I thank you for allowing me to raise this most important matter on the Adjournment tonight. I welcome the Junior Minister to the House. I thank him for his time and attention. I hope he does not take personal exception when I state that I am disappointed that the Minister, Deputy O'Hanlon, was unable to join us this evening. The Minister of State is very welcome personally, but the Minister is very familiar with the difficulty we have in Wexford in this area. Through his obstinancy in refusing to meet either the Wexford paediatric action group or the Oireachtas representatives from County Wexford, major concerns have arisen. I hope the Minister will bring me good news this evening and that, at the very least, he will be able to tell me that the Minister, Deputy O'Hanlon, will meet the Wexford paediatric action group and the Wexford Oireachtas representatives to discuss the provision of a full paediatric service at Wexford General Hospital.
Last autumn, the Minister announced the provision of a consultant paediatrician with the necessary back-up staff. That post has been advertised in recent weeks, but there is a very strong view on the ground — which is not confined to the politicians nor the action group but has been researched by the medical consultants in Wexford — that a single paediatric consultant would increase referrals from Wexford to both Ardkeen and Dublin. The view of the medical staff in Wexford — it was published in the Irish Medical Journal in December 1990 — is that the appointment of one consultant paediatrician would worsen the present situation because any consultant worth his or her salt would take no risks with seriously ill neonates or young children when they were not on duty and were unable to give 24-hour a day cover. One consultant can work only a limited number of hours and days per week. A seriously ill child would have to be transferred either to Ardkeen Hospital or to Dublin to ensure consultancy level care around the clock. At the moment, any child with a serious illness is immediately referred to Ardkeen Hospital or to Dublin. The provision of one consultant would not be improving the matter.
It is now some years since a case was made for the provision of this full paediatric service at Wexford General Hospital. Even though in 1986 the post was advertised and the then Minister, Mr. Barry Desmond, agreed to the filling of the post, because of subsequent cutbacks at the time the South-Eastern Health Board felt unable to locate the paediatrician in Wexford on a full-time basis. The consultant was located in Waterford, even though the post had actually been advertised for Wexford. A two day a week visiting service was provided for Wexford General Hospital by the paediatrician who took up the post but who was based in Waterford.
Since then that paediatrician, and the service in Waterford and Dublin, have coped admirably, but there has been growing concern and alarm among the parents in Wexford whose 30,000 children are affected by the lack of a full service in Wexford.
I quote from the Irish Medical Journal of December 1990:
In a ten year review from 1980 to 1989 of Wexford perinatal statistics, particular emphasis was placed on neonatal deaths and transfer rates of normal formed infants. It has been shown that sick infants treated in units without paediatric skills have a threefold increase in this odds of dying, and survivors could be expected to have a higher incidence of handicap compared to those treated in properly staffed units.
Wexford General Hospital is a medium sized maternity hospital without on site paediatrician. It is unacceptable in the 1990s that a general hospital, with a catchment area of over 100,000 as in Wexford's case, especially one with a busy maternity unit, be deprived of experts and support staff to care for sick children.
The appointment of one paediatrician, which was advertised two to three weeks ago, would inevitably result in even more transfers when that consultant was off duty or on holiday. Therefore, it would make the situation nearly more unacceptable than it is at present. At least two full-time consultants must be appointed to provide continuous service. One paediatrician would increase transfers to either Ardkeen Hospital or Dublin. It would increase perinatal mortality over what it need be if the service was available where the maternity hospital is, which is in Wexford.
In Cavan-Monaghan — and which Minister comes from Cavan-Monaghan — with half the birth rate in Wexford General Hospital, they have two paediatricians and the necessary back-up staff, accommodation and equipment. This whole problem emphasises the lack of the Government's political will and commitment to Wexford.
The Minister for Health has refused to meet the paediatric action group and the Wexford Oireachtas Members. I would ask the Minister of State, Deputy Flood, to be at least able to state now that the Minister, Deputy O'Hanlon, will meet those of us who requested this meeting last October. The deputation will include medical staff from Wexford General Hospital. We do not expect him to meet a group to pursue a matter on a political basis because the local elections are coming up. This issue has been there for four years. It has not just arisen now with the local elections around the corner. It is not the view of any one political party. This issue is supported across political boundaries, by a very broadly based Wexford paediatric action group and by all the medical staff concerned in Wexford General Hospital.
I implore the Minister of State to ensure that his senior colleague, the Minister for Health, at the very least meets us so that the case in detail can be put to him, away from the political arena, so that the medical facts, as printed in the Irish Medical Journal, and as researched by the medical staff in Wexford General Hospital, can be put on the table.
Even though there has been a shortfall in funding to the South-Eastern Health Board by £1.8 million this year we are assured by the Minister that sufficient moneys will be available for the commissioning of both the new surgical wing at Wexford General Hospital and, indeed, Ardkeen Hospital in our region. There will be sufficient moneys to establish the paediatrician in Wexford with the necessary nursing and backup staff. We understand the cost to be in the region of £500,000. All we are requesting at this stage is that one extra consultant's salary be added to that bill. Put him in at £40,000 a year. I am not quite sure of the sum because consultants would also have a private practice to boost their income. But put in a consultant at a gross of £40,000 a year, a second paediatrician. It is very little on top of the £500,000 that will be spent on providing half a service which could only increase the transferral rate. For an extra £40,000, or even leave it at £50,000, an extra 10 per cent of £500,000, we would have a full paediatric service, a full paediatric unit, at Wexford General Hospital, where we have a very high birth rate and a huge catchment area of 100,000, not to mention the enormous increase in our catchment area during the summer season because we are a major tourist resort.
Our case is without argument, to be honest with you. The Minister has been generous. He has come some of the road with us. He is providing a paediatrician with the necessary backup. The medical view shared throughout medicine in Ireland is that you need a minimum of two to provide round the clock service. Without two, you are just increasing your referrals. The mothers and fathers of the small children and of neonatal infants in Wexford Hospital want them treated in Wexford so that they can be with them on a daily basis and in order to minimise the disruption of the other children in the family when there is a sick child who must be treated far from base. What frustrates us all on this whole issue is that the Minister has been relatively generous in acceding to the request for a paediatrician but has refused to even talk to us about going that final step to put the full service in place. I would make a final plea, which is broad based and which comes from all the political parties in Wexford. It comes from the Wexford Paediatric Action Group, who have fought so valiantly for a full paediatric service. Before them we had AWCH, the Association for the Welfare of Children in Hospital, who fought for years up to 1986 to get a service in Wexford but who were thwarted by the last minute transfer of the paediatrician to Waterford because of the economic cutbacks at the time. I appeal to the Minister on behalf of the medical staff and of the other consultants who are based in Wexford who have over the years valiantly tried to cope with the sick children and neo-nates in the absence of a full-time paediatrician to go that final step of the road. A sum of £550,000 would give the full service and would provide the full paediatric unit that is essential to allow the parents of Wexford have treatment in their own town for their neo-nates and sick children. I thank the Minister for his interest in this issue and I ask him to assure me that his senior colleague, Deputy O'Hanlon, will meet the paediatric action group and the medical profession concerned to put the final piece in place and ensure a happy outcome for what has been a long campaign by a broad section of people in our county.
