Vol. 345 No. 12
Deputy O'Rourke has sought and been given permission to raise on the Adjournment the delay in sanctioning Athlone Hospital as an orthopaedic centre for the midlands.
I must ask for silence. There is a question on the Adjournment and there is very limited time. Deputy O'Rourke has ten minutes, and the Minister has five.
First of all, I wish to thank the Minister for coming in to answer my question. This is my fifth attempt to raise the issue and I am glad the Minister had the time. The purpose of the Adjournment Debate is to receive from the Minister a formal recognition of the appellation of Athlone District Hospital as the siting for the orthopaedic centre, albeit in a temporary sense, for the midland area. I want to sketch briefly the history of the matter. In April 1981, the Midland Health Board were invited to set up a sub-committee to come up with recommendations as to the most——
Silence in the Gallery.
——attractive site for the orthopaedic centre, bearing in mind that it was fully recognised that there was a very great need for such a centre in the midlands area. They set about their business and took about a year, quite correctly, to fully research their subject, visit the various hospitals in the area and come up with their solution. Twelve months later they came up with two solutions, a long-term and a short-term.
This brings me to the point of my mission here tonight. The most outstanding point which they made was that first in order of priority was a centre for elective orthopaedics. They stated:
The Comhairle recommends that a regional centre should be developed in the Midland Health Board area in the long-term and should incorporate the following specialties:
1. Elective orthopaedics.
Having mentioned the most desirable location they went on in their report to say — and this is the relevant point of my question here tonight:
However, should such a solution prove impossible, in the interim pending the building of a regional centre then, in view of the urgency of the problem, elective orthopaedic surgery will have to be done wherever beds and other facilities are available.
I submit to the Minister that St. Vincent's District Hospital, Athlone has the beds and many of the facilities. What we need is a commitment that the Minister is willing to grant such a service to the Athlone area, sited in St. Vincent's Hospital.
It would be wise to point out tonight that we serve such a very large urban and rural hinterland and yet have not got even what one might call the most basic medical facilities available in our hospital. We have an excellent building, a very highly trained staff and a great tradition of caring in this hospital. We are a centre for education, with the siting of the regional college, for industry with the siting of the IDA district regional offices. We have a district veterinary laboratory in our town and are a major traffic centre for CIE for the linking up of trains and buses leading to all areas, yet one cannot get the most basic casualty services in the Athlone hospital. This has led to great disquiet among the citizenry of the town and among the industrialists. The elected body of the town, the Urban District Council, had taken the initiative, of setting up, some two years ago an open committee representative of various groups in the community. They came up with their final solution to press for the immediate implementation of the orthopaedic centre in Athlone, knowing that from it would come basic casualty services as well and that we in Athlone would get what we justly deserve — proper hospital facilities.
I am making my submission tonight, very confident that it is not out of line with what has been suggested as a short-term solution by both the Midland Health Board and, I understand, Comhairle na nOspidéal. What I am saying is not pie in the sky or something which I have conjured up for the purpose of furthering my cause and my case. There is backed up medical evidence that there is urgent need for a short-term solution for elective orthopaedic surgery based in the Athlone area. The Minister is aware that there is a very long waiting list for such cases in Navan at one end of the area and the Dublin hospitals at the other end. He is also aware that much of what is required for the orthopaedics is already in Athlone Hospital. We have an excellent building and we have space. I understand that the Midland Health Board are about to acquire space in the vicinity of the hospital. This will be important if the Minister gives us the go ahead for this important development.
I understand that the studies carried out by the sub-committee of the Midland Health Board, when they were doing their year's research into this particular project, were very thorough and deep-searching. They came up with a long-term solution and stated that the siting of such a centre should be in a general hospital. Their over-riding conclusion was that that was a very long-term solution. I am very conscious of our economic situation and I am also very conscious of the economic strains under which the Minister for Health has to operate. I have noticed in various debates and when he has been answering requests for various hospitals that economy allied with sound medical sense in his basic priority. I can tell him that in the short term the basic economic commonsense of the solution to the need for orthopaedics in the midland area is to site it in Athlone in the building already available in St. Vincent's Hospital.
I am speaking tonight as one of the elected Deputies for Longford-Westmeath putting forward a case which has the backing of all the people of the surrounding area. Perhaps we have not marched and protested but we have gone about our business in a democratic fashion with the elected representatives having a public meeting and getting the goodwill of the people. I understand the recommendation is with the Minister for some time. There is a long-term solution which I believe in the present economic climate is not feasible. I ask the Minister to give the commitment tonight to set up the orthopaedic centre for the midlands in the Athlone area.
I never cease to wonder at the capacity of health boards, the more I have to do with them, to straddle the fence on where particular facilities should be sited. At this rate health boards will suffer acute political hernia if they keep going on like that. This is another example. The health board in effect say that while they fully accept the advice of Comhairle na nOspidéal that the existing Tullamore Hospital would be the best location for a regional orthopaedic centre in the long term, nevertheless, they decide that, in the short term, there should be a facility provided in Athlone Hospital.
My problem is, what is the long term and what is the short term? I suppose, in the long term, all of us who are politicians are dead. Meanwhile, it is impossible as the Deputy well knows, to close a particular facility once it is opened even if it is only a temporary centre. While taking note of the double-barrelled ambivalence of the health board on this issue I am arranging for a detailed examination of the relative merits of siting the unit at Athlone or Tullamore. It should be in one or the other on a permanent basis. That is the way the money should be committed. When that decision is reached I hope to allow the planning to proceed as soon as the resources permit.
I admire the Deputy for her diligence in raising this matter. She has now made five attempts and the Ceann Comhairle has graciously acceded. I am only too pleased to reply. I assure Deputy O'Rourke that I am aware that the present arrangement for the provision of orthopaedic services in the midlands is unsatisfactory. At the moment, there are other major unsatisfactory things in the midlands, particularly on the maternity side and the paediatric side. That is why, as a first priority for the midlands, we are going straight ahead with the £8 million building of Mullingar Hospital. We have got the unanimous agreement of the health board that Longford surgical and medical hospital will close and will be transferred to Mullingar. Thank God there is unanimity with the health board on that and I do not have to face any problems there.
I have a problem in providing an effective orthopaedic service. For example, there is no elective orthopaedic service provided for the people of Laois and Offaly and there is no orthopaedic surgeon employed in the Midland Health Board. These are issues that I want to come to grips with quite rapidly. I assure the Deputy I will not be delaying on them. I have been in constant communication with my Government colleague, the Minister for Defence, on this issue. He has been in very regular contact with me on it, as have been the other public representatives in the area, Deputy Gerry L'Estrange and Senator Lena McAuliffe. They have all been with me on the question and I am well aware of the intense preoccupation of Deputy O'Rourke, understandably, with Athlone.
Has the Minister any short-term plans?
I prefer long-term planning. If one commits oneself exclusively to Athlone and spends a great deal of money in setting up the facility, one should not act on the presumption that one is going to remove it. If one decides on Tullamore, spends a great deal of money and appoints an orthopaedic surgeon one should not act on the presumption that it is purely on a temporary basis either. One must come down firmly on one venue or the other.
At the moment I assure the Deputies I have an open mind. I have to take into account the views of Comhairle na nOspidéal and the health board. They are an excellent health board with an excellent CEO and staff. I concede that Athlone is an excellent hospital. I take all those things into account. I assure Deputy O'Rourke and Deputy Enright that as soon as the examination is completed on the relative merits of siting the unit in Athlone or Tullamore I will make that announcement. It will be a positive decision.
When will that be?
Early in the New Year.
Early 1984?
Early in 1984 I will make a decision on the matter. The reason I say 1984 is that my capital programme will be decided in the weeks ahead and only then will I have some indication of the resources available for 1984.
The Minister mentioned the development of Mullingar Hospital. Will the Minister confirm that the development in Tullamore will continue as well on the same level as Mullingar?
Tullamore's case stands on its own merits and the short-term solution proposed for Athlone stands equally on its particular health board support. I have to decide between both sites and make a firm commitment for what is urgently needed, a formal orthopaedic service for all the midland health board area. At the moment that is very unsatisfactory and it is absolutely essential that we have a planned service for all the midland area as quickly as possible.
When the Minister says he will make up his mind early in 1984 will he have finance available?
I will know that as soon as my colleague, the Minister for Finance and I reach agreement on our capital and current programme for 1984. We have not yet reached agreement. We are in the throes of it. I wish I had the Deputy's incisive persistence at my shoulder to help me in that matter.
How sweet of the Minister.
The Dáil adjourned at 9 p.m. until 10.30 a.m. on Thursday, 17 November 1983.
