take Questions Nos. 14, 15 and 16 together.
I am aware that the health board have passed a resolution to close the small four-bed maternity unit at Dungarvan. This is a matter for the South-Eastern Health Board in the first instance.
Expert medical opinion is that it is safer to have babies delivered in a consultant-staffed unit with support facilities such as specialist paediatric, gynaecological, medical, surgical, pathological and radiological services close at hand, and that this is essential for the well being of mothers and babies. There is no obstetrician-gynaecologist attached to Saint Vincent's Hospital.
The number of births delivered in Dungarvan is very low and has declined from 148 in 1975 to 65 in 1982. It is the intention of the health board that future deliveries should take place in consultant-staffed units in the areas such as Waterford. The board intend to provide a consultant-staffed out-patient clinic in Dungarvan which would be a valuable service for mothers in the area. The South-Eastern Health Board have decided that no further bookings for admission for delivery in Saint Vincent's Hospital, will be accepted after 30 April 1983.
Would the Minister accept that the unrest among the people of Dungarvan and west Waterford is fully justified? This closure is unjustified. The maternity unit in Dungarvan was the only unit available to the town of Dungarvan and the area around it. Is the Minister aware that Dungarvan is an expanding town with an expanding hinterland? Is he aware of the distance from west Waterford — which includes the towns of Cappoquin, Lismore, and Tallow — to Waterford City? It is a distance of 65 to 70 miles. The final decision taken by the South Eastern Health Board was only taken on the casting vote of the chairman. The onus is on the Minister to take action in this matter especially as there is no private maternity unit in all of that area. Would the Minister accept that the unrest of the people is justified?
This is a four-bed maternity unit in a small hospital of 30 medical and minor surgical beds. In 1980 the number of births was 87, in 1981 it was 73 and in 1982 it was 65. I do not have any statutory powers to direct the health board in relation to a change of use of a hospital premises. A decision was taken by the health board. My powers only arise where there is a formal decision to close a hospital. I have to give assent to that. The health board have decided by a resolution in January 1983, confirmed in April 1983, admittedly by a casting vote of the chairman, to close the hospital. In that health board area in New Ross, in Tipperary, in Clogheen and Carrick-on-Suir, similar maternity units were closed in recent years and there were no protests or local opposition to the decisions. I have a substantial number of closures from health boards throughout the country at present. It is of critical importance that we have consultant staffed maternity units available to mothers to ensure that they have every paediatric, gynaecological, surgical and pathological facility available to them in those units. Where a health board takes a policy decision of this nature I would not wish to interfere with the provision of the best possible medical care for the women and children of the country.
Surely the Minister will accept——
A short question, Deputy. There are 100 questions down to the Minister for Health and at the rate we are going we will not dispose of any other Minister's questions.
Surely the Minister will accept that this is one case in which he should intervene? I accept that it is a small unit but it is a unit which I believe should be expanded rather than closed down.
You must put a question, Deputy Fahey.
The Minister has made a comparison with the closure of Clogheen——
The Chair is bound by Standing Orders and Standing Orders say that Deputies must ask questions and not make statements.
Surely the Minister must accept that there is no comparison between the distance from Carrick-on-Suir and Clogheen to Clonmel and the distance from west Waterford to Waterford City? Clonmel is roughly 16 miles from Carrick-on-Suir and Clogheen the same. Would the Minister take a closer look at it?
The reality is that there has been a considerable decline in the number of births in St. Vincent's Hospital. Women have not been using the maternity beds there. They have obviously preferred to go elsewhere. Apart from that, the health board, as a matter of general policy, have decided that there should be in that area consultant staffed units. I have received petitions from the urban district council, from my own party colleagues and the Deputy's party colleagues. Despite that, the health board are statutorily entitled to take a decision of this nature and I cannot, in conscience, have what I would call Departmental interference with the health board on whom devolves the responsibility of providing the best care for the women of this country irrespective of political considerations.
Is the Minister aware that the intention of the health board is to save £60,000 by closing this unit? This money will be saved at the expense of six jobs. Is it the policy of a Labour Minister for Health to have economies made in this way? Is it now the policy of the Department of Health that deliveries will only be done in consultant staffed units? If this is the case, what is the Minister doing about the non-consultant staffed units? We have one in Carlow. Would the Minister make an announcement on that? The Minister also said that the South Eastern Health Board are shortly to provide an ante-natal clinic in the Dungarvan area. Does he think this will alter the situation in Dungarvan? Is it not a fact that the number of deliveries in the Dungarvan area have increased dramatically in the last month? This is something that could not have been planned in advance because nine months ago we were not aware that the unit was to be closed.
The health board are having discussions with consultants from Ardkeen General Hospital concerning the provision of clinics at St. Vincent's Hospital. I am sure the Deputy shares my concern that where births take place it is highly undesirable that there should be no obstetrician or gynaecologist available in the immediate precincts of the hospital. I am sure that in his professional competence and as a member of a health board he would share that view. It is true that the health board decided to have discussions with the doctors and staff involved to ensure that there is proper ante-natal consultant facilities available in Dungarvan. I will provide whatever encouragement and assistance I can towards having the ante-natal facilities and clinics available, but as a matter of overall policy the health board have decided, and I cannot reverse their decision.
A final supplementary from Deputy Mac Giolla. There is a very important question, Question No. 100, put down to the Minister for Health, and at this rate it will not be reached for weeks.
(Interruptions.)
I asked a question and I have not got a reply.
The Chair cannot do anything about that. I am calling Deputy Mac Giolla.
The Minister indicated in his reply that he was closing this unit in the interests of mothers and their children. What new factors have made the Minister come to that decision in view of the fact that the unit only opened in 1971? The Minister also said that he did not have direct control, so in view of the outcry in the area and in view of the fact that——
A question, Deputy.
——local people have indicated that the births in the unit would increase if it was upgraded, would the Minister ask the South Eastern Health Board to review their decision?
The opening in 1971 arose when maternity services which were provided in St. Joseph's Hospital the former county home, ceased. While I have responsibility for overall health policy, I do not have responsibility in terms of the change of use of a particular four-bed maternity unit in a district hospital. It would be irresponsible for me to reverse the decision of the health board and as Deputies will know the Chairman of the health authority gave his casting vote in favour of the board's proposal.
Question No. 17.
(Interruptions.)
I have one important supplementary question.
We have been debating this question at length. I will allow one final supplementary.
Will the Minister assure the House that an out-patients' consultant maternity service will be made available in Dungarvan?
I hope so. I will contact the health board.
Will the Minister make a comment on the distances involved especially from West Waterford to Waterford city?
That is factual, Deputy.
Surely the distance must play an important part in this, and it must be——
The Deputy does not have to go to the Department of Health to find out the distances. Question No. 17.