Dáil Éireann debate -
Wednesday, 11 Oct 2000

Vol. 523 No. 5

Adjournment Debate. - Hospital Services.

Mr. Hogan:

We are in a time of unprecedented financial prosperity. Never before have we had the opportunity to deal with so many inequalities and issues where the quality of life of people can be improved nor have we been able to have the issue of health care as one of the benchmarks whereby we can judge what progress we are making as a country.

It was brought to my attention some time ago that young children have had considerable difficulty in gaining access to heart treatment. One can only speculate as to the enormous pressure and trauma on children and their parents in living with this experience. A voluntary group was established some time ago in Kilkenny to give young children requiring heart treatment a chance to live a more normal life. This group, the Children Heartcare Action Group, has had enormous success in gaining access for some children to heart operations in the Great Ormond Street Hospital, London. In other words, a voluntary group based in Kilkenny appears to have had more success than the Department of Health and Children and the health board in sending children to England for heart surgery.

This group recently met the Minister for Health and Children, Deputy Martin, and indicated to him that additional funds would need to be made available to deal with the local regional demand for this treatment. The Minister and his officials should hang their heads in shame at this development and at the revelation that a local voluntary group can make more progress than the officials in the statutory bodies.

The Children Heartcare Action Group grew out of a trust fund which was set up to send a one and a half year old little boy from County Kilkenny to England for an operation. The response to the fundraising event was magnificent and, within weeks of the fundraising committee gathering the money, the boy was sent to England to correct the hole in his heart. This young boy had been languishing on a waiting list for a considerable period and there were serious concerns that he would not survive while waiting for the procedure to be performed.

There have been other examples which I could mention but will not, where the group has been successful in sending young children for heart operations which help them live more normal lives. One can only think about the huge difference these operations and procedures have made to these children, their parents and relatives – in other words, to those fortunate enough to be supported by this group.

I raised this motion to highlight the need for the Minister for Health and Children to investigate fully the reasons Our Lady's Hospital for Sick Children, Crumlin, is unable to cope with referring more children to England for this type of heart surgery and to remove the scandalous bureaucracy which is obviously preventing our health system from dealing with this problem quickly, especially in these urgent cases where heart operations are required. Is it right that a local fundraising group is necessary before some of these children receive heart operations rather than risking their lives on a waiting list? It is unacceptable to be told that we cannot organise our priorities as a society to help very young children overcome problems which can be resolved with treatment. I hope the Minister for Health and Children will be able to give some satisfaction regarding this problem and that the waiting list for children who require heart operations can be rapidly reduced.

Ms Hanafin:

I welcome the opportunity to speak on this matter because I share Deputy Hogan's concerns about it.

As the Deputy will be aware, Our Lady's Hospital for Sick Children, Crumlin, is the national paediatric cardiac centre and is, therefore, the only facility which has the necessary expertise to treat children requiring heart surgery. I am very aware of the concern regarding waiting times for children in this specialty and the development of this specialty at the hospital is the subject of ongoing discussions between the Department of Health and Children, the Eastern Regional Health Authority and the management of hospital.

I am also aware of the difficulties being encountered by Our Lady's Hospital for Sick Children because of insufficient capacity to deliver the number of paediatric heart operations required nationally. Some of the measures cited by the hospital as contributing to the increasing pressure on this service were the lack of theatre space and ICU beds, a shortage of ICU trained nurses and advances in surgical and interventional techniques available.

Approval was given by my Department in 1997 for the development of new theatre suites at the hospital at a cost of over £20 million. When the development is completed the hospital will have five operating theatres – three new and two existing theatres substantially upgraded – complete with ancillary accommodation, a day surgery area and a central sterile supplies department. When these theatres are fully commissioned, it is expected that Our Lady's Hospital for Sick Children will be in a position to perform an additional 100 paediatric cardiac procedures per annum, an increase of 40% on its existing capacity. I am advised that work on the development is progressing with an expected completion date of 2002.

In December 1997 my Department allocated the hospital a sum of £500,000 from the cardiac waiting list initiative to implement measures aimed at reducing pressures in the most effective and appropriate manner. The hospital proposed to use the funding for a number of measures. These included the provision of an additional four ICU beds, the implementation of a training programme for ICU nurses and the implementation of arrangements for the purchase of cardiac procedures from appropriate UK paediatric hospitals.

In 1998, the Department allocated the hospital a sum of £878,550, in 1999, £679,000 and in 2000, £700,000 under the same initiative. I am pleased to inform the Deputy that a third cardiac surgeon took up a post in the hospital in August 2000 and a new consultant anaesthetist post has recently been approved.

The Deputy should note that the hospital has been experiencing difficulty recruiting specialised nurses. It has appointed a specialist nurse agency to recruit in the Far East on its behalf and the director of nursing at the hospital is involved in oversees recruitment in the UK and the Middle East. The hospital recently advertised the position of a senior nursing personnel officer who will have responsibility for recruitment and retention of key nursing personnel, particularly for ICU and theatre.

The Minister for Health and Children recognises that further interim measures will be required to address the delays in treatment currently being experienced by patients at the hospital. In this regard, I wish to advise the Deputy that the ERHA recently met with the hospital management and relevant clinical staff. They agreed that the hospital would immediately draw up a submission setting out a comprehensive approach to the management of paediatric cardiac surgery and cardiology. A plan will be agreed between the ERHA and the hospital this month. This plan will include a full assessment of the opportunities for sourcing additional capacity elsewhere, including the UK and other countries. It will also deal with the staffing and infrastructural needs in relation to both cardiac surgery and cardiology.

I am advised that the hospital has identified options to allow a greater number of patients to go abroad for cardiac surgery and these will be addressed in the plan. I understand that the hospital intends to actively pursue places in the UK but it is also examining the possibilities in other countries. I am confident that this initiative, together with the appointment of additional consultant staff and the completion of the theatre development will have a positive impact on the reduction of waiting times in this specialty.