Thank you, a Cheann Comhairle, for choosing this item on the Adjournment. With the permission of the House, I wish to share my time with Deputy Enda Kenny.
Adjournment Debate. - Mayo General Hospital Services.
Is that agreed? Agreed.
Mayo General Hospital cost £10 million to build and by any standards it is a fine, modern hospital which is well equipped. It was a long awaited and eagerly anticipated development. However, rather than improving the quality of service available to the patients in the area, constant cutbacks and under-funding have repeatedly turned back the clock.
Last July, the Western Health Board closed the 12-bed gynaecology section. For the past number of weeks, elderly male patients have been transferred to the maternity section. This is an appalling development. It is not fair to the males in question, who are weak, ill and vulnerable; but it certainly is not acceptable to pregnant women awaiting the birth of their babies or women who have just given birth to babies. It is simply an unacceptable practice and marks a new low in the quality of service.
The final straw was the announcement this week that D block, the only female surgical ward in the hospital, is to close for a seven week period as and from Sunday next. Taken in conjunction with the conditions obtaining in the maternity unit, with the locking up of the gynaecology section, this represents an appalling attack on the health and dignity of female patients. It means that anything of a routine nature will have to be deferred. It also means that potentially dangerous ailments, which appear on first analysis to be routine and simple enough, will be given time to worsen and become potentially life-threatening. It now means that acute female surgical cases will be scattered among the remaining open wards where all elective surgery has to be put on hold. This is simply unacceptable.
Deputy Enda Kenny and I have been contacted by distraught patients at the hospital. We have been contacted by the relatives of patients at the hospital. We have been contacted by the nursing staff and authorities at the hospital who are appalled at what is now happening and at what is planned.
I contacted the Western Health Board today. The raw reality is that finance is the root of the problem. Mayo General Hospital has pruned its level of services to the very bone. In regard to expenditure on those services, every possible economy has been made. However, there is a level below which it simply cannot go. That level was reached in July last, has now been reached in relation to the maternity treatment and has certainly been reached with the decision to close the only female surgical ward.
The fact is that, after all necessary economies, the hospital authorities are now £350,000 short of what they require to run the hospital. I listened to the Minister for four years when he was in Opposition; but I warn him now, in his capacity as Minister for Health, that this money simply must be found. It is his job as Minister for Health; it is his social and moral responsibility to find this money. By his failure to provide adequate funding to run the hospital he has placed the hospital authorities in a position in which they are faced with impossible choices. This is an attack on the health of women. In fact, it is a breach of human rights. We are aware of the increasing incidence of mastectomy operations and the trauma involved for patients. Surely we have reached an all time low when mastectomy patients, whose ongoing treatment and prosthesis require privacy and individual specialist attention, will not now be given this attention because the nurses will have been switched to some other section.
Dreadful.
The Minister can tuttut all he wants. Because of the closure of the female surgical ward all booked admissions will be cancelled. People on waiting lists are being told that they cannot be attended to in the foreseeable future.
The Minister can play around with words and figures all he wants. What I have relayed to him is the position on the ground in the hospital if this closure goes ahead. There is no point in building a new, modern hospital with a grandiose opening if the money is not provided for running the service, because the level of service now envisaged is scarcely on a par with that applicable in some Third World countries. I warn the Minister that this will not be tolerated.
I am grateful to Deputy Jim Higgins for allowing me a proportion of his time on this matter of grave concern and of very serious consequences for the entire population of County Mayo.
I respected the present Minister for Health as Opposition spokesperson on Health for the Labour Party before his present appointment. But in his present capacity he has to preside over the selfsame service he decried from those benches. While he might attempt to run them in a different fashion, the consequences on the ground are horrific.
I live in Castlebar town. Mayo General Hospital is of great importance to the town and surrounding regions. The method being adopted by the Western Health Board of day surgical treatment does not take into account the distance travelled in a county such as Mayo. For example, it is 70 miles from Castlebar to Belmullet and Blacksod. How is a patient expected to travel up by ambulance for a day operation and return the same evening?
I challenge the Minister, as a man, as a politician and as Minister, to travel down to Mayo General Hospital on Monday morning next and explain to the matron, nurses, doctors, patients and staff how he envisages the hospital being run at optimum levels when there has been a padlock on the gynaecology ward since July last, when there will be further padlocks placed on D block, particularly when one takes into account that since 1987 the number of admissions has increased from 12,050 to 14,900, an increase of 23 per cent; that casualty treatments have increased from 11,757 to 16,420, an increase of 40 per cent, with no increased employment there; and that 19 jobs are being lost as a result of this latest proposal. In circumstances in which the Government have promised that everything would be bright and beautiful under the National Development Plan, people are absolutely appalled that 42 beds are proposed to be closed in Mayo General Hospital.
When replying I hope the Minister will give us some consolation, some hope. Indeed, I hope he will take up my challenge to him to travel down to Castlebar on Monday morning next, when the Western Health Board intend implementing this draft, nonsensical and very serious proposal, and explain what is happening.
It is regrettable that once again Deputy Jim Higgins has made an unwarranted attack on the quality of services at Mayo General Hospital without any regard to its impact on the patients or the service providers. It is difficult to believe that Deputy Jim Higgins, for whatever reason, is prepared to label the general hospital serving his area as "Third World" as he did in this morning's papers. He knows as well as I do that the service provided there by highly trained, dedicated staff is on a par with the very best available anywhere in the country.
Nonsense.
He must be aware also that there are no waiting lists at Castlebar General Hospital. Despite the fact that the Western Health Board received nearly £2.2 million additional money under the current waiting lists initiative, it was not necessary to allocate any proportion of these funds to Castlebar because there are no waiting lists in any of the relevant speciality services provided by that hospital. Deputy Jim Higgins should also be aware that, there was a significant increase in activity throughput in the hospital in 1992 as compared with 1991, this heightened the level of activity will be maintained in 1993.
The decision of the Western Health Board to close some beds on the surgical side of the hospital is being presented by Deputy Higgins and others as unjustified and related solely to budgetary considerations. Let me put the issue in context. During 1993 the Western Health Board has taken a number of practical steps at the hospital to improve efficiency in line with good established practice everywhere else. This year it has established an eight bed medical assessment unit to ensure that all overnight medical admissions are necessary and has opened an eight bed day surgery unit. The board is also about to implement an integrated admissions policy which will ensure that all beds at the hospital are used efficiently to meet patients' needs. Inter alia, that should eliminate the problems which have arisen in relation to the placement of male and female patients within that hospital.
The Deputies opposite have made much of the fact that the closures are directed at women. Of course, this is not the case. The decision of the board in relation to elective surgery applies equally to men and women. There is absolutely no threat to emergency admissions, irrespective of the numbers that may arise. In order that the position can be made crystal clear locally the Western Health Board itself has arranged for a briefing of Mayo members of that health board later this week.
Given that the hospital does not have a waiting list, it would be reasonable to expect that the introduction of these measures, that is, the day surgery — the current normal advance in medicine nowadays — would reduce the need for existing surgical beds to be open throughout the year.
Of course, there is a financial dimension with which the Western Health Board and all other health boards must cope. When I made allocations to the health boards in respect of this year I was satisfied that those allocations would support the approved level of activity. This assessment is supported by the information available to me in respect of this year, that the throughput will at least maintain last year's record throughput. I made it clear to the health boards that I did not expect them to produce more activities than their allocations could sustain, that I expected them to live within their allocations subject to certain exceptions, notably demand-led schemes and certain other unavoidable costs such as increases in medical defence fees. I am sure that Deputy Jim Higgins and his party will agree that this approach is reasonable, especially in the light of the financial strategy disclosed by his colleague last week, that of wanting to cap expenditure in mine and every other Department to 2 per cent this year.
They cannot argue both ways simultaneously over on those benches. I want to repeat that, even with the temporary closure of beds between now and the end of the year, the Western Health Board has confirmed that there will be no reductions in the overall level of activity at Mayo General Hospital.
The Dáil adjourned at 9.10 p.m. until 10.30 a.m. on Wednesday, 17 November 1993.