I welcome the opportunity to raise this important matter in the House. The threat of industrial action in Tallaght Hospital is the latest and most alarming chapter in the short history of this new hospital. What began as a crisis is rapidly turning into a disaster. The prospect of all out strike action at the hospital beggars belief and a super-human effort is required by all the key players, particularly the Minister for Health and Children, if the hospital is to be put on a sound footing and allowed to develop as it should.
It is worth remembering that we are talking about the biggest investment in a hospital facility by the State in a rapidly growing area of Dublin city. It is a state of the art centre of excellence which promised to be a flagship for today's health services. Yet a few short months after opening, the hospital has been undermined by gross underfunding, poor communications and management and by Government and ministerial diktat. The resultant extent of demoralisation among the staff has reached the point where no one appears to have confidence in the Minister to deal fairly and competently with the current situation.
It is worth remembering how successful the opening of Tallaght Hospital has been and how the high level of patient satisfaction has been maintained in extraordinarily difficult circumstances. The move from three run-down hospitals was carried out with skill and efficiency. In reply to a parliamentary question in April 1998 the Minister stated: "enormous efforts have been and are being made by very committed people, including the staff of the transferring hospitals, construction staff and suppliers". He went on to say the move was done in a spirit of partnership and dedication in the interests of the patients. Indeed since opening, productivity in the accident and emergency department alone has increased by 30 per cent in comparison to that of the original three base hospitals. Yet it is the same dedicated staff who are now threatening to go on strike against a background of the disintegration of trust and confidence which originated long before the opening of the hospital.
Inevitably, because of departmental miscalculations from the start, cost overruns became a matter of concern to the board of Tallaght Hospital. The Department was advised of the prospect of serious funding deficiencies. Yet it is clear that in their determination to get the hospital open, the Minister and his Department did not take sufficient heed of the warnings of the board and the chief executive. It is clear from the Deloitte & Touche report that the board erroneously, as it turned out, believed that the Department was taking its submission seriously.
When he did act, the Minister sent in consultants who made a report itemising the problems relating to management and funding. The board accepted the findings of the report and undertook to work to resolve the difficulties but its commitment and co-operation has, regrettably, not been reciprocated by the Minister.
The Minister has not acknowledged that the origin of the chaos now looming at Tallaght Hospital is in a formula used by his Department in calculating a budget based on a faulty premise. The Deloitte & Touche report gets to the nub of the problem. It says the decision to base the 1998 determination on the cost structure of the three base hospitals plus certain additional moneys was inappropriate. It goes on to say that it has concluded that the determination process does not lend itself well to a situation of major change such as the opening of a new hospital. To this day, I do not believe the Minister has accommodated the conclusions.
The report outlines the profile methodology which should have been undertaken and it is damning in its conclusion that early financial planning would have brought about the benefits required to keep Tallaght Hospital from running into difficulties. The Minister's refusal to face up to this core failure in his Department is now leading the hospital into dangerous and uncharted waters. The current situation is impossible to reconcile. He simply cannot square the circle on this one.
No doubt the Minister will claim he has provided for an increase in this year's determination and while that is true, it is not enough. If the board is to keep within the limits of the 1999 service plan, there will inevitably be a loss of services and of jobs and a breakdown in industrial relations. Certainly, if nothing else, there will be a curtailment in developing services which are so essential to the future growth of the hospital. This is an untenable prospect.
Will the Minister outline in detail how he intends to deal with the current impasse? It is worth noting that when the Taoiseach visited Tallaght Hospital last Friday the Minister was noticeable by his absence. A visit which should have been a triumph was noted for the distance which the Taoiseach kept from patients and patients' families who had hoped to talk to him about their concerns. It is indicative of a breakdown between the Government and the Tallaght Hospital which is supposed to be a flagship of modern Irish acute hospital care, that we have reached this point. It has lead to plummeting morale among staff and demoralisation to an extent which I have not witnessed before in the medical profession.
Will the Minister avail of this opportunity to outline in detail how he intends to deal with the problems and undo the damage done in terms of the gross underfunding at the start and inherent to the tune of £5 million the deficiencies of the current 1999 budget? Will he outline the number of jobs at risk in this current dispute and assure the House he will not accept a service plan which provides for cutbacks in services or job losses in a hospital which is still only operating at approximately 60 per cent capacity and still requires further investment if it is to realise its full potential and prevent its downgrading at a time when demands for hospital care are escalating?