Dáil Éireann debate -
Tuesday, 6 Mar 2001

Vol. 532 No. 1

Adjournment Debate. - Hospital Services.

Mr. Healy:

Go raibh maith agat. Ar dtús ba mhaith liom mo bhuíochas a ghabháil le hoifig an Cheann Chomhairle a thug cead dom an cheist thábhachtach seo a phlé. What steps does the Minister intend to take to end the daily occurrence of overcrowding at St. Joseph's Hospital, Clonmel, and the resultant treatment of acutely ill medical in-patients on the hospital corridors? The position is that anything up to 12 acutely ill elderly patients are being treated on the hospital corridors almost on a daily basis. They have little or no privacy. Their personal belongings are left on the end of their beds. It is difficult if not impossible to bring medical equipment to them and staff at all levels, medical, nursing, non-nursing and administrative, are totally frustrated by the situation that has developed and which continues to be in place.

The lack of medical beds in the hospital has its genesis in cutbacks in medical beds in the south Tipperary area in the mid-1980s when St. Vincent's Hospital in Tipperary Town, with 50 medical beds, was closed by the Fianna Fáil Government of the day. From that day on, there has been difficulty in relation to the question of medical patients being treated on hospital corridors. Staff at all levels are frustrated by the difficulties that have arisen. Patients and their relatives are frustrated also with what is occurring on a daily basis.

Is the Minister aware that industrial action is currently being balloted on by the non-nursing staff who are represented by the SIPTU trade union in the hospital? They find it impossible to do their work and they have drawn attention to various health and safety matters arising from treating patients on the hospital corridors.

Is the Minister aware also of the unacceptable proposal to reduce the number of gynaecological beds in the hospital to try to deal with this problem? That is totally unacceptable and it involves the cancellation of gynaecological procedures in a situation where the gynaecological ward has already been reduced by six beds. Has the South Eastern Health Board applied to the Department for more funds to provide additional beds to deal with this problem? If so, when did it apply? What funds did it request and when does the Minister propose to approve that application?

I am sure the Minister will refer in his reply to the capital development at the hospital, which is welcome but long overdue. However, it will not address this problem since additional medical beds are not involved in that project. Will the Minister take immediate steps to put additional beds in the system in south Tipperary to ensure that patients are treated as human beings and cared for in proper conditions in wards in the hospital. I ask him to put back into the system the 50 beds taken out of it in the 1980s.

Minister for Health and Children (Mr. Martin):

I am pleased to have the opportunity afforded me this evening by Deputy Healy to set out the position in relation to St. Joseph's Hospital, Clonmel. I apologise for being somewhat late.

In the South Eastern Health Board region, in-patient numbers increased by an average of 6% for acute hospitals during the period January 2000 to October 2000. In an effort to deal with this increased demand, the health board recently appointed a bed manager to St. Joseph's Hospital. It has also designated a 12 bed convalescent unit as part of the community nursing unit in Clonmel and has contracted private nursing home beds to facilitate earlier discharge from the hospital. Detailed proposals submitted by the health board for additional beds under the bed capacity review are currently being considered by my Department.

In terms of the overall development of services at St. Joseph's Hospital, Clonmel, contracts have been signed in relation to phase 1 of the development at the hospital and enabling work has commenced on site. This landmark development in the history of the health services in south Tipperary will involve the provision of a new accident and emergency department, ward accommodation, operating theatres, ICU, day care unit, central sterile supplies department, physical medicine department, education centre and consulting rooms. I know the Deputy will concur when I say this development will represent a hugely significant advance in the quality of service that will be available to south Tipperary hospital patients, and the Government deserves to be given some credit for the significant investment it is making in the hospital.

I have initiated a national review of bed capacity in both the acute and non-acute sectors. The review is in line with the commitment in the Programme for Prosperity and Fairness, which the Government agreed. The review is being conducted by my Department in conjunction with the Department of Finance and in consultation with the social partners. I have presented the interim findings of the review to my Government colleagues and identified a range of short to medium-term investment proposals aimed at addressing identified service difficulties in both sectors. Further work is now being undertaken to develop a longer term investment strategy for the acute and non-acute sectors. The second phase of the review will be completed in spring 2001.

As part of the review, I announced in October 2000 a £25 million investment package to help alleviate anticipated service pressures and to maintain services to patients in the acute hospital sector over the winter period. The investment package was targeted at a number of key areas including approval to recruit 29 additional accident and emergency consultants; approval to recruit 15 additional consultant anaesthetists; provision to contract at least 500 additional nursing home places for patients who have completed the acute phase of treatment; and provision of additional aids and supports for older persons.

Mr. Creed:

What about those on trolleys?

Mr. Martin:

This initiative was quite effective during the winter period, in particular the provisions relating to the additional nursing home beds we contracted into the system and the provision of additional aids and supports for older people in the community and in their homes. Many people benefited from this increased investment. The 29 accident and emergency posts and the 15 anaesthetist posts have been sanctioned, which is the largest investment ever in human resources in terms of the accident and emergency area. We have a great deal of work to do in accident and emergency but we are providing both the capital infrastructure and, more importantly, we are providing the resources to employ accident and emergency consultants in the various hospitals across the system.

In relation to the South Eastern Health Board area, we have provided additional funding of £1.5 million to alleviate anticipated service pressures and to maintain services to patients in the acute hospital sector in 2001. Funding totalling £2.981 million was also provided to the South Eastern Health Board in the year 2000 for waiting list initiatives in the board's area and a further £1.750 million has already been provided this year. There was a reduction of 17.4% in the overall waiting list figures for the period 31 December 1999 to 30 September 2000 in the South Eastern Health Board area, with a reduction of 20% in the corresponding period at St. Joseph's Hospital, Clonmel. Clearly extra work is in evidence in St. Joseph's Hospital, Clonmel, and I thank all the staff for their commitment.

The overall objective is to ensure that the services available to the people of south Tipperary are responsive to their needs and I know that the developments under planning and under way will be seen as tangible evidence of my commitment in that regard.