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Dáil Éireann debate -
Wednesday, 21 Feb 2001

Vol. 531 No. 1

Adjournment Debate. - Appointment of Hospital Consultants.

I wish to share time with my constituency colleague, Deputy McGahon.

Is that agreed? Agreed.

Anyone residing in the north-east will know that in recent times the proposal to close the maternity units at Louth county hospital and Monaghan County Hospital has been a live political topic. Naturally, my priority is the maternity unit at Louth county hospital. To close that unit in Dundalk is an unthinkable move. We are talking about the largest provincial town in the country which has a significant population growth projection, both in the immediate and long term. A proposal to close the maternity unit is difficult to understand given the broad outlines we have for a spatial strategy for the north-east and for County Louth in particular. The most significant population growth is along the east coast, particularly between the major cities of Dublin and Belfast. Dundalk falls roughly half way between the two.

The maternity unit has operated successfully for many years but for some peculiar reason the North Eastern Health Board or Comhairle na nOspidéal are finding it difficult to make the necessary consultant appointments that would ensure that public trust and confidence in the hospital will not alone be maintained but will be enhanced. They operate on the basis that the viable unit size is approximately 1,000 births per annum. I have no doubt that given the population catchment we have in and around Dundalk, we would reach that target in a relatively short period if we have the necessary consultants.

I appeal to Comhairle na nOspidéal to pull back from the decision that seems to be imminent. It should re-think the position and appoint consultants, even on an interim basis, to allow public trust and confidence in the hospital's maternity unit to be built up, thus ensuring its future viability and sustainability.

Over the years I have shared a warm friendship with Deputy Kirk and I thank him for sharing his time with me. On this occasion, however, I must leave that warm friendship aside and indict both him and his party for the appalling decision to close the maternity unit in Dundalk. With a population of 30,000 it is the biggest town in Ireland and is on its way to achieving city status. Dundalk has suffered over the years and, consequently, it has a high rate of social welfare dependants. Many of the girls who have children in the Louth county hospital are single parents. It is absolutely staggering that in this day and age a hospital unit could be closed. The gynaecological unit will also be moved. The Fianna Fáil Party must find a solution to this matter and the Minister for Health and Children will have to intervene. The Minister for Social, Community and Family Affairs, who resides in Dundalk and has a strong commitment to the town, must become involved. He will be judged by the people of Dundalk and the County Louth hinterland if he allows the hospital to close.

If the boot was on the other foot, I would say the same thing to my own party colleagues. To close a hospital when the country is rolling in unprecedented wealth defies logic. This week, the Minister for Social, Community and Family Affairs, Deputy Dermot Ahern, announced savings of £214 million from combating social welfare fraud. Surely that would pay for an obstetrician and a paediatrician? Over the years the North Eastern Health Board allowed this to happen. It is closing the hospital by stealth. A 14-bed unit was not ever going to be viable. The number of births in the catchment area for Louth county hospital is roughly 1,300. Because of the lack of confidence in the region, many Dundalk people by-passed the local hospital and went instead to the Lourdes Hospital in Newry.

A political party that closes a hospital in the biggest town in Ireland will do so at its peril. I am hanging that issue around the neck of the Fianna Fail Party. I thank Deputy Kirk for sharing his time with me. I hope the concerns he undoubtedly has for the Louth General Hospital will be alleviated by the immediate action of the Minister for Health and Children.

I welcome the opportunity to respond on behalf of my colleague, the Minister for Health and Children, Deputy Martin.

Both Deputies will know that the provision of maternity services at Louth General Hospital is a matter for the North Eastern Health Board which has statutory responsibility for the provision of health services in its functional area. The board is committed to developing its acute hospital services in line with the needs and requirements of its resident population.

In 1998, the board adopted a policy framework for the development of its acute hospitals, called North East Hospitals – The Next Five Years: A Framework For Continuing Development. This emphasised the need for high quality, safe and accessible acute hospital services, utilising all five hospital sites within the board's area. It confirmed the commitment of the board to developing each hospital site within the two hospital groups, the Cavan-Monaghan hospital group and the Louth-Meath hospital group.

The framework document recommended that the maternity services in the region be reviewed. A review group established for that purpose reported in late 2000. Briefly, the report indicated that: consultant led maternity services at Monaghan and Dundalk must cease due to concerns about patient safety; a pilot centre for midwife led obstetric services be established in Dundalk; and consultant led delivery units should be located at Drogheda and Cavan.

Balderdash.

That was the report of the review group.

The Minister has been advised that the health board decided "not to accept in full the recommendations" in the review group's report, and that it unanimously approved the establishment of a further review with a broader remit that will reflect on the potential for cross-Border co-operation and the requirements of spatial planning, as anticipated in the national development plan.

The make up and terms of reference of this further review is an item on the agenda for consideration by the board at its next meeting, which is scheduled for Monday next, 26 February 2001. In this regard I should like to correct a statement the Minister of State, Deputy Moffatt, made during the debate in this House last week on the issue of maternity services in the north east when he stated, on behalf of the Minister, that plans for this further review would be finalised by the board at its meeting scheduled for Thursday, 15 February 2001. The Minister has since learnt that this statement was factually incorrect and he wishes to avail of the opportunity now presented to set the record straight on the matter and to assure the Chair that it was not the intention to mislead the House.

The Minister is of the firm view that the way forward for maternity services is about putting in place services that comply with safety standards and internationally recognised best practice recommendations. He met the chairman and representatives of the board and emphasised the need to ensure patient and staff safety. He also informed the board that it was imperative that it establishes and finalises a clear view on what services will be provided at each hospital in the region, the new services which need to be developed and the enhancement of existing services, in the light of the £160 million NDP funding that has been notified to the board. The Minister looks forward to receiving the board's proposals in this regard.

The Minister has been advised that the board further considered the question of maternity services on 5 February last. To avoid the suspension of maternity services at Louth and Monaghan county hospitals, the health board mandated the chief executive officer to seek approval, as a matter of urgency, for the appointment of temporary consultant obstetricians to Cavan-Monaghan and Louth-Meath hospitals and, in addition, to seek approval for the immediate appointment of on-site paediatric cover at both hospitals.

The approval of any such posts is a matter for Comhairle na nOspidéal, which is the statutory body—

Appointed by the Minister.

—set up to regulate appointments of consultant medical staff in hospitals providing services under the health Acts. In the circumstances and particularly in view of the need for an early decision, my Department had no objection to the submission of this proposal to An Chomhairle for its consideration and notified the board accordingly.

I understand the board has submitted applications for approval to the additional temporary posts to An Chomhairle and that these applications are on the agenda for consideration by that body at its next meeting which is scheduled for Wednesday, 28 February 2001.

The Dáil adjourned at 10.45 p.m. until 10.30 a.m. on Thursday, 22 February 2001.

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