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Dáil Éireann debate -
Wednesday, 10 Jun 1992

Vol. 421 No. 1

Adjournment Debate. - Proposed Transfer of Patients from Cashel (Tipperary) Hospital.

I thank the Ceann Comhairle for allowing me to raise this very important and sensitive matter on the Adjournment. I wish to place on record my appreciation of the excellent services provided by St. Luke's Hospital, Clonmel, and St. Patrick's Hospital, Cashel. However, widespread concern has been expressed by the patients, their relatives and staff of the hospital about the proposal, which is now before the South Eastern Health Board, to move 80 non-ambulant patients from St. Patrick's Geriatric Hospital in Cashel to St. Luke's Psychiatric Hospital. This proposal is contrary to the concept of integrating psychiatric patients into the community contained in the excellent document on psychiatric services, Planning for the Future, published by the Minister's Department. This proposal is contrary to that concept as it proposes to move patients from a geriatric institution, where they have been for a long number of years, to a psychiatric campus. I understand that this proposal was put forward in view of the fire hazard in St. Mary's ward in St. Patrick's Hospital, Cashel. Even though fire escapes were provided in this hospital not very long ago obviously they are not adequate. Our primary concern is for the safety of these patients.

It is estimated by the board of the hospital that the cost of removing these patients will be approximately £97,000. I suggest to the Minister that this money could more usefully be spent in refurbishing the ground floor accommodation in St. Patrick's Hospital so as to ensure that it would not be a fire hazard. Under a rationalisation programme, this accommodation was recently vacated and laundry and kitchen services were centralised in St. Luke's Hospital. This proposal could contain a hidden agenda; it may even be a sinister move on the part of the health board. I ask the Minister to ask his Department to initiate immediately an investigation into this proposal as the health board will make a request to the Minister for funding to refurbish accommodation in St. Luke's Hospital, Clonmel, to accommodate these patients.

This proposal is a backward step. We must have some regard for the patients and their relatives. We must also bear in mind the fire risks which exist in the hospital. I accept that patients from Carrick-on-Suir and Clonmel would like to be closer to home, but St. Patrick's Hospital is the established geriatric unit for County Tipperary. This hospital, which has provided a service for 150 years, was recently commemorated by a tremendous ceremony there. Books have been written about the hospital. As I said, this proposal is a backward step. The hospital has already lost its kitchen and laundry facilities. The hospital authorities accepted this decision because it was part of a cost-saving and rationalisation exercise. However, they do not want to lose half their patients. I plead with the Minister not to accede to this request from the health board and to use his influence and that of his Department to use this money to refurbish St. Patrick's Hospital so that it will not be a fire hazard.

I must confess that the public representatives in the South-Eastern Health Board area are very attentive to this matter. Deputy Ferris, Deputy Davern, Senator McCarthy and Senator Byrne have raised this matter with me. I congratulate them all on their vigilance in bringing this very important issue to my attention in such a speedy manner.

A proposal from the management of the South-Eastern Health Board to transfer patients from St. Patrick's Hospital, Cashel, to alternative accommodation in Clonmel is on the agenda of the special hospitals committee of the South-Eastern Health Board who will meet tomorrow, Thursday, 11 June. The committee will consider the issues involved and recommend a course of action for decision by the health board. The question of alternative accommodation for patients in St. Patrick's Hospital is a matter for the South-Eastern Health Board in the first instance. I will await their decision in due course.

I wish to give the background to this issue. Following a recent inspection of St. Patrick's Hospital, Cashel, the fire authority came to the conclusion that the existing means of escape from the upper floors of the hospital were inadequate for the ready evacuation of non-ambulant patients. The authority immediately notified the South-Eastern Health Board that they considered it necessary as a matter of urgency that such persons be relocated in suitable ground floor wards which had an adequate means of escape. I believe all of us would agree with that proposal.

In a subsequent letter they asked for details of the board's plan for these patients. I understand that the estimated cost of complying with the fire officer's requirement is approximately £400,000. In view of the high costs of carrying out the fire precautions to the first floor accommodation in St. Patrick's Hospital it is proposed by the management to transfer 35 non-ambulant patients from the south of the county to a soon to be vacated free standing unit at St. Luke's Hospital, Clonmel. This unit is away from the main hospital campus. Existing long-stay patients in Cashel would not be moved without their agreement. Any proposed transfers would be discussed with patients and their families. The unit would cater for elderly patients, mainly from the southern end of the county, including Clonmel and Carrick-on-Suir. The assessment rehabilitation unit for the elderly in south Tipperary would remain at St. Patrick's Hospital, Cashel. As the free standing unit would no longer be part of St. Luke's Hospital, management feel there would be no conflict between the proposal to transfer elderly patients to it and the policy in relation to psychiatric services as outlined in the document Planning for the Future.

St. Patrick's Hospital, Cashel, and the unit in Clonmel would be operated jointly as part of a unified service and both would be under the nursing management of the matron at St. Patrick's Hospital. Existing permanent nursing and non-nursing staff in Cashel would be given the option of transferring to Clonmel but it is not envisaged that there would be any compulsory staff transfers. Catering and laundry services for the Clonmel unit would be provided by the central laundry and the central kitchen which supply existing Clonmel hospitals. The non-pay costs would be met within existing budgets. There would be four nursing posts, one non-nursing post and a part-time medical post, and a sessional physiotherapy and occupational therapy post would be required in addition to the existing staff. The pay costs associated with the transfer of patients is estimated at £97,000 per annum.

As I said at the outset, this proposal will go before the special hospital committee of the board tomorrow — I compliment the Deputies and Senators concerned — and this committee will in due course make a recommendation for consideration by the full board. In this context it may be premature to make a statement in relation to the proposal at this stage, but I have to say I would not be in favour of it.

Well done.

It is attempting to swim against the tide in proposing to bring elderly patients back to a location associated with a psychiatric hospital, when all our efforts at this time are, as Deputy Ferris rightly said to me today, devoted to transferring elderly patients away from psychiatric hospitals. This is an important proposal in the Green Paper on the Psychiatric Services which I launched last week. I trust that we can rely on the good sense of the board members not to approve this proposal but to ask the management to come up with alternative options for meeting the requirements of the fire officer in this instance.

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