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Dáil Éireann debate -
Tuesday, 10 Jun 2003

Vol. 568 No. 1

Hospital Services.

I am grateful for the opportunity to raise this important issue and I am glad the Minister of State at the Department of Health and Children is here to respond to it.

People in the catchment area of Cavan General Hospital are particularly alarmed and concerned that surgical services are under threat. In early May, the Royal College of Surgeons in Ireland notified the North-Eastern Health Board that it was withdrawing recognition of five surgical trainee posts from 30 June. The reason given was that interpersonal problems at the level of consultant surgeon in the unit were creating an environment that was not conducive to training. According to local media reports, a special committee, set up by the RCSI, told the health board these concerns related to both interpersonal and clinical issues.

With 1 July approaching, the threat to the future of the surgery department of Cavan General Hospital looms larger. The decision by the RCSI to cease recognition of the five training posts in the department of surgery on the last day of June leaves the future provision of full surgical services hanging in the balance. I also note from local media comment, that the director of surgical affairs at the RCSI confirmed that it was possible for the problems to be resolved in time for accreditation to be reinstated in the hospital by 1 July. Hopefully, the necessary resolution can be achieved.

Along with other Members, such as Deputy Connolly, I have been pursuing this matter with the health board. The health board recently informed me that the RCSI has suspended the hospital's ability to recruit non-consultant hospital doctors who require basic surgical training. In its correspondence, the health board also outlined that it is attempting to recruit non-consultant junior doctors who do not require basic surgical training, in order to alleviate this problem and ensure that surgical services at Cavan General Hospital will continue to be delivered at their current level.

The message I wish to impart to the Minister of State, his Department and the House, is that these difficulties must be resolved without further delay. If the health board has not made the necessary progress by now, I suggest that Department officials, along with senior health board management, officials of the RCSI and the relevant personnel from the department of surgery at the hospital, sit down and resolve the issues which are causing difficulty in order to ensure that the relevant accreditation is restored and to ensure the continuation of full surgical services at the hospital.

Throughout Cavan, and the wider constituency, I have met numerous people who express satisfaction at the work carried out by the personnel in the surgery department of the hospital over many years. In every parish, I have heard the utmost praise for the personnel. Outside Leinster House this afternoon, a gentleman, whom I did not know, told me that had it not been for the department and its personnel, he would not be alive. I was glad to hear that comment and it is one I have heard throughout the catchment area of Cavan General Hospital.

I cannot over-emphasise the importance of that department and the high esteem in which its personnel, working in all disciplines, are held by the community of Cavan, Monaghan, north Longford, south Leitrim and north Meath. This issue must be resolved.

Every Member of the House, including the Minister of State, receives daily queries about the health service. Generally, it is about inadequate funding or delays. However, this is not a question of funding. It is a question of people sitting down and giving leadership to resolve some outstanding issues. There is no reason for this issue to be protracted and delayed. The only people who will suffer are those who need surgery. The personnel in the hospital want to have these issues resolved. We want that fine modern hospital working to full capacity.

I could not better sum up the high esteem in which the hospital is held by the community than by quoting from the leading article of a recent issue of The Anglo Celt which reads:

The surgical department of Cavan General Hospital has given an outstanding service, both in professional excellence and patient care, to the people of this region. It is a service very greatly appreciated and it is one the region cannot do without.

I am particularly grateful and delighted that the Minister of State, Deputy Callely, is here because, only last week, he provided €1.1 million in additional funding to ensure that the nursing unit in Virginia can open by mid October. I thank him.

I welcome the opportunity to clarify the position regarding the issues raised by the Deputy. I appreciate his interest in the enhancement and development of health services in the Cavan-Monaghan region and, in particular, the unit to which he referred about which he asked me to intervene and invited me to visit. I am pleased that we have made progress together. I congratulate Deputy Brendan Smith on his endeavours and his interest.

Responsibility for the provision of services at Cavan General Hospital rests with the North-Eastern Health Board. The Department is advised by the North-Eastern Health Board that it has been informed by the Royal College of Surgeons in Ireland, RCSI, that the RCSI council, on the advice of its basic surgical training committee, is to cease recognition of five posts in the department of surgery of Cavan General Hospital for basic surgical training with effect from 30 June 2003.

It was brought to the attention of the BST committee of the RCSI, through hospital inspector's reports and through the regular counselling sessions for all trainees on the BST scheme, that interpersonal problems at the level of consultant surgeon in the unit were creating an environment that is not conducive to training. The health board further advises that a group was set up by the BST committee to interview the Cavan trainees. The interviews highlighted a number of serious concerns which are interfering with the work.

The chief executive officer of the North-Eastern Health Board is currently examining and considering a number of concerns relating to the unit which have been brought separately to his attention by the consultant surgeons. The chief executive officer sought the advice and guidance of the Royal College of Surgeons in Ireland regarding clinical issues raised. The response of the RCSI is currently being considered by the chief executive officer. The Deputy will be pleased to learn that it is anticipated that the chief executive officer will seek an early re-inspection by the college with a view to restoring recognition of the basic surgical training posts. I concur with some of the views expressed by the Deputy regarding the need and benefit accruing from this facility in Cavan.

The North-Eastern Health Board advertised for fully-registered candidates for the five posts in the department of surgery at Cavan General Hospital. Interviews have now taken place and I am pleased to report that a sufficient number of fully registered candidates were selected to fill the available posts. The health board hopes – as do I – that all posts will be filled and that services will continue as heretofore. I hope the Deputy finds that reply helpful.

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