Skip to main content
Normal View

Dáil Éireann debate -
Tuesday, 25 May 2010

Vol. 710 No. 1

Hospital Services

The history of St. Mary's Orthopaedic Hospital on the north side of Cork shows that in its day it provided a vision of the future. The new buzz word in Cork in terms of health services is reconfiguration. Everything will be moved around. It is as if one were talking about pieces on a chessboard. It does not matter if it is right or wrong; services will be moved. It started with the breast clinic in the South Infirmary-Victoria University Hospital which was moved to the new campus in Cork University Hospital, CUH. We are all agreed that centres of excellence are the way of the future and the unit has proven to be very successful.

However, I am concerned about the proposed move of St. Mary's Orthopaedic Hospital in Gurranebraher. I am surprised that Professor John Higgins has recommended the move as I have great admiration for the work he does in his specialist field, namely, gynaecology and obstetrics. I do not understand the logic of taking an orthopaedic service from a 30 acre site which was specially designed for that purpose to put it into the South Infirmary-Victoria University Hospital. Plans were unveiled last year for the merger of that hospital with the Mercy University Hospital which involved the building of a new hospital to replace the two original hospitals because they were deemed not fit for purpose. It is planned to take the orthopaedic service from a 30 acre site to put it into a hospital that was not considered fit for purpose as a general hospital.

I am pleased the Minister of State, Deputy Connick, is present as he knows what I am talking about. Orthopaedics is the heavy lifting end of surgery yet it is planned to put it into a hospital that has no parking. If one goes to the hospital with a broken leg that will be the least of one's troubles. One will leave the hospital either in a wheelchair or on crutches but one's car will be parked half a mile down the road because there is no parking outside the hospital. The parking in the hospital is for staff only yet it is planned to incorporate an orthopaedic service into a hospital that has outdated lifts and no ground floor service. That is what is proposed although orthopaedic patients more than likely will not be able to walk on their own.

The orthopaedic hospital is on a 30 acre site. We were promised that a new rehabilitation service to serve the entire south of the country would be built there but that will not happen now. The Health Service Executive is in discussion with the local authority and other interested parties about turning the site into a commercial area. This move is more about making it convenient for doctors than providing a better service for patients which worries me very much.

When the North Infirmary closed 22 years ago the last general hospital on the north side of Cork was removed. If the orthopaedic hospital goes then that will be the last vestige of inpatient service available on the north side of Cork. When Professor John Higgins first spoke about reconfiguration — I have no doubt he is well intentioned — he told us that no hospital would close as a result of reconfiguration. I do not know what one would call a unit that does not have beds but it is not a hospital. He might talk about primary care and other issues but St. Mary's will not be a hospital and orthopaedics will not fit well into the campus where he intends to put it.

There is one aspect of health services in St. Mary's Orthopaedic Hospital that he should reconfigure, namely, Grove House, which houses people with severe intellectual disabilities. I am told by the HSE that no money is available for that move and that the service will remain on the site. It is a case of people being put in the most inappropriate place one could possibly imagine for their condition yet no move is proposed for them. This is about selling the site and getting money for HSE south. It is not about providing a better service. The people of Cork had every faith in the service, which had the only public orthopaedic outpatients' clinic in the country. That worked extraordinarily well but it is going to be moved because it is located on a valuable 30 acre site on the north side of Cork. A total of 220 jobs will be taken out of the area, one which desperately needs the type of investment which those jobs provided. However, that does not matter to the HSE. It should matter to the Minister of State how the service is provided and how areas will manage without it.

I thank Deputy Kathleen Lynch for raising this matter. I assure her that reconfiguration is also a buzzword in Wexford and the south east. I will be taking this Adjournment matter on behalf of my colleague, Deputy Mary Harney, Minister for Health and Children. The Government is committed to ensuring delivery of the best quality health services possible, in an effective and efficient way. We are all familiar with the expert advice that, for the delivery of complex care, outcomes for patients are better if the care takes places where the necessary staff and equipment are to hand and, crucially, where there is a sufficient volume of activity. The success of this approach has already been demonstrated through the national cancer service, based on the principles of patient safety and quality. The expert opinion is that the adoption of this approach throughout the acute hospital system will lead to improved services.

The HSE south's business plan for 2010 prioritises the reconfiguration of its acute hospital services. Undoubtedly, this will produce significant changes in the way health services are delivered and organised in the region. Principal to this new delivery is the plan to create a single acute hospital system across the region to achieve the best possible health outcomes for the people of Cork and Kerry. As part of this process, the HSE will be relocating some services between the six acute hospitals. Earlier this month, HSE south announced its intention to relocate orthopaedic services, including elective inpatient, rehabilitation trauma and day surgery, from St. Mary's Orthopaedic Hospital to the South Infirmary-Victoria University Hospital. The objective in relocating orthopaedic services to an acute hospital setting, with related specialties on-site including rheumatology and anaesthetics, is a much enhanced service.

The relocation of orthopaedic services to an acute setting is the first element of the reconfiguration programme. Patients from Cork, Kerry and the wider Munster area will benefit from improved treatment and surgery for conditions including spinal and skeletal injuries and deformities, in addition to rehabilitation for damaged joints and muscles. The redeveloped facility will have three dedicated orthopaedic theatres, compared to the two in St. Mary's. It is also intended, following the move, to recommence orthopaedic surgery for children, for which HSE south patients must currently attend Our Lady's Children's Hospital, Crumlin, in Dublin. Patient accommodation will also be upgraded. The HSE remains fully committed to the future use of the St. Mary's site as a health complex. It intends to maintain existing services on campus, including mental health, intellectual disability, ambulance, outreach, maternity and health centre services. The newly built 50-bed community nursing unit is due to open this year. The outpatient facility site will also be retained and a range of consultant and nurse-led outpatient services will be delivered.

HSE south has had discussions with Cork City Council and is working with other partners on the future use of the site for additional health facilities, such as a major primary care centre. A key purpose of this engagement is to ensure that adequate provision is made to meet the future health service requirements of the population of this area. This will be undertaken as part of the city council's review of the master plan for the area. The move of orthopaedic services into an acute hospital setting, as part of a coherent and structured reorganisation of the delivery of acute services in the HSE south area, supported by best international practice, is a progressive and innovative initiative. The result will be better outcomes and health services for the people of the region.

Top
Share