Judging by the way the Minister of State came in he will not be needing the services to which I refer on the Adjournment anyway.
Adjournment Matter. - Manorhamilton (Leitrim) Hospital.
Let us hope I will not.
The reason I am raising this matter on the Adjournment is that the North-Western Health Board have for quite a considerable time proposed the provision of a rheumatology department with rehabilitation facilities at Our Lady's Hospital in Manorhamilton, County Leitrim. This was decided by the health board following the transfer of the orthopaedic theatre facilities from Manorhamilton to Sligo some three or four years ago. The health board felt that there was a grave need for the provision in the area of a rheumatology service with rehabilitation facilities to back it up. They then proposed and the Department agreed, the provision of same at Our Lady's Hospital in Manorhamilton. They had provided in their estimates for 1983, 1984 and 1985 for an amount of money from the Social Fund moneys being made available to them to be put aside to be used as capital for this project. In 1985 they were instructed by the Minister for Health to cut a proportion of that which had been left aside and to take it into their budget for that year. This continued again this year because the health board, I am told, are approximately £3½ million short in their allocation from the Department. The net result is that without the provision of a special grant from the Department of Health they will not be in a position to continue the development of this facility at Manorhamilton.
There is an undisputed need for the provision of this facility. There are no similar facilities in this country outside of Dublin. We all know the pressures that are on the facilities that exist here in Dublin. Indeed, the North-Western Health Board area has the highest incidence of arthritis in the country per head of population. I believe the Arthritis Foundation have even recognised that, because they have proposed to make a grant of £43,000 available to the health board for the provision of this facility. I would like the Minister of State here this evening to ask the Department to provide the necessary capital for the immediate development of this facility at Our Lady's Hospital, Manorhamilton. I believe from my inquiries that the provision of the facility will not involve further expense on the Department or on the health board with regard to running the facility. The staff are already there but the facilities are not those that are necessary for the provision of proper service as far as the rheumatology and rehabilitation is concerned in that area.
I know that the Minister of State would understand the need for this type of development. We see that many of our hospitals, such as that in Manorhamilton, which are modern hospitals having been built in the fifties, are in a position to provide the bed accommodation necessary for the service. With the development of this proposed service it would be a safeguard to the employment which is created by the hospital facilities in that very small community. The distance of the north-west from Dublin would make it very attractive to patients from that area and to their families who would be in a much better position to visit them if the full facilities were provided in Manorhamilton. I also feel that this is a project which not alone would serve the counties in the North-Western Health Board area but would also be in a position to serve Fermanagh and Tyrone, as well as Cavan, which are all quite close to Manorhamilton.
I would like to appeal again to the Minister of State to provide for the North-Western Health Board the necessary finance for the extension proposed to Our Lady's Hospital in Manorhamilton.
Manorhamilton hospital was formerly the county hospital for Leitrim and provided a service in the specialties of general medicine, general surgery, maternity and gynaecology. A temporary orthopaedic unit was established at the hospital in 1978 pending the provision of a unit in Sligo. Subsequently all the consultant-staffed services in Manorhamilton were transferred to Sligo. The orthopaedic unit in Sligo opened in August 1981 and this enabled the North-Western Health Board to vacate the temporary 28-bed orthopaedic unit in Manorhamilton. At this stage the health board approached the Department with a proposal to establish a regional rehabilitation unit in Manorhamilton based on this 28-bed unit. This regional unit was intended to provide a service in rheumatology and rehabilitation for the entire North-Western Health Board area. Comhairle na nOspidéal approved the appointment of a consultant in rheumatology-rehabilitation for the unit in 1981 and approval in principle to establish the unit was issued by the Department in January 1982 and final approval to recruit the consultant issued in November 1982. The consultant took up duty on 1 July 1983 and the unit treats the following range of conditions: arthritic; post-operative; post-stroke; post-accident and sport injuries.
When the unit was being established it was indicated by the board that the present range of facilities available at Manorhamilton was adequate to initiate the rehabilitation service. It was, however, envisaged that, as the service developed, extended facilities would be required but these could be provided on a phased basis.
In November 1983 the health board proposed to my Department that funds which were at their disposal might be used for, among other things, improving the rehabilitation service at Manorhamilton.
It was proposed to provide custom-built accommodation and facilities to support the consultant-staffed rehabilitation services. These included facilities for hydrotherapy, physiotherapy, occupational therapy, out-patients, day and community services. Special emphasis was to be placed on the social and vocational aspects of the service and it was indicated that the total capital cost involved was about £400,000. This proposed use of funds was approved by my Department in November 1983.
In August 1985 the health board informed my Department that: (1) the funds at their disposal were no longer available; (2) the cost of the project was now estimated at £700,000 (3) tenders had been received for the project and (4) a grant of £700,000 was now required to enable the project to go ahead.
The normal procedure in cases where my Department are being asked to provide funds for capital schemes is that the various proposals and drawings have to be submitted regularly to my Department so that they can be checked and evaluated at each stage of the planning process. This was not done in the case of the scheme at Manorhamilton and the board have now been asked to submit their detailed plans and the tender documentation so that the scheme can be assessed in detail.
No provision has been made in the capital programme for my Department for this scheme and in view of the current extreme limitations on capital funds it is highly unlikely that I will be in a position to provide funds for this project in the near future.
The fact is that I was asked for funds for this scheme only late last year and many other desirable projects have been in the queue for much longer than that and, in all fairness, they will have to be considered before the scheme in Manorhamilton.
I would like to say also that my Department have a well-defined procedure for the planning of projects of this nature which, in this instance, was not adhered to. This procedure is laid down so that projects can be planned correctly, can be programmed to fit the capital allocation and to ensure that each project fits into the national order of priorities.
As I say, the correct procedure was not followed in this case and, until the technical staff in my Department vet the plans and the documentation, I cannot even say if the planning done to date is acceptable. Even if it is, I am not regrettably, in a position to say when funds can be made available for the project.
Another ice-box job.
The Seanad adjourned at 4.10 p.m. until 2.30 p.m. on Wednesday, 19 February, 1986.