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Dáil Éireann debate -
Thursday, 8 Jul 1993

Vol. 433 No. 7

Ceisteanna — Questions. Oral Answers. - Clinical Waste.

Máirín Quill

Question:

9 Miss Quill asked the Minister for Health when the final report on hospitals waste management will be published; when this report will be circulated to health boards; and if a time frame will be put on discussions with a view to achieving action on these grounds.

Máirín Quill

Question:

128 Miss Quill asked the Minister for Health the present position in relation to the drafting of a hospital waste management policy document; when this document will be ready for circulation to health boards; and if he will make a statement on the matter.

Ivor Callely

Question:

134 Mr. Callely asked the Minister for Health the way in which clinical waste is disposed of by health boards and hospital authorities; if he has satisfied himself with these procedures; and if he will make a statement on the matter.

I propose to take Questions Nos. 9, 128 and 134 together.

The current practice of health agencies is to dispose of clinical waste by incineration. I am aware that there are difficulties associated with the incineration arrangements currently in place at some hospitals.

A document entitled Draft Health Services Waste Policy has been finalised recently by a working group in my Department. A process of consultation with officials of health boards and the major voluntary hospitals will commence shortly. It is the intention to conclude the process of consultation by the end of September.

I thank the Minister for that information. At least some progress is being made. Is the Minister convinced that a proper waste management policy is a priority with hospitals or with health boards or is it the case that in times of scarce funding patient care comes first and very little, if any, money is left over for a proper waste management operation? That being so there is an obligation on the Minister's Department to make funding available specifically for a proper waste policy management in hospitals for the elimination of problems arising in the case of incinerators, such as that in the Regional Hospital, Cork?

There are two aspects to addressing the issue: a comprehensive policy of waste minimisation and a comprehensive and safe policy of waste disposal. I have approached the issue in three strands. The preparation of a departmental health waste policy is complete. Then there is the preparation by the individual health agencies of their own plan. The implementation of that plan will be the next phase. I hope all that can be done within the next couple of months. I am concerned that we should not always be dragged into fulfilling proper environmental standards by EC legislation. A number of EC Directives impinge upon environmental protection and environmental purity. More are being drawn up which will specifically address the issue of hospital waste. I am anxious that we should be ahead of that rather than dragged behind it.

In regard to EC Directives, is the Minister aware that a recent Eolas survey carried out on hospital incinerators at Cork Regional Hospital and St. Finbar's Hospital proved that the incinerators there were antiquated, overloaded and inefficient and were emitting dangerous toxic fumes?

Is the Minister aware that his predecessor conceded in this House last November that those incinerators were antiquated? Will the Minister implement a policy immediately to deal with the safe disposal of all hospital waste, especially polypropylene, disposable blood bags and syringes, whether by way of incineration or storage?

I have indicated that I am determined that a comprehensive policy will be put in place. From a departmental point of view that policy is already complete and discussions with individual agencies to fulfil and implement their localised policies will be under way shortly.

Is the money available to implement it?

I hope those discussions will be concluded by September as I am anxious that this issue should not drag on.

I asked the Minister already if the money will be provided. As a member of the Southern Health Board, Deputy Allen is aware that, while the problem has existed there for some years and has been well analysed and documented, no action has been taken either by the health board or the hospital. The Minister is aware of that also. Will the Minister issue a special directive and provide the funding? In what manner will the Environmental Protection Agency be involved so that we can put an end to the talk and the grumbling and start taking action to eliminate this problem which exists not alone in the regional hospital in Cork but in other hospitals in Cork and practically every health board area in the country? This is a serious problem and it is time that the talking and the grumblings ceased and action commenced.

It is not my style, where possible, to issue directives.

The Minister may have to do it in this instance.

I prefer to hold discussions and reach agreement. I firmly believe that every hospital and health board want to address this problem as safely as possible. By the nature of their work hospitals generate hazardous waste. The Department of the Environment informed my Department that an EC directive on hazardous waste will be published in December this year. Those regulations will cover such matters as the handling, transport and disposal of hospital waste. The departmental policy has been complete, the discussions with local agencies are ongoing and I am determined the issue will be resolved.

Will the policy include nursing homes as well as general and special hospitals? Obviously, the number of nursing homes will continue to grow and they use a large number of hypodermic needles, drugs and so on. Will nursing homes be included in the waste management plan or will they continue to use ordinary waste disposal methods?

Obviously, all hospitals and nursing homes will be subject to the law and the law will determine what constitutes hazardous waste. Syringes and similar waste would come under the title of hospital waste and be covered under the directive.

The management in the Cork Regional Hospital are anxious to eliminate the problem there, but they do not have the funding. For the third time, will the Minister——

I cannot afford the Deputy time now.

The Minister has not answered my question. This is answer time as well as Question Time. Is it his intention to provide the funding to enable hospital staff to do what must be done?

The Deputy is well aware that a large amount of money is allocated to each health board to carry out their statutory duties. They will obviously be required to implement the law, whether that involves the implementation of EC directives or laws enacted by the Oireachtas. I do not give piece by piece instructions to health boards in regard to how they should spend their money. They receive a global allocation and, obviously, will put pressure on the Department of Health to ensure that all their needs are met.

The health board has not done it to date.

I will do my best to achieve the maximum resources possible around the Cabinet table for the full implementation of all those directives and for the resourcing, to the maximum possible extent, of health services generally.

I realise how frustrated Deputy Quill must feel because she is not receiving an answer from the Minister. In view of the clear cut concession by the Minister's predecessor in this House that incinerators in Cork and elsewhere are dangerous and injurious to health, has the Minister's Department allocated capital funding this year to provide up-to-date, efficient and safe incinerators?

The capital allocations have already been issued for this year to each health agency. On the question of money, I have allocated the resources available to me for this year and people are aware of that. I do not know how much money will be allocated for individual tasks because I do not know the full cost of such tasks for each individual hospital throughout the country.

That is not true.

Once that information is available to me, I will have to make a case for it as part of the overall health requirement for next year.

The Minister must make a case, otherwise it will not happen.

In other words it will not happen this year.

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