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Dáil Éireann debate -
Tuesday, 17 Dec 2002

Vol. 559 No. 5

Adjournment Debate. - Hospital Services.

Go raibh maith agat, a Cheann Chomhairle, as an seans a thabhairt dom an ceist seo a ardú. I recently asked the Minister for Health and Children about the plans for bio-preparedness in this State. He referred me to the report, "Biological Threats: A Health Response for Ireland", which was produced by the expert committee on contingency planning for biological threats. It was published last May.

The report recommends the designation of key hospitals as centres for the reception of patients with smallpox and quarantine units for those who have been exposed to smallpox. In keeping with best practice and in the event of an outbreak of a contagious disease, the emphasis is on containment or preventing the epidemic from spreading. Patients diagnosed with a disease such as smallpox should be isolated in a negative pressure isolation room in a designated unit. The expert committee's report also states that in cases of suspected anthrax, plague or tularaemia, all human samples will be analysed in the public health laboratory at Cherry Orchard Hospital.

Cherry Orchard Hospital opened in the 1950s, when the Dublin Fever Hospital on Cork Street transferred its services to Ballyfermot. Its admissions policy obliges it to admit all cases of schedule infectious diseases. It has four wards available for the treatment of communicable diseases. Three of these are in regular use and one is available to meet any emergency situation. The facilities provided by Cherry Orchard Hospital are vital in the event of a State-wide outbreak of an infectious disease or if the country was struck, either deliberately or accidentally, by chemical or biological weapons.

I was recently advised that Cherry Orchard Hospital might be downgraded from an acute hospital to a step down facility from 1 January 2003. The Minister for Health and Children must clarify the position of the Government in relation to the current and future status of the hospital. As the only hospital specifically equipped to deal with infectious diseases in the State, it would be extremely shortsighted if the isolated units in the hospital were closed and the hospital downgraded. If downgrading is to proceed, will the Minister explain both the reasons for it and the ramifications? Will he provide funding to other facilities so they will be prepared and fitted out with the equipment they would be required to have on standby in case of emergency?

The reality of closing down hospital units and reducing service without preparing contingencies has become only too clear recently with the tragic death of baby Bronagh Livingstone in Monaghan. It is not good enough that the staff at the hospital and the general public still do not know what is planned for Cherry Orchard Hospital from 1 January next. In light of the above and in view of the recent decision by the IMO to direct public health doctors and medical professionals not to participate in a meeting arranged by a sub-group dealing with the threat of bio-terrorism, will the contingency plans for a bio-terrorism attack not fall into disarray? I call on the Minister to halt any plans to downgrade Cherry Orchard Hospital. Instead, he should have the hospital upgraded in line with the assessment of the Irish Medical Council recommendations.

I thank Deputy Ó Snodaigh for the opportunity to clarify the position in relation to Cherry Orchard Hospital, Ballyfermot and to respond positively to a number of issues he raised on the Adjournment debate.

Cherry Orchard Hospital, Ballyfermot, is managed by the South Western Area Health Board. I assure the House that the South Western Area Health Board has no plans to downgrade the hospital. Indeed, the board is proposing to extend the services provided on the campus and has plans for the hospital to play a major part in the development of services in the eastern region, which I am sure Deputy Ó Snodaigh will welcome.

At one stage Cherry Orchard had 231 beds for infectious diseases and had become by custom and practice a hospital where people with infectious diseases were accommodated. However, over the past 15 years the majority of its work has been in other patient services. Two wards have continued to be made available for persons with infectious diseases.

In recent years it has become the practice to refer and treat patients with infectious disease in acute general hospitals. It is now generally agreed by the medical profession, including the Medical Council, that an acute general hospital is the appropriate setting for the delivery of this service. Because of this the number of patients with acute infectious diseases admitted to Cherry Orchard has significantly reduced. The majority of these admissions have been from the eastern region.

The following services are currently provided from the Cherry Orchard campus, primary care services, community services, 66 residential beds for older persons, 30 in-patient psychiatric beds, 17 in-patient detoxification beds, 52 beds for paediatric and adult infectious diseases and 24 beds for young disabled adults. The complex also accommodates a public health laboratory for a number of health boards.

While there are 52 beds for persons with infectious diseases in Cherry Orchard the average daily admission of patients with infectious diseases to these wards is three with the average length of stay ranging from one to five days.

Cherry Orchard does not have a range of back-up services and staffing to manage patients with acute illnesses. These are more appropriately treated in acute general hospitals where a range of specialist expertise and facilities are present.

In light of the small number of referrals and admissions of acute infectious diseases to the hospital, and in view of the general agreement that it is most appropriate to treat these patients in acute general hospitals, the South Western Area Health Board is in the process of arranging for all cases of acute infectious diseases to be managed in acute general hospitals. Discussions to put this arrangement in place are in train. Accordingly, it has been determined that patients with acute infectious diseases will no longer be treated in Cherry Orchard Hospital from 1 January 2003. The Department is advised that there is at present only one child and seven adult in-patients in the infectious diseases section of the hospital.

In the event of a terrorist attack with chemical or biological weapons or a national outbreak of infectious diseases, arrangements will be in place as part of the emergency planning function to co-ordinate acute hospital and all other health services throughout the country. This will involve a major partnership project in which all health facilities, including Cherry Orchard, may have a role.