Denis Naughten
Question:58 Mr. Naughten asked the Minister for Health and Children his plans regarding maternity and accident and emergency services in view of recent media reports; and if he will make a statement on the matter. [11607/03]
Vol. 566 No. 1
58 Mr. Naughten asked the Minister for Health and Children his plans regarding maternity and accident and emergency services in view of recent media reports; and if he will make a statement on the matter. [11607/03]
63 Mr. Eamon Ryan asked the Minister for Health and Children his plans for the State's maternity hospitals; if there is a schedule of closures; if he has plans for new midwife-led maternity clinics; and if he will make a statement on the matter. [12115/03]
81 Ms Harkin asked the Minister for Health and Children his views on the configuration of specialist services in the hospital sector; and his further views on paediatric and obstetric services. [11616/03]
I propose to take Questions Nos. 58, 63 and 81 together.
As these are three oral questions, not more than 18 minutes is allotted.
I presume the Deputies are referring to recent media reports arising from the apparent leaking of drafts being considered by the task force on medical staffing.
I established a national task force on medical staffing in February 2002 to make recommendations about how best to organise hospital medical staffing within the hospital system, having regard to the requirement of the European Working Time Directive to reduce the average weekly working hours of non-consultant hospitals doctors. The first report of the task force is not yet finalised. When it comes to hand I will consider its recommendations and bring proposals to Government in the normal way.
As far as I am concerned there is no question of the closure of any of our acute hospitals. However, as indicated in the health strategy, Quality and Fairness, there is a need to review the configuration of our acute hospital system, including the location of the particular services or specialities. This work will be taken forward by the National Hospitals Agency on its establishment.
My commitment to the acute hospital system is evident in the significant increase in acute hospital bed capacity that I have approved. During 2000-01 my Department, in conjunction with the Department of Finance and in consultation with the social partners, conducted a comprehensive review of acute hospital bed capacity needs.
The Government decided, on foot of the report entitled Acute Hospital Bed Capacity – A National Review, to provide an additional 3,000 beds in acute hospitals over the next ten years. Last year I announced the first phase of these additional beds with the commissioning of an extra 709 beds in acute hospitals, which represents a 6% increase in capacity and 520 of these beds are in operation. The remaining beds will be brought into use shortly. My Department is currently examining the regional issues associated with the allocation of the remainder of the 3,000 acute beds.
The acute hospital system in general is experiencing increased pressure on services due to a number of factors, including the growth in population, the availability of in-patient beds and the increasing number of elderly people who have a higher than average length of stay. The pressure on the hospital system is particularly evident in hospitals providing accident and emergency services.
In 2002 there were some 1.2 million attendances at emergency medicine departments throughout the state. It has also been established that approximately 70% of all hospital admissions come through emergency medicine departments. Therefore, I am very conscious of the central function of these departments within the acute hospital system.
I have provided capital funding in recent years to the ERHA and the health boards to support the development and refurbishment of emergency medicine departments. For example, new construction is taking place at Cork University Hospital and Tullamore General Hospital and at accident and emergency departments at a number of other hospitals. Funding has also been provided to support a range of initiatives such as the provision of minor injuries units and chest pain clinics in some of the major Dublin hospitals.
I have also approved the recruitment of up to 29 additional emergency medicine consultants. Nineteen of these new consultants are in place throughout the country and the remaining ten posts are being progressed by the ERHA and the health boards. The increased availability of senior medical staff will facilitate rapid clinical decision-making, enhanced management, diagnosis and treatment of patients.
I put it to the Minister that morale in many hospitals and in maternity and accident and emergency centres throughout the country is at an all time low because of threatened downgrading in the imminent report now due. When will the report be received and will the Minister publish it?
On specialties, are we talking about the services provided in some of the smaller hospitals, such as cancer services? Are such services to be centralised in the major regional hospitals and taken out of communities where support services are currently in place? Is that what is meant by the definition of regional specialties?
Yes, we will publish the national task force report on medical staffing as part of the wider health service reform programme which deals with structural and financial reforms. Members need to stand back and not rush to judge by using phrases such as "downgrading local hospitals" and "downgrading local services". They should not create illusions about what those local services mean on a day-to-day basis.
The medical manpower report deals with improving quality of service, patient care and health outcomes. The Deputy asked about cancer services. Cancer surgery should not be undertaken in every hospital in the country and no one in the House should advocate that. Proposals will be made by Hanly on the fundamental reconfiguration of services such as cancer and heart surgery and, in some instances, renal surgery. Other areas of activity of major speciality levels require a significant throughput of patients to provide a caseload for doctors and consultants who can then build up their expertise and work in accordance with international best practice. That is the ultimate objective of the task force. It should be seen in a positive light in terms of improving the quality of health for people treated in our hospitals.