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Dáil Éireann debate -
Tuesday, 5 Nov 1991

Vol. 412 No. 1

Adjournment Debate. - Tralee (Kerry) Hospital Cutbacks.

I thank you, a Cheann Comhairle, for allowing me to raise this very urgent matter on the adjournment. There is serious concern in County Kerry about recent cutbacks in our health services, the further proposals to close the Clonfert ward in Tralee General Hospital on 2 December for five weeks and to turn another ward into a day ward which would, in effect, take 45 beds out of use. I should like to remind the Minister that a day ward in a county like Kerry is of little use because people have to travel such long distances and they need to stay overnight after even a minor operation. As a result no hip or ENT operations, etc., will be carried out. As Tralee General Hospital is the only acute hospital in the county, the closure of the ward will have major repercussions for many acute patients. A similar closure in Cork Regional Hospital would not have the same effect as there is a wide choice of hospitals offering acute facilities in that county.

The fear among the staff in Tralee General Hospital is that the Clonfert ward may not reopen in January and could remain closed for the remainder of 1992. The ward closure will put tremendous pressure on the nursing staff, they are carrying a heavy workload at the moment as 14 temporary whole-time nursing staff were laid off during October with the result that the staff are under extreme pressure, physically and mentally.

I am also very concerned about the 50 per cent cut in mileage allowances for public health nurses in the country. This will result in a curtailment of visits to old people and a reduction of services. This will increase the waiting lists for long stay beds in our hospitals and block acute beds because patients cannot be released from the hospital due to the lack of support services when they return home. A back-up programme of six full-time general nurses has been cut to three nurses. Indeed, the positive progress in services for the elderly made in our county in recent years is now coming to a standstill, which is very unfortunate.

I should like to take this opportunity to point out the problem of the non-availability of wheelchairs and their maintenance because of a dispute between the Southern Health Board and their suppliers MED AID in Cork, as a result of the failure of the health board to pay their debts to MED AID. I am personally aware of one child who has been unable to go to school since September because his wheelchair cannot be adapted by the Southern Health Board. Over 60 people, representing the nurses and the staff of Tralee General Hospital, SIPTU, the IFA, the ICMSA and the INO, picketed the Southern Health Board meeting in Kerry yesterday. They were vocal and very angry. I hate saying it and I am reluctant to say it, that this is the first of the type of protest march which will be organised against what is happening in Tralee General Hospital because the consultants and the nursing staff will just not accept it.

I appeal to the Minister to ensure that services are retained in Tralee General Hospital even at their present level and that the old and sick people of County Kerry will be protected and provided with a proper service.

I would, first, like to thank the Deputy for raising this matter and for giving me the opportunity of clarifying the situation.

The Deputy will, of course, be well aware that the provision, organisation and management of services at Tralee General Hospital is a matter in the first instance for the Southern Health Board. Indeed, decisions on the level of resources available to Tralee General Hospital are essentially taken by the health board, having regard to their service priorities.

The board have made a decision to close 15 five-day beds at the hospital during December. Seasonal closures are a feature of hospital services throughout the country and have been for many years. I would point out with regard to Tralee General Hospital that seasonal closures are planned with a view to facilitating patients and staff during the summer and Christmas holiday periods. The five-day beds in question are used for planned admissions rather than emergency cases. The board are satisfied that there will be sufficient beds available to meet the demands placed upon the hospital and that all emergency and urgent services will continue to be provided.

With regard to staffing levels for the Southern Health Board, my Department have approved an employment ceiling of 6,340 whole time equivalent posts. This reflects the creation of 266 additional posts since December 1988 arising from the expansion and enhancement of services in the Southern Health Board area. I might add that my Department's records indicate that staffing in Tralee General Hospital increased from 557 — whole time equivalents — at December 1988 to 601 at December 1990.

With regard to the question of staffing proposals for the filling of both new and replacement posts in all health agencies, these are reviewed on a regular basis by my Department. This review is undertaken having particular regard to financial and employment control criteria and to the priority afforded to each post by the agency concerned. The deployment of existing staff at local level is a matter for the management of each individual agency, having regard to operational, financial and personnel constraints.

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