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Dáil Éireann debate -
Thursday, 18 Apr 2002

Vol. 552 No. 2

Adjournment Debate. - Hospitals Building Programme.

Thank you, a Cheann Comhairle, for giving me the opportunity to raise this important matter. I raised the issue of the funding for the new community hospital in Tuam several times before in the House and on each occasion the answer was more evasive than the previous one. I hope this does not happen again tonight.

A well attended public meeting in Tuam last week heard angry calls for urgent action to be taken to get the padlocks off the gates and the hospital opened. Something sinister is going on and it appears the Government is trying to hoodwink the people of Tuam and north Galway on the issue. When the Department of Health and Children funded the purchase of the existing site, it was expected that great urgency would be displayed in getting specifications, sketch plans and other details in place in order that the type, size, shape and main functions of the new hospital would be outlined in great detail and agreed between the Department and the health boards. I do not believe that indepth discussions have taken place.

The fact is the procedures outlined have still not been implemented because the Western Health Board does not have a penny to pay for the specifications and sketch plans. Only recently, while under pressure in Ballinasloe, the Minister told a delegation from Tuam that he did not even have available the €1 million required to do the initial specifications. He said, however, that he "would try to find it". Even more curious is the fact that for €6 million major work could be carried out which would allow part of the hospital to open to the public. However, there is no sign of money or a guarantee from where it will come.

As the project is not under the auspices of the national development plan, we must wait for all other projects to be funded first. If the Government was sincere in its intentions towards Tuam hospital, the money would be earmarked. It is remarkable what can be done when there is cash on the table. One needs only consider what happened with the national aquatic centre and the Jeanie Johnston project where money was made available in an instant.

Even more curious still is the direction given, I presume by the Minister for Health and Children, to instruct officials of the Western Health Board to display the so-called artist's impression of the new hospital, even before it has been agreed what the hospital will do, when it will open, what activities it will have and, more importantly, from where the funding will come. This was a publicity stunt to keep the people of Tuam happy. If this is the case, it has certainly backfired.

The Minister must produce a better answer tonight. It is imperative that the hospital opens quickly. Given some of the signals which have been emanating from both the health board and the Department of Health and Children in recent times, unless something spectacular is done to get upfront funding, the hospital may not open in the next four or five years. In fact, if the opening is delayed long enough, the strategists in both the Department of Health and Children and the health board may find a very good reason for never opening it.

It is against this background that I ask the Minister to state from where the money will be earmarked to allow the hospital to open and when this will happen.

On behalf of the Minister of State at the Department of Health and Children, Deputy Moffatt, I thank Deputy Connaughton for raising this important issue. The provision of health services in Tuam and throughout County Galway is a matter, in the first instance, for the Western Health Board. The board has identified the need for a community hospital in Tuam. The needs assessment on which the current proposal is based relates to the population of 31,609 in the immediate catchment area, which includes Tuam and Glenamaddy. Within that population 4,432 persons, or 14%, are more than 65 years of age and in some areas this group extends to 18% of the population. Of those over 65 years, 1,059 live alone.

The case for a community hospital in Tuam is primarily underpinned by national policy which recommends such a service for every 30,000 population. The policy is being reinforced by the provision of new and upgrading of existing community nursing units and the designation of district hospitals to mirror that model of service. Generally speaking, community hospitals are not intended to have an institutional character, but rather a smaller, more homely care environment serving local communities with both out-patient and in-patient services. The case for a community hospital in Tuam is further strengthened by the inevitable increase in population because of the town's key location as a satellite town of Galway.

The needs assessment refers to the requirement for a 60 bed community hospital comprising a mix of up to 30 beds for continuing and long stay care, with the remaining 30 beds made up of direct access beds, including rehabilitation-convalescent, respite and palliative care beds. In line with what is generally provided in the board's institutions, the Tuam hospital will have a very significant multi-disciplinary mix of staff, including medical, nursing, nursing support, paramedical as well as other complementary therapists. Coupled with this, the board envisages that the hospital would be at the hub of a comprehensive outreach service providing home care programmes, including physiotherapy, occupational therapy, chiropody, home nursing, home help as well as other flexible packages of care. These specialist care services would, of course, be supported by social services such as community welfare and home advisory programmes.

An important dimension of the Tuam community hospital would be its linkage with acute services mainly in Galway, but also in Castlebar and Roscommon. This arrangement would enable patients to be discharged early for convalescence and would ensure that they would be only away from their families and communities for the minimum period. There would also be a close linkage with private nursing homes so as to give every resident in need of long stay care a choice as regards placement. The community hospital would open the way for the development of consultant led out-patient clinics from Galway regional hospitals and tele-imaging X-ray services could be developed.

The board has established an overall management group for the development of the various services on the site. A planning group for the community hospital and the proposed day care centre has been established and has been requested to prepare the planning brief and bring the project to design stage. When this process has been completed the project will be referred to the Department of Health and Children for approval to invite tenders. At this stage it is not possible to give a precise date for the commencement of construction work at the site.

The Dáil adjourned at 8.10 p.m. until 2.30 p.m. on Tuesday, 23 April 2002.

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