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Dáil Éireann debate -
Tuesday, 7 Dec 1993

Vol. 436 No. 7

Adjournment Debate. - County Kerry Dialysis Treatment Unit.

On the last occasion I raised this matter, unfortunately, the Minister was not present and it is regrettable that he is not present again tonight. Nevertheless, I am sure I will receive good news from the Minister of State, Deputy Browne. The provision of a kidney dialysis unit at Tralee General Hospital has been on the agenda since 1985. On 15 April of that year a deputation from the Kerry branch of the Irish Kidney Association was received by the health committee of Kerry County Council whose members gave the association its unanimous support for the provision of a dialysis unit at Tralee General Hospital. In July 1986 a deputation from the Irish Kidney Association attended a meeting of the General Hospitals Committee. At that meeting the deputation gave a commitment that if a decision was made to go ahead with a satellite unit at Tralee General Hospital it would collect further funds for a water filtration system and would be willing to provide money through fund raising for replacement of equipment.

The Kerry branch of the Irish Kidney Association was established in October 1984 and collected £90,000 within a few months. In response to the meeting of July 1986 Mr. Christy Walsh, then programme manager of the Southern Health Board, informed the branch in March 1987 that the Department of Health had indicated that it would not be in a position to provide funds for the running of the proposed dialysis unit. Before the 1987 general election definite commitments were made by public representatives in Kerry that a dialysis unit would be provided if Fianna Fáil was returned to power.

In April 1989 the Kerry branch of the Irish Kidney Association was received by the Southern Health Board in Cork where it was given further assurances and commitments regarding the provision of the dialysis unit. In reply to a motion at the Southern Health Board meeting in June 1982, Mr. Pat Madden, acting programme manager, replied that the Department of Health had approved the setting up of a Protocol team to discuss the funding of such a unit. The report of that committee, when completed, was circulated to health board members. It detailed the costs and setting up of the unit in the Ratoo ward in Tralee General Hospital. The Protocol team estimated that the start-up cost would be £189,000 and that the annual cost of running the unit would be in the region of £351,000. Therefore, the total first year cost would be approximately £540,000. I understand that since then these figures have been revised downwards and that it will cost considerably less to provide the unit in Tralee.

In July 1992 the County Kerry Branch of the Irish Kidney Association was requested by Mr. Pat Madden to raise a further £84,000 to cover the cost of the water treatment unit to which the branch agreed. They are actively fund-raising at present and by Christmas they hope to have their contribution of £174,000 collected. It is now up to the Minister to respond.

In early November 1992 Dr. John O'Connell, then Minister for Health, gave Senator Tom Fitzgerald a verbal commitment that he would provide £140,000 in the 1993 subvention to the Southern Health Board to fund the unit. Before the November general election Dr. John O'Connell informed Deputy John O'Donoghue of Kerry South that the development of a dialysis service at Tralee General Hospital was included in developments for consideration for funding in the 1993 Health Estimates.

On 7 April last in this House the Minister for Health, Deputy Howlin, in reply to a matter I raised with him stated that his Department was discussing with the Southern Health Board the provision of a dialysis unit in Tralee in the context of the board's 1993 service development plans. What developments have taken place since 7 April? Will the Minister indicate whether the necessary funding will be provided in 1994? How long more must unfortunate patients in need of dialysis treatment in County Kerry wait for a service in Tralee? For many of them it is a matter of life and death. Seven patients have to travel to Cork for dialysis treatment on a weekly basis along bad roads and five patients are on home dialysis. These five patients would use the unit in Tralee if it was provided. Patients in County Kerry in need of dialysis treatment who have to travel to Cork devote their entire lives to dialysis leaving home at 6 a.m. and returning at 8 p.m. or 9 p.m. three days a week with rest days in between. This situation could be changed dramatically with the provision of a unit in Tralee. Units were opened in Sligo and Letterkenny with two patients and these numbers have since grown.

Dr. Murnaghen of Cork Regional Hospital has suggested that medical cover could be arranged in co-operation with Dr. D'Arcy of Tralee General Hospital. The appointment of a nephrology senior registrar at Cork Regional Hospital would enable this to be done with supervision with a monthly nephrology clinic at Tralee Kerry General Hospital being part of his duties.

The County Kerry Branch of the Irish Kidney Association has received verbal support from all public representatives in County Kerry as well as written support from two Ministers for the provision of a kidney dialysis unit in Tralee provided they can come up with local funding. It has raised £174,000. It is now up to the Government to make a decision. I appeal to the Minister for Health, the Tánaiste and all concerned to provide this unit in 1994.

Wexford): I apologise for the absence of the Minister for Health, Deputy Howlin, and thank Deputy Deenihan for raising this matter and for presenting an opportunity to clarify the situation regarding the establishment of dialysis services at Tralee General Hospital.

The Minister said on previous occasions that he is very much aware of the needs of dialysis patients in County Kerry and elsewhere. However, it is important to stress this again and to make it clear that the Minister hopes to see the establishment of a dialysis unit at Tralee General Hospital as soon as resources allow.

The provision of services at Tralee General Hospital is a matter in the first instance for the Southern Health Board which must have regard to its competing service priorities and the resources at its disposal. On a general note, the Deputy will be well aware also that there are many competing priorities within the health services nationally and that difficult decisions have to be made if we are to provide the people of Ireland with the best possible health service in an effective and equitable way.

Proposals for the provision of dialysis facilities at the hospital must be looked at in the context of the board's overall priorities and in the context of its priorities for Tralee General Hospital. Over the past few years, the Southern Health Board has identified certain service and equipment requirements as priorities for Tralee General Hospital. In this regard, the Minister is pleased to say that his Department was in a position to make extra funds available in 1992 and in 1993 for the development of ear, nose and throat services at the hospital and that extra resources were allocated to the hospital this year for additional orthopaedic operations under the waiting list initiative. The Deputy might also be aware that substantial capital funds have been approved in recent weeks for the purchase of anaesthetic and monitoring equipment for Tralee General Hospital. This approval was of great importance to the hospital.

As I indicated earlier, the Minister hopes to see the establishment of a dialysis unit at Tralee General Hospital as soon as resources allow. In this regard, the development of a dialysis service at Tralee General Hospital will be considered for funding in the context of the overall funds available to him in 1994.

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