Dáil Éireann debate -
Tuesday, 12 Feb 2002

Vol. 548 No. 2

Adjournment Debate. - Hospital Services.

Mr. Crawford

I thank you, a Cheann Comhairle, for giving me the opportunity to raise this important issue and the Minister of State, Deputy Moffatt, for coming in to reply.

The further erosion of vital services at Monaghan General Hospital, with the closure of gynaecological services and the diversion of accident victims from the general hospital area to Our Lady of Lourdes Hospital, Drogheda, must be stopped by the Minister of State. Otherwise Fine Gael in Government will do so after the next election.

Accident and emergency services must be upgraded as a first step and that will be delivered by us. Our party leader visited the hospital and met the personnel there last autumn, but in the past few days he has again guaranteed that under his leadership Monaghan General Hospital will be funded so that the necessary work to retain and upgrade the services will be provided, not only for structures but also for additional staff.

While I welcomed the recent visit of the Minister for Health and Children, Deputy Martin, it seems the executives continue regardless. They have closed gynaecological services and, from 1 February, have diverted accident victims from the Monaghan General Hospital catchment area to Our Lady of Lourdes Hospital, Drogheda. Health board officials have often spoken of the "golden hour". How can any accident victim in Knockatallon, Carrickroe or Moybridge – which are on the borders of Tyrone and Armagh – get anywhere within an hour? It would take a minimum of half an hour for an ambulance to get there and another one and a half hours to get from there to Drogheda if the roads are clear. Can the Minister imagine an ambulance finding its way through Monaghan town, Carrickmacross or Castleblaney in wintry weather with snow and ice, or at rush hour on any ordinary day? As I mentioned earlier this evening, there are no bypasses for those towns.

If the removal of accident services from Monaghan General Hospital is allowed to continue lives will be lost. Many patients that were dealt with at Monaghan General Hospital can verify that without its availability and expert services they would not be alive. Will the Minister advise me what his understanding was when he left Monaghan town after his visit? Did he realise or understand that the health board would close gynaecology services? Did he understand that accident victims would have their services rendered in Drogheda rather than Monaghan and that this decision would be made by ambulance personnel wherever the accident happened? Does the Minister accept that with the further erosion of services it becomes more and more difficult to sustain full surgical services at Monaghan hospital which, in turn, will make it more difficult to retain industry and other services in the area?

In 1998 the executives of the North-Eastern Health Board asked its elected members and those interested in upgrading Monaghan General Hospital to meet them. They advised the meeting of their plans and that £5 million was needed to build a new theatre, improve accident and emergency services and make improvements in 17 other areas, including the upgrading of maternity services. None of those promises have yet been carried out. The maternity service has been closed. In-patient treatment in gynaecology services ceased at the time the Minister for Health and Children visited the hospital and now, just two weeks later, few are being serviced at the out-patient department. I will tell the House what happened in the children's ward last week. A paediatrician on out-patient duty refused to check on a child patient. It certainly seems like a winding down policy is in place.

By 2001 costings of the new proposal of the health board were put at £10 million and were supposed to be part of the national development plan. However, no plans have been submitted to Monaghan County Council, therefore none of the major works can be done in the next year. The national development plan ends in 2006. Executives now say €50 million is needed to do the job. Are they raising the jumps or just creating obstacles? A commitment from the Minister is needed.

Dr. Moffatt

I thank Deputy Crawford for raising this issue on the Adjournment. On behalf of my colleague, Deputy Martin, I thank Deputy Crawford for the opportunity to clarify the position in relation to Monaghan General Hospital. First, I remind the Deputy that the North-Eastern Health Board is responsible for the provision of services at the hospital. It is a matter for the board to determine service provision at the hospital in line with its commitment to the provision of a high quality, efficient and cost effective service.

The Minister recently visited Monaghan Gen eral Hospital and met the hospital staff, local representatives and members of the general public. The Minister took the opportunity to outline a comprehensive investment package for Monaghan General Hospital. A significant level of capital investment is proposed in the short-term. In this regard plans are being advanced by the North-Eastern Health Board for the development and upgrading of the high dependency unit at the hospital in addition to substantial upgrading and refurbishment of ward accommodation, the development of the treatment and minor injuries unit and the development of a midwifery led unit. The associated capital cost is of the order of €7 million. The Minister also indicated that he would support the board's proposed development of new consultant-led services in dermatology and geriatric medicine at the hospital. These developments will be progressed in the current year.

The Minister has announced the immediate commissioning process for an additional 709 acute hospital beds in public hospitals nation-wide at a cost of €65 million this year. This is the first phase in the provision of an additional 3,000 acute hospital beds by 2011. Thirty eight of the additional 709 public hospital beds will be provided in the North-Eastern Health Board region with ten of these in Monaghan General Hospital. All of the additional bed capacity at the hospital will be designated for public patients and will allow the hospital to significantly increase activity levels for its public patients. I am satisfied the proposed development of additional consultant-led services, together with the provision of additional bed capacity and the proposed significant level of capital investment reflects the commitment to the provision and development of acute hospital services to the catchment area population served by Monaghan General Hospital. Furthermore the Minister promised to give careful consideration to issues raised by staff representatives in relation to surgery, staffing and management and to revert to them in a number of weeks.

The Deputy was concerned regarding the transportation of persons from the Monaghan area who are involved in accidents. He also raised the issue of gynaecology services at Monaghan hospital. Prior to 1 February 2002, patients who suffered multiple trauma or orthopaedic injury arising from a road accident in the catchment area of Monaghan General Hospital were taken to Monaghan General Hospital to be subsequently transferred to Drogheda, Navan or a Dublin Hospital as deemed appropriate by the clinician in charge of the case. With regard to gynaecology services, in-patient treatment ceased in Monaghan General Hospital at the end of 2001. Facilities continue to be available for out-patient and day services at the Monaghan hospital site. The board will maintain and develop this out-patient and day services facility at Monaghan.

I again thank the Deputy for affording me the opportunity, on behalf of my colleague to outline the developments that will take place in 2002 at Monaghan hospital. There is no reason to doubt that these will take place in the near future.