Deputy Ahearn gave notice of her intention to raise the serious cutbacks proposed by the South-Eastern Health Board for St. Joseph's Hospital, Clonmel, due to inadequate funding by the Department of Health and the hardship which will result for patients and staff.
Adjournment Debate. - Clonmel (Tipperary) Hospital.
Thank you for the opportunity to raise this matter. The announcement that from 24 November the gynaecological ward in St. Joseph's Hospital, Clonmel, is to close for one week in every four caused shock and consternation, not only among the staff of the hospital but in the entire area. As a result, only emergencies will be catered for by St. Joseph's Hospital, which covers south Tipperary, west Waterford and north Tipperary south of Thurles. In addition to this closure, two nursing posts will be lost in a hospital already operating on a minimum staff allocation.
These cutbacks are as a result of a cash crisis in the South-Eastern Health Board and the growing chaos in the health service nationally. The result of this decision will be that the current waiting lists for gynaecological services will be increased, there will be early discharges and a reduction in the quality of patient care caused by the reduction in nursing posts. The entire staff of St. Joseph's Hospital have indicated their grave concern, not for themselves but for the patients under their care. They feel frustrated knowing that they will be unable to provide a proper and adequate service for patients owing to this decision.
I want to impress on the Minister that the crisis in Clonmel is a direct result of inadequate funding allocated by this Government to the South-Eastern Health Board. The entire blame for the closure of this ward one week in every four and the loss of two nursing posts rests with this Government.
At present, St. Joseph's Hospital is approximately £250,000 over-spent. This is through no fault of the hospital, as the budget given is too small and is based on a period when the hospital had a lesser workload.
In recent years the number of patients and the amount of work has continued to increase, yet the budget to the hospital has continued to decrease. The South-Eastern Health Board realise the difficulties, but they are cash starved and cannot help.
This is happening at a time of year that tends to be the busiest in regard to medical cases, yet the hospital is expected to work in this period and in the future with fewer staff. I warn the Minister that so great is the concern of the staff that they have informed the South-Eastern Health Board that they will not take responsibility for patients when the cutbacks are implemented from next Sunday. Surely we can accept their bitterness when debts of £9 million could be written off at Knock Airport and there was no scarcity of money for Carysfort College. Yet the lives of the patients at St. Joseph's Hospital are put at risk for an additional £250,000.
The Minister must take immediate action to provide the additional finance to maintain the present allocation of staff in that hospital and allow the gynaecological ward to remain open on a full-time basis. We cannot accept the implementation of a decision which will affect the lives of women in south Tipperary. The lives of our women and the welfare of our staff in St. Joseph's Hospital are surely worth more and I appeal to the Minister to ensure that this decision taken by the South-Eastern Health Board does not have to be implemented.
I thank Deputy Ahearn for raising this matter on the Adjournment and I welcome this opportunity to explain the current position in relation to St. Joseph's Hospital, Clonmel.
The provision of services at St. Joseph's Hospital, Clonmel, is a matter in the first instance for the South-Eastern Health Board. Each health board are responsible for determining the funding needs of the individual hospitals under their management and for the establishment of priorities within the approved allocation for the board's area.
My Department are in regular contact with health agencies, including the South-Eastern Health Board, on financial, personnel and service matters. In discussions the South-Eastern Health Board have indicated that they have been experiencing pressure on their cash resources. However, my Department have taken all possible steps to meet the board's needs within the limits of their approved bank overdraft and cash profile based on approved spending limits, including adjustments of the allocation agreed to during 1991.
I must stress that, while every assistance possible will continue to be extended to the board, it is ultimately a matter for each agency to maintain spending within approved budgeting limits. All agencies were notified in their letter of allocation for 1991 that expenditure must be contained within the limits of the approved allocation and that any expenditure excess arising in 1991 will be a charge against the 1992 allocation. I understand that a number of corrective measures are being introduced by the board in order to deal with their financial situation.
As regards St. Joseph's Hospital, Clonmel, I understand that the board have closed six beds, from a total of 177 beds and that the number of posts at the hospital has been reduced by nine, out of a total staff complement of 221. These limited restrictions were necessary because of the financial constraints under which the board, in common with all health agencies, have to operate.
I should emphasise, in accordance with undertakings which have been given in relation to health services in 1991, that the non-capital allocation of the South-Eastern Health Board will be adjusted to take account of approved increases in expenditure, including pay, increases in the rates of allowances and certain services-related items.
The Minister for Health also met the chief executive of the South-Eastern Health Board to emphasise once again the vital importance of achieving agreed service targets within budgetary limits so as to ensure that the level of expenditure is geared to enable the health board to deliver the approved 1990 level of service in 1991. There is no information available to me in the Department which suggests that lives are being put at risk in this hospital. I am satisfied that this hospital is operating very efficiently, is taking its responsibilities very seriously and has considerably increased its throughput of service during 1991.