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Dáil Éireann debate -
Wednesday, 2 Jun 1999

Vol. 505 No. 7

Adjournment Debate. - Hospital Services.

I thank you, a Cheann Comhairle, for allowing me to raise this matter on the Adjournment. The senior citizens of Tralee are seeking a district hospital which will cater for older people who require long-term care close to their homes, friends and relatives; post-operative patients who need convalescent care and those who need residential hospice care. Currently, they must go to St. Columbanus Home, Killarney, which, although an excellent district hospital, is considered too far away for the elderly people of Tralee to travel and for family and friends to visit.

In many cases they are unable to travel because of disabilities, old age, etc. A purpose built unit is needed in Tralee for the care of the elderly within reasonable reach of the general hospital so that they will have access to the facilities there. It would make a great deal of sense if a district hospital were located on the grounds of the general hospital because many facilities and services provided by the general hospital could also be made available to the district hospital. That certainly would reduce expense.

Senior citizens comprise a significant segment of the population in Tralee. According to the 1996 census report, Tralee had a population of 19,056 – obviously this figure has increased substantially since – and of that figure, 18 per cent were aged 65 or over; in County Kerry 14 per cent of the population was over 65 years. This means that in 1996 2,349 people in this area were aged 65 or over. The population of Tralee has increased significantly since as more people have moved in from the country.

Previous efforts to get a district hospital for Tralee have ended in failure. Efforts to have the former St. Catherine's Hospital converted to a district hospital failed some years ago and that building now houses Kerry County Council offices. An excellent convalescent home was closed by the health board in the days of the Haughey health cuts in 1987. It was closed for no reason in the name of fiscal rectitude and when one considers now what went on at that time it makes the decision even more farcical and hard to understand.

As a result, the senior citizens of Tralee must now travel outside their own town and away from their relatives and friends to the facilities in Killarney. Their representatives have come to the conclusion that the health board executives are determined to ignore their pleas for a community hospital in Tralee. Mr. Sean Hurley, chief executive officer of the Southern Health Board, stated on 26 March that a central element of the board's philosophy of services for the older person is to provide services as close as possible to the older person's home, in other words, it was the health board's philosophy to provide facilities as near as possible to their homes for old people living in Tralee. I am asking the Minister of State for an indication that it is the Department's intention to urge the health board to provide this much needed facility.

The Southern Health Board's priority development for services for the elderly in County Kerry was the establishment of a department of medicine for the elderly in Tralee General Hospital. Funding for this development was provided by my Department to the board in 1997 and 1998. The development of the department of medicine for the elderly com menced with the appointment of a consultant physician with an interest in medicine for the elderly in January 1998. The establishment of the department included the appointment of additional nursing, medical and paramedical staff to the hospital. Following these appointments, an assessment and rehabilitation unit for the elderly has now been established in the hospital.

The establishment of a department of medicine for the elderly in County Kerry is a strategic step towards the attainment of the aim of the national health strategy of providing appropriate care in the appropriate setting. The experience of existing specialist geriatric departments throughout the country shows that they restore the majority of patients to independent living quickly, they reduce admissions to continuing care beds and reduce pressure on other acute hospital beds.

The level of continuing care beds in the Tralee catchment area has not been reduced by the development of the department of medicine for the elderly. In addition to continuing care beds provided in Tralee General Hospital itself, the Southern Health Board has contracted with private nursing homes in the area to ensure that the same level of continuing care beds remains available for public patients.

The next priority development in relation to services for older people in the Tralee area is the establishment of a day hospital attached to the department of medicine for the elderly in Tralee General Hospital and the Southern Health Board is at present drawing up plans for this development. The Southern Health Board has an existing plan to develop the capital infrastructure of its existing community hospitals. This plan has prioritised the need for extensions to Schull and Kanturk Community Hospitals and the replacement of Dingle Community Hospital. At its August 1998 meeting the board agreed to a notice of motion that it would include a district hospital for Tralee among its list of priorities and it is finalising a strategy for services for older people which has as its central aim the improved health and quality of life for older people in Cork and Kerry. This strategy will address the continuing care needs of the population of Cork and Kerry. Tralee is one of four urban areas in the Southern Health board area that does not have a community hospital facility at present.

My Department has injected an additional £7 million per annum into the capital programme for services for older people and projects are ongoing in all health board areas. It is accepted that a community hospital is needed in Tralee and I am confident that when the Southern Health Board has completed the day hospital I referred to earlier, it will take into account the requirement for a community hospital in Tralee in determining its future services for the older population of Tralee and its environs.

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