Seanad Éireann debate -
Thursday, 26 May 1983

Vol. 100 No. 12

Adjournment Matter. - Coole (Westmeath) Hospital.

Mr. Cassidy

I want to thank the Cathaoirieach for allowing me to being this matter into the House for discussion and to highlight the problem with regard to St. Joseph's Hospital in Coole. I should like to congratulate the Minister of State and wish him the best of luck in his new undertaking.

I have addressed the House on several occasions but not when you were in the Chair, a Leas-Chathaoirligh and I want to congratulate you and wish you well. I know it is only the start of greater things for you. You treated us very fairly when you were in the Chair in the last Seanad and I have no doubt that you will do the same for us in this Seanad.

I should like to call on the Minister to reconsider his decision with regard to St. Joseph's Hospital, Coole. The hospital is situated on 12 acres. The entire building is perfectly maintained and contains four wards, a modem operating theatre, recreation hall, a physiotherapy room, hydrotherapy pool, laundry, five classrooms, dining halls, playgrounds, workshops, sunken bathrooms etc., all on the ground floor and covering in all 75.000 square feet. There is bed space for over 150 adults. There is also an administration building, a nurses' home containing over 50 rooms and a doctors' suite.

All this arose from a reply from Deputy Desmond, Minister for Health, to one of our local Oireachtas representatives, Deputy Gerry L'Estrange. He stated in the letter to the Deputy that since the closure of Coole hospital in 1981 considerable thought had been given by both the Midland and North-Eastern Health Boards in conjunction with his Department to devising a scheme whereby the hospital could be used in the health services. He said that no realistic proposal had emerged, which was hardly surprising as both the location and structure of the building stood in the way of it being used for health purposes. The health board have written back to the Minister asking him to reconsider his decision. How can the Minister condemn something he has not even seen?

There is no doubt in my mind that a hospital such as St. Joseph's in Coole, which is in perfect structural condition, could not be erected at today's prices for anything less than £5 million or £6 million. With no money available to build a similar structure, St. Joseph's in Coole can be used immediately at very little expense. It is a disgrace to leave Coole hospital lying idle when there is such a great need for a hospital with its potential. In present financial circumstances, this valuable asset should not be lost. This hospital, which is awaiting occupancy, is threatened by so-called experts who say it has outlived its usefulness, at a time when the Midland Health Board admit widespread overcrowding. This is not the view of the ordinary Westmeath person.

The Minister for Health, Deputy Barry Desmond, went on public record to say that Coole hospital was not suitable for health services. With all due respect to the Minister, who has not been to Coole, he has been badly advised. The Health Board have made four suggestions to the Minister as to how they could service Coole hospital and keep it open as a hospital.

We all know there is a crying need for facilities for adult mentally handicapped patients. With 150 beds available this could alleviate the problem to some extent. Coole hospital is only 12 miles from St. Loman's in Mullingar and it is only three miles from St. Peter's hospital in Castlepollard. It could not be said to be out in the wilderness and too far away to take patients of that nature. At present there is a two to three year waiting period for hip operations and hip replacements in Navan hospital. If Coole hospital were in operation this waiting list would be reduced greatly. As we have the highest unemployment — 18 per cent — in north-west Meath of the five midland counties, it would help in no small way to have State participation to keep jobs in rural Ireland. This is a very fine hospital in a beautiful part of the country. It is in perfect repair and is needed for the treatment and accommodation of the sick. It is also needed to give employment to our people. As the only Oireachtas Member living in the Coole electoral area, I personally invite the Minister to come down to see this very valuable unit, which could be a great asset to the State, before making his final decision.

Mr. Lynch

I should like to take this opportunity of thanking the Minister of State for coming to listen to our plea with regard to St. Joseph's in Coole. I should like to wish him well, he is a man for whom I have a great personal regard. I do not reside in the Coole electoral area but Coole hospital is situated about 12 miles from Oldcastle and I know it very well. I had the pleasure and honour of entertaining young patients for many years. Coole hospital has served the needs of the people of the midlands and Meath areas for many years. Young, physically handicapped children were brought to Coole hospital and, thanks to the care and expertise of the medical staff of the time and the Sisters of Charity, many of these young people have turned out to be great athletes. I know some of them personally.

What happened in the intervening years was that through modern day medicine and early detection etc., the numbers being admitted to Coole hospital bacame fewer and fewer. The unit was not viable and its full facilities were not utilised. The Sisters decided to withdraw. While that situation existed in Coole with regard to the facilities it was originally intended to provide, at the same time the North-Eastern Health Board had an input into hospital down through the years as the surgeon, Dr. McGrath from the orthopaedic unit of Our Lady's Hospital in Navan performed operations in Coole hospital. Orthopaedic operations were being carried out in Meath and in other areas and matters reached a chronic stage. We have not got the facilities in Our Lady's Hospital in Navan and they have not got them in the Midland Health Board either. The North-Eastern Health Board serve the needs of parts of Westmeath, Longford and other areas. We are terribly cramped for space.

We have a hospital in Coole worth £5 million to £6 million which is left idle. It is a perfect structure and all wards are at ground level. It has ramp facilities that many hospitals have not got. It could be used in many different ways. There is an urgent need for accommodation for mentally handicapped adults. There is need for long-term geriatric beds and long-term post-operative orthopaedic space. I can assure the Minister there is nothing political in my motivation in supporting this matter. I refer to a letter sent to me on 1 July 1981 from the chief executive officer of the North-Eastern Health Board. I tabled a notice of motion as follows:

That the North-Eastern Health Board take note of the present intention to dispose of Coole hospital and that every effort should be made to ensure that patients for whom the North-Eastern Health Board is responsible shall continue to have the benefit of access to the services which this hospital has.

In the course of his letter the CEO stated:

Since talking to you last, I have had a long discussion with the Chief Executive Officer of the Midland Health Board. He is, at the moment, in active negotiation with the Bishop of Meath and the Trustees of Coole and he intends making an offer for the hospital and its facilities in the near future. He has assured me that our needs will be provided for in Coole and knowing him of old I am quite satisfied that, being a man of his word, we will have no problem there.

I have also asked him that in the event of his negotiations on behalf of the Midland Health Board breaking down with the Trustees that he will advise me immediately and I will then seek to negotiate on behalf of the North-Eastern Health Board. This would, of course, have to be subject to Departmental and Ministerial approval. Nonetheless, I take your point fully that this matter is urgent and that action is required rather than words. I would mention, however, that Coole hospital is, of course, within the territory of the Midland Health Board and it should, by right, have first chance in seeking to make arrangements which will allow us all to continue in Coole.

I hope the above will be satisfactory and I am fairiy certain that a reasonable and acceptable compromise can be worked out by the Midland Health Board in relation to for Coole.

He then goes on to mention staff with which we are not concerned here, although as local people we are very concerned about what happened to the staff there.

That letter was from the chief executive officer of the health board and it is a complete contradiction of what is outlined in the Minister's statement. I would like to know what happened in the space of two years to have Coole hospital regarded as a non-viable unit. I would like to know where the Minister got his information. I believe there is some move to regionalise and provide a unit perhaps in Athlone which will cost the taxpayers £10 million while, at the same time, we by-pass the existing hospital at Coole which in the opinion of the CEO and the doctors employed there is quite fit to meet the needs of the locality.

I believe it is time to call a halt to over-regionalisation. Rural communities are losing their identities rapidly due to a policy geared entirely towards monopoly urban development. This policy in all areas of development is crippling employment prospects in rural Ireland. The cost to the State is astronomical in terms of the cost of implementation of these programmes and the very high unemployment figures. I invite the Minister and the Minister of State to visit Coole hospital. I can guarantee they will be pleasantly surprised and will be given food for thought. Then I am sure they will agree with the sentiments expressed here by Senator Cassidy, by myself and all the elected representatives in the Longford-Westmeath constituency and the Meath-Westmeath constituency also.

Mr. Fitzsimons

The reason I wish to make a very brief contribution with regard to Coole hospital is that one of my very close friends has a child who was treated satisfactorily at Coole hospital. The child had a very serious foot problem which, fortunately, was discovered in time and the child spent a considerable period in the hospital. She was very successfully treated and almost miraculously cured and is now in perfect health. There are many other instances of children from my locality who have been treated in Coole hospital.

I believe that 80 per cent of the staff are still unemployed. In the Minister's letter to Mr. L'Estrange he says "You will appreciate that in the present difficult budgetary situation we simply must allocate financial resources to best effect". I know of many cases — as, I am sure, do many other Members — where people are waiting for up to four years to be admitted to orthopaedic hospitals for hip operations. It seems to me that we are simply reducing the services and this is not acceptable. If we continue along these lines we will create a situation where when funds run out the institutions will simply close down. I am concerned about this. Numerous people have called to me who are awaiting admission to orthopaedic hospitals but the hospitals are booked out for a very long time into the future. Because positions are not being filled due to financial problems the waiting lists are building up. Instead of reducing the number of people waiting for admission to hospital the figures are building up.

The position of Coole hospital should be reconsidered. As Senator Lynch said, it is a very suitable premises. It has ramps which are not available in most other places. It is a pity that the hospital cannot be used for the purpose for which it was intended. The requirement is there and I am sure something could be done to get the necesary finances.

Minister of State at the Department of Health (Mr. F. O'Brien)

All health services must be planned in a rational and realistic manner if we are to make the best use of the scarce resources which can be made available. While this principle applies to all services, it applies with even greater force to the hospital and other institutional services which take the highest proportion of health expenditure.

Over the past six or seven years detailed consideration has been given to the planning of hospital facilities in the Midland Health Board area. These plans have been carefully developed to ensure that an adequate hospital service is available to the population of the area within the constraints of available funds. The planning of the first phase of the development of the general hospital at Mullingar has reached an advanced stage. This phase of the development provides for maternity and paediatric facilities which are urgently needed and I have already indicated my intention to allow this scheme to proceed at the earliest possible date.

I am aware that in some respects the health services in the midland area are not as fully developed as they might be. This applies in particular to paediatrics and orthopaedics. The development at Mullingar will relieve the situation in relation to paediatrics and in the meantime I am examining a proposal from the health board to establish this service in the interim at Tullamore and Portlaoise. The health board are currently studying the possibility of establishing an orthopaedic service at Athlone and I am awaiting their proposals on this. I have recently given approval for the completion of the final phase of the geriatric home in Longford and for the re-wiring and the installation of fire alarms at the geriatric home in Mullingar. I am satisfied that these developments when completed will provide the population of the area with a level of hospital facilities which is adequate for its needs and on a par with services elsewhere.

In considering these developments I was, of course, acutely aware of the fact that there is a hospital at Coole which has been closed since 1981 and I gave serious consideration to the possibility of using Coole for some of the services which I have mentioned. However, I must point out that since the closure of Coole considerable thought has been given by the Midland Health Board and the North-Eastern Health Board in association with my Department to developing a proposal which would make a viable use of this hospital in the health service. However, no realistic scheme has emerged and this is hardly surprising when the facts are considered.

First, there would be considerable capital expenditure involved in acquiring the hospital and adopting it to modern day standards. Then, of course, there would be hefty annual revenue implications as well. Because of this I could not sanction any proposal in relation to Coole unless the health boards were prepared to give it a higher priority than the other proposals for developments in their areas. This the health boards were not prepared to do.

Secondly, the location of the hospital has to be considered. It is situated towards the northern end of the health board area and as such is not a suitable location for a regional service such as orthopaedics. In addition, it is located in a somewhat isolated area, removed from any sizeable centre of population. This fact alone makes it unsuitable for the care of, say, geriatric or mentally handicapped patients since the whole emphasis in the development of services for such patients is to integrate them as far as possible into the community. This simply would not be possible at Coole.

Other factors also have to be borne in mind. For example, the hospital was only about 50 per cent occupied for the last four or five years it was open and prior to its closure there were only 30 patients there although it had accommodation for 114. Also the previous occupiers of the hospital, The Daughters of Charity of St. Vincent de Paul, had considerable difficulty in recruiting and retaining trained staff.

I am, of course, well aware that a basic hospital facility does exist at Coole but any one of the factors which I have outlined puts a serious question mark over it. Taken together, all these considerations are quite compelling and suggest that Coole can have no place in the hospital services of the future.

I could not give approval to any scheme which would consume scarce resources for no sound reason other than to continue in use the vacant buildings at Coole. I should add that Coole is in no way unique. For example, we are actively planning for the closure of certain hospitals in Dublin as major developments there come on-stream and since assuming office I have approved the closure of the maternity hospital at Trim.

To be frank, it is my view that the hospital at Coole is not suitable for use as a health care facility and I see no possibility of using it as such.

Mr. Cassidy

Obviously the Minister or the writer of the letter is not aware of the present health board situation which was set out at their urgent meeting held last week. They are not aware that the Department are getting a letter. The author of that letter definitely was not aware of the facts. Recruitment of staff was in the good old days when Fianna Fáil were in office, not like today when we have massive unemployment. I totally reject the contents of that letter.

Mr. O'Leary

On a point of order, is it in order to have a discussion subsequent to the Minister concluding?

An Cathaoirleach

The House stands adjourned until 2.30 p.m. on Wednesday next.

The Seanad adjourned at 9.10 p.m. until 2.30 p.m. on Wednesday, 1 June 1983.