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Dáil Éireann debate -
Tuesday, 2 Dec 1997

Vol. 483 No. 6

Adjournment Debate. - Hospital Waiting Lists.

The waiting list for cardiac surgery for children in Our Lady's Hospital for Sick Children in Crumlin is approximately 160 and rising, compared to 120 at this time last year. Operations are regularly cancelled due to the lack of a surgeon or an intensive care bed or a qualified intensive care nurse.

There are two cardiac surgeons available to the hospital and they give one day per week for surgery. As a result, children who are due to have operations have their operations cancelled to allow urgent surgery to be carried out on newborn babies. There are also two cardiac consultants attached to the hospital and the number of patients they must attend to each week is, to put it mildly, staggering. The waiting list for a public out-patient is approximately 12 months. The Minister will agree this is unacceptable, particularly for a child with a heart condition.

I wish to outline what it means to have a child with a heart problem. I recently received a letter from a constituent which set out her deep concerns about her five year old son who has a heart condition. She told me her child's skin colour is quite blue, while his mouth and tongue are almost black. He cannot climb the stairs in his home and gets breathless walking from room to room. All outdoor journeys are conducted in a child's buggy. This year he started school and he must be carried to his classroom. It is not difficult to imagine how this child's quality of life would improve if the necessary surgery was available to him. That surgery should be carried out without further delay. However, this child is 106th on the waiting list. It must be heartbreaking for the parents to have a child in that condition and to know he is only 106th on the list. Indeed, it is heartbreaking for the parents of children who are behind and in front of him on the list.

Members of the public regularly complain that they cannot understand how this situation is allowed to continue. I have raised the issue of cardiac surgery for children but a recent Sunday newspaper carried a major article on the problem of waiting lists for cardiac surgery for adults, where there is also a huge problem. At a time when Ireland has a booming economy, it is difficult for parents, spouses and other relatives of ill people awaiting cardiac surgery to understand the situation. I hope that in his reply the Minister of State can give me some assurances. In particular, I ask him to arrange without further delay for another cardiac surgeon to be allocated to the Children's Hospital, Crumlin, and to have at least another cardiac consultant as well as providing more intensive care beds and ICU trained nurses. The theatres in Our Lady's Hospital are like something from the 1950s. The Minister of State should give some hope to people who have to face this dreadful situation every day. We would all like to see immediate attention being paid to this serious problem. I trust the Minister of State can give us some hope.

I thank Deputy Barrett for raising this issue. I am grateful to him for giving me an opportunity to clarify the situation regarding paediatric cardiac services at Our Lady's Hospital for Sick Children in Crumlin.

This hospital serves as the national referral centre for paediatric heart disease and has recently experienced an increase in the number of children awaiting cardio-thoracic surgery. This additional demand has resulted in extra pressure on the service and an increased waiting time for some patients. My Department has had discussions with the hospital and is fully aware of the need to address this situation. The reasons for the additional pressure have been identified as a lack of theatre space and ICU beds, a shortage of ICU trained nurses and advances in surgical and interventional techniques which have resulted in increased demand.

In April 1997 my Department invited proposals from the hospital for the spending of £500,000 to be made available from the 1997 waiting list initiative to alleviate the pressures on this specialty. Proposals submitted by the hospital were accepted by my Department and the funding was immediately provided to support them. In a recent progress report on the initiative the hospital stated that:

Since the appointment of a locum consultant paediatrician the hospital has achieved an increase in its cardiology out-patient department's activity and in the number of echo-cardiograms performed. The combination of both these factors will result in an additional 545 procedures being carried out in 1997. Building works on four additional ICU beds were recently completed. An additional training programme for ICU nurses commenced in September and six candidates have been selected for participation.

In addition, a project team, which consists of officials from my Department and hospital representatives, is currently working on a development plan for the provision of additional theatres at the hospital. The Minister, Deputy Cowen, has asked that this work be concluded as a matter of urgency so that the hospital can proceed to the next stage of this important development which has his and my support.

The Minister recently met the chairman and representatives of Our Lady's Hospital and confirmed that the project would be included as a priority in the Department's capital programme. A budget cost cannot be set for the development until the project team has completed its brief.

The measures outlined above will combine to address the problems which have been identified at the Crumlin hospital. The Deputy will also be aware that proposals are currently being developed for a wider range of measures in relation to cardiac care services, both adult and paediatric. I am confident that these initiatives will have a positive impact on the service levels available for this specialty in the near future.

In fact, I have been in contact with Dr. Des Duff in Crumlin hospital. He advised me also, as the Deputy said, that there is a problem with the cardiac services there. As I outlined, the Minister for Health and Children has taken steps to alleviate the difficulties, and within a short time we hope to have made an impact on that problem.

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