Written Answers. - Hospital Services.
Liz McManus
Question:
135
Ms McManus
asked the
Minister for Health and Children
his policy in relation to the securing of jobs for 139 staff under review in view of the deferral of the service plan for Tallaght Hospital until 12 February 1999; the position of the paediatric surgery facilities and paediatric haemotology; the position in relation to the possible temporary closure of one paediatric ward; and if he will make a statement on the matter.
[3009/99]
The Deloitte & Touche report found that staff numbers on the hospital's payroll at 11 October 1998 were 139 whole-time equivalents above approved levels. This number included 40.7 commissioning staff which the hospital anticipated would be released by April 1999. The Department is currently awaiting the hospital's service plan for 1999 which should provide details on the current position and state how the hospital proposes to manage this situation.
The Deputy will appreciate that it would be inappropriate for me to comment further at this stage except that to say that I expect the hospital to comply with relevant labour legislation and best industrial relations practice in accordance with the industrial relations protocol agreed with the trade unions.
Public hospitals in Dublin, Cork and Galway currently providing paediatric haematology services were advised recently by my Department that following a recommendation by the National Cancer Forum, all children with cancer will initially be referred to Our Lady's Hospital for Sick Children, Crumlin, Dublin, for assessment and advice/referral on treatment. The National Cancer Forum is an expert body, chaired by Professor James Fennelly, which advises the Minister on all aspects of cancer services. Its principal concern is the quality of care and service which offers best outcome for patients.
The question of the most appropriate means for organising acute hospital services for children has been under discussion and debate for a number of years without agreement being reached as to the best location for certain services. In these circumstances and conscious of the need for quality services for children diagnosed with leukaemia, I asked the National Cancer Forum to examine issues in relation to the provision of treatment for such children and specifically to advise on the most appropriate approach to the assessment, care planning and follow up of cases.
In looking at this area, the forum's major and paramount concern was to identify how best to provide a high quality service for children, from initial diagnosis through to all forms of appropriate treatment. Account was taken of expert international evidence, which indicates that there should be one paediatric oncology unit per five million population, and that the treatment of solid tumours should not be separated from the treatment of leukaemia. The international evidence also indicates that a paediatric cancer unit should have the appropriate infrastructure of services, personnel and equipment to provide the optimum level of service to children.
The forum subsequently recommended that all paediatric oncology cases should be referred to the specialist paediatric oncology unit at Crumlin for initial diagnostic work-up and treatment planning. This does not mean that all cases would necessarily have to be treated in Crumlin. However, given the level of specialised expertise required in dealing with paediatric oncology, the forum recommended that every childhood case of cancer should be seen in Crumlin initially for advice/referral on treatment. Subsequent treatment, including chemotherapy, could then be delivered in the child's most appropriate local hospital, on a clearly defined and agreed share care basis, subject to proper supervision. Health agencies have been asked to commence discussions in the near future as to how best to implement this decision and the Department has stressed the need for close working relationships between the relevant hospitals.
I am confident this collaborative approach will facilitate the continuing provision of high quality services for children.
I wish to emphasise that there is no question, nor was any proposal put to me, of transferring the haematology unit at Tallaght Hospital to Crumlin. I also stress that, contrary to some completely inaccurate media reports, I have no intention of closing the unit at Tallaght. No proposal in this regard was ever made to me, nor have I ever considered this step. It simply does not arise.
The provision of specialist paediatric surgery has also been under discussion for a number of years. Currently surgeons work between the three hospitals but this requires the consultants to cover an extensive number of hospitals and also necessitates full specialist on-call teams at each site. Comhairle na nOspidéal reviewed the existing structure and in November 1998 put forward its recommendations in this area, namely, that paediatric surgery should continue at the three hospitals but that Crumlin should be designated as the specialist paediatric surgery centre. Comhairle na nOspidéal's proposal incorporates the appointment of an additional surgeon and the restructuring of current posts. I understand that this recommendation has the support of the existing paediatric surgeons.
The Deputy will be aware that the hospital's service plan is due in my Department within the coming weeks, following which officials will meet the hospital management to review the plan. Without having sight of the hospital service plan, it is not appropriate for me to comment on what it may contain.
