asked the Minister for Health if, in view of the serious crisis facing many of our public hospitals, such as St. James's in Dublin 8, Galway Regional Hospital, County Galway and Temple Street Children's Hospital, Dublin 1, which has led to patients having to spend hours waiting on trolleys and has led to increased waiting lists for urgent treatment, he will indicate the measures he intends to take to deal with the crisis; if he will increase the financial allocation for these hospitals; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Public Hospital Services.
18.
I cannot accept the Deputy's allegation that there is a serious crisis facing many of our public hospitals: in fact, we continue to have an excellent hospital service comparable with any in the developed world. There has been a lot of media exaggeration in the recent past regarding patients on "trolleys" and waiting lists for "urgent" treatment. I would like to set the record straight however in regard to trolleys. Trolleys have always been a normal feature of Accident and Emergency departments in general hospitals.
The whole purpose of the casualty department is to have observation beds or trolleys to accommodate patients who require observation. While these people are being maintained on trolleys all appropriate medical attention is provided. People on waiting lists are those who are not regarded as emergency cases. Where people are in urgent need of immediate medical attention they are treated promptly in acute general hospitals.
Deputies will know that I have instituted a major rationalisation programme which continues to address any difficulty in our hospital services.
I find the Minister's statement amazing in view of the number of complaints I have received and which I am sure every other Deputy in this House has received in regard to waiting lists and so forth in hospitals. Is the Minister aware that a child of five years of age cannot have an urgent operation for two-and-a-half years in Temple Street Children's Hospital to save his hearing?
I would make the point that allegations have been made both inside and outside of this House about patients being left on trolleys at Temple Street Children's Hospital, but the reality is that there are no trolleys. I accept that there are delays for certain specific procedures, such as, tonsils and adenoid and orthopaedic procedures. There have been such delays for many years and they have not just started occurring over the past 18 months. I would point out to the Deputy and for the benefit of the other Deputies in the House that 500,000 people were treated as in-patients in hospitals while 1.5 million people attended out-patients clinics in 1987. These figures do not include patients who attended their own general practitioners and were not referred to hospitals or those who attended consultants privately or those who were admitted to private hospitals. Those are sizeable figures when we consider that our population is 3.5 million and they support my view and the view of most Members of this House that there are adequate and proper services available for the people.
Would the Minister accept that there are long waiting lists, both for children and adults, for urgent operations and that in many cases casualty patients are left lying on trolleys in public hospitals because there are no beds available for them and because there are no nurses to man the wards? Would the Minister also accept that the decision he has made to peg the allocations to health boards for 1989 at the 1988 level, an effective 3 per cent cut, is going to mean we are going to have longer queues and more problems in our public hospitals as a result?
May I ask for brevity as a number of Deputies are offering and I want to facilitate them?
I do not accept that patients are left lying for a long time on trolleys while awaiting beds in hospitals. In one instance during the current year while a number of patients were lying on trolleys there were vacant beds available in a sister hospital in the same group. That was a matter between the two hospitals. As I have already stated in answer to Deputy Mac Giolla's question, trolleys have always been a feature of casualty and out-patients departments. One reason for this is that it may be necessary to observe patients for some time and another reason is that it is easy to move a patient on a trolley to the appropriate area of the hospital if they need immediate treatment. It may be necessary to move patients to specific areas of the hospital from accident and emergency departments as a matter of urgency.
Would the Minister accept that reputable consultants, objectively stating their views, have confirmed that waiting lists in public hospitals for cancer and cardiac investigations have grown enormously during the past 18 months and that the waiting lists for many other specialities, particularly of an investigative nature, are now dangerously long and that very serious concern is being expressed, particularly by the medical profession, by a wide range of consultants——
I did ask for brevity.
——that no matter which public hospital one goes into one will find consultants who will stand over the length of the lists when they cannot get patients into hospital to have these particular investigations carried out. This is leaving aside orthopaedic and ENP procedures.
I do not accept what Deputy Desmond is putting forward, as from time to time I have seen consultants make public announcements which, when the facts were analysed, did not always stand up. For example in St. James's Hospital where the number of beds has been reduced by 25 per cent the throughput of patients has increased by 7 per cent. In this country we perform one and a half times the number of cardiac by-pass operations per 1,000 people than they do in Britain. I accept that there is a problem with admissions in the major hospitals, particularly in the Dublin area and to a lesser extent in Cork and Galway, because of the impact of the accident and emergency departments on those hospitals, where a major accident and emergency service is provided. This is a problem we are addressing and we are trying to see how the accident and emergency service can be improved having regard to the level of consultant staff in the accident and emergency unit and having regard to the general practitioner service that is available. We are also looking at the area of prevention, as many people who find themselves in accident and emergency departments, if they had taken a little bit more care would not have found themselves there.
Is the Minister familiar with the position which obtains in Galway Regional Hospital, referred to in this question and which is also the subject of Question No. 59, where patients have been refused admittance in very large numbers and where there is a real crisis due to the lack of staff and the effects of the Minister's decision in regard to financial allocation to the Western Health Board region? Is the Minister aware of the serious concern which has been expressed on more than one occasion by the senior consultants in the hospital and is he also aware that it is now accepted that the only way to gain admittance to the hospital is to go into the casualty department?
I do not accept that there is a massive shortage of staff in Galway Regional Hospital. There are 1,434 people working in the hospital. Indeed, Galway Regional Hospital is one of the hospitals where throughput has increased in the current year. I accept that in order to live within the allocation the Western Health Board have been obliged to close a number of beds for the remainder of this year. This is a temporary measure and, hopefully, those beds will be opened at the end of this month.
Can the Minister——
We are coming up to the time to deal with Priority Questions and I am sure the Deputy will have regard to that factor.
This question relates to the future of Temple Street Children's Hospital. Now that the Minister has received the report of his officials who are investigating Temple Street Children's Hospital, can he now state what the future of that hospital will be?
I have not as yet received the report of the group who looked at Temple Street Children's Hospital but I expect to receive it within the next few days.
We now come to deal with questions nominated for priority.
A Cheann Comhairle——
Can the Minister——
I am sorry, Deputies, I am proceeding to deal with Priority Questions.
I seek your permission, a Cheann Comhairle, to raise on the Adjournment the closure of the Babygro plant at Belmullet.
I will communicate with the Deputy. Question No. 62.