asked the Minister for Health the proposals he has for the provision of an accident and emergency unit at the North Infirmary Hospital, Cork.
46.
Ceisteanna—Questions. Oral Answers. - Cork Accident and Emergency Services.
15.
asked the Minister for Health the changes, if any, which are being introduced in the accident and emergency services in Cork city.
I propose to take Questions Nos. 15 and 46 together.
When the decision was taken to transfer services from the North Infirmary to the Mercy Hospital at the end of last year, I agreed that a casualty service at the North Infirmary should continue pending the improvement of accident and emergency facilities for the people of north Cork city. In practice the number of patients attending the casualty department at the North Infirmary has been very small — an average of less than two patients per day. From 1 to 24 November this year, only five new patients attended the casualty department of the North Infirmary, all of whom were referred to the Mercy Hospital.
In these circumstances I felt that the proposed expenditure of £100,000 on the casualty unit at the North Infirmary could not be justified and that the best way to improve accident and emergency facilities for the people of the north city was to improve the cramped facilities at the Mercy Hospital. I increased the level of the proposed capital grant to £335,000 to provide for renovations to the accident and emergency department at the Mercy Hospital and to provide a separate out-patient department. The new casualty department will open next week and will be fully operational by the middle of January. This will provide a much improved accident and emergency service for the people in north Cork city and I am satisfied that a separate casualty service at the North Infirmary will no longer be required.
On the question of accident and emergency services in Cork city generally, I am concerned that there should be close co-operation between the three general hospitals in Cork so that services are provided as effectively as possible. Officials of my Department have held a series of meetings this year with representatives of the two voluntary hospitals and the Southern Health Board to explore the potential for closer co-operation, including the co-ordination of accident and emergency services. The work of the accident and emergency departments has been analysed closely and a number of organisational changes has already taken place. The relationship between the work of the departments and the role of general practitioner services is also under examination. I would like to assure the Deputy that my, and my officials sole concern is to improve the quality of accident and emergency services in Cork through the closest possible co-operation between the three general hospitals.
Would the Minister accept that the reason the casualty unit that was promised for the North Infirmary Hospital never functioned, as it ought to have functioned, was because a doctor was never appointed to the casualty unit despite the fact that when the hospital was closed down and the beds had been taken out a firm commitment was given by the Minister that a proper accident and emergency service would be set up in that hospital? When and why did the Minister change his mind and break his promise to the people to whom he made the promise at that time?
In November 1987, it was decided to transfer in-patient services in the North Infirmary to the Mercy Hospital. It was agreed that the Mercy Hospital would maintain a casualty service at the North Infirmary on an interim basis. In the event, the Mercy Hospital experienced great difficulty in providing a full casualty service at the North Infirmary. It proved impossible to attract medical staff of a sufficiently high calibre to fill the post of casualty officer. Casualty sisters and a radiographer with clerical support have provided a minor casualty service, referring those who require medical attention to the Mercy Hospital.
I have no quarrel with what the Minister is proposing to do in the Mercy Hospital, it is quite welcome. In relation to the appointment that was promised, but never made, in the North Infirmary, may I ask the Minister if the post was advertised, if so, what qualifications were stipulated in the advertisement and why the post was never filled?
My information is that the Mercy Hospital were unable to attract medical staff of a sufficiently high calibre for that post in the North Infirmary. Obviously, on the basis of the numbers attending — five new patients between 1 November and 24 November — I do not think anyone in the House would consider it justifiable to spend £100,000 in the casualty department of the North Infirmary.
Perhaps we could have a final supplementary from Deputy Quill.
I have two questions and I will have to plead your indulgence. May I ask the Minister again — I repeat a question——
That is not in order, Deputy.
When was the post of doctor to the casualty unit in the North Infirmary advertised?
The Deputy is engaging in repetition. That is not in order at Question Time.
I did not get an answer.
I have no control over these matters.
When was the post advertised? Surely the Minister will answer, this is meant to be answer time as well as Question Time.
I do not have that information available to me nor was it included in the question asked by the Deputy.
It is a specific matter worthy of a particular question.
I tried to raise the matter four times in the past two weeks by way of a debate on the Adjournment, and failed. I have failed again and I am surprised that the Minister does not seem to have the answer to the question. What I am seeking is the key to the retention and maintenance of what was promised when the hospital was closed down. May I ask the Minister, in relation to the general accident and emergency services in Cork city in general if any kind of feasibility study has been carried out preparatory to the decision now being put in place and to the re-organisation that is now about to take place, bearing in mind that not only do we have the ordinary demands for an accident and emergency service——
I am afraid this is becoming a very long question. I am facilitating the Deputy to the best of my ability but she cannot dwell unduly long on this question.
Any city in the country brings on its own set of demands for a very efficient and accessible type of accident and emergency service and it has——
I must ask the Deputy to desist. She is seeking to debate the matter now. It is not in order.
My question is——
I would be grateful if you would come to the pertinent question.
I ask the Minister not to take a decision without taking all the circumstances into account.
Because I share concerns similar to that of the Deputy, I personally arranged that representatives of the Regional Hospital, the South Infirmary, the Victoria and the Mercy Hospital would meet so that they could examine how they might improve the accident and emergency services for the benefit of the people of Cork. I am glad to say that the work of the accident and emergency departments in the three hospitals has been closely analysed and that some operational changes have already taken place such as the provision of a dressings clinic at the South Infirmary.