I thank the Cathaoirleach for allowing me to raise this urgent issue on the Adjournment. I am not casting any aspersions on the Minister of State, but I was disappointed that the Minister for Health——
Adjournment Matters. - Manorhamilton Hospital.
The Minister of State, Deputy O'Dea has a dual role tonight.
Sorry, I withdraw that comment. I am glad the Minister of State is here. This new Government has confused me.
It shows how interested I am in what the Senator has to say. I came here to hear him.
A recent tour of inspection of Our Lady's Hospital, Manorhamilton, by three members of Leitrim County Council, Councillors McGloin, Cullen, McTiernan and by myself has led me too raise this issue on the Adjournment. We were taken aback by conditions there. For many years, this hospital has served the medical and acute patient needs of Leitrim with a professional dedication which is second to none. As the only hospital in Leitrim, the county and the community have relied on the hospital staff to continue to provide excellent care and attention. Yet, even the most dedicated of professionals become frustrated and angry when their calls for assistance on staffing levels and infrastructural investment are continually ignored and when their ideas and suggestions for an improved service and health care system are dismissed.
Manorhamilton hospital has, over the years, been neglected and forgotten by the North-Western Health Board. At present, staffing levels at the hospital are not only the lowest in the county, but the lowest in the North-Western Health Board area. To cater for 37 to 40 beds with acute medical and long stay geriatric patients, five nurses are on duty in the mornings, two in the afternoons from Sunday to Wednesday and four on afternoons from Thursday to Saturday. Three nurses are on duty each evening and two SN nurses look after these patients at night. In addition, a ward sister is available only four days a week and two domestic ward attendants assist with all the domestic duties, with the help of one other domestic, who has other duties in the hospital. Furthermore, only one porter is available for a limited number of hours per day.
When the staffing levels at Manorhamilton hospital are compared with those at the Dungloe hospital and Shiel hospital in Ballyshannon, a stark imbalance becomes apparent. For example, Dungloe hospital, with 43 beds, has seven nurses on duty at 8 p.m. and four on duty each afternoon and evening. Staff also have the assistance of one SN from the day hospital for two hours each morning and three hours each evening. While the Shiel hospital has only 22 beds, it can provide a staffing level which includes four nurses on duty in the morning and two on duty in the afternoon, evening and night.
These hospitals provide a good patient to nurse ratio, a benefit which is mutual. Patients are given an excellent standard of nursing and medical care, while nurses are not stressed and achieve some job satisfaction. No such feeling of job satisfaction exists at Manorhamilton hospital. Indeed, medical and nursing staff there are extremely angry and deeply concerned that their calls to redress the imbalance of staffing levels are met with casual indifference. They fear about their ability to provide a safe and comfortable environment for their patients, especially when one realises that of the 40 odd patients in their care, 15 of them are termed totally dependent. They need assistance with tasks of daily living such as feeding, dressing and washing. Other patients who are mobile and able bodied but suffering from differing levels of confusion, also need constant supervision. Nurses have little help to lift and handle patients. The demands on their time is constant. Medical staff, constantly hampered by lack of funds and proper medical service support, feel they can no longer provide the type of care and attention our senior citizens deserve, especially if they are to live out the rest of their lives with dignity and comfort.
Low morale among the staff is not helped by the state and condition of the hospital; frankly the building is archaic. Despite attempts by the staff to brighten it up and make it more homely and pleasant, it urgently needs infrastructural investment. The outside of the building needs to be painted and anybody visiting the hospital who examined its condition, would be appalled. The windows are rotten and paint and plaster are falling from the walls of some rooms. In other areas floor covering is cracked and there is a serious danger of somebody tripping. In the larger wards, there is little space between beds for nurses to work and patients have virtually no privacy. Bed lockers are old, broken and in need of repair or replacement. Bed linen is worn and tattered. Radiators cannot be switched off because they have no control valves. The swimming pool, which was funded by the public — and this should be taken into consideration — has not been opened since last October, except for a few hours. The litany goes on.
This hospital is an important and integral part of the community of Leitrim. The staff and its patients deserve better treatment. Therefore, I appeal to the Minister to make funds available to upgrade the hospital with regard to staffing and structure. The requirements are very straightforward and not difficult to fulfil. The hospital needs its permanent nursing posts filled; an addition of two care assistants to help in the mornings and evenings; an extra nurse Sunday to Wednesday for three hours; a qualified ambulance nurse available seven days a week; resources to help the development of the rheumatology unit and help to establish a rehabilitation unit; greater availability of a speech therapist; and funding for infrastructural development of the hospital building.
The needs of the staff and patients of Manorhamilton hospital are just as important as those in the Dungloe and the Shiel Hospitals. Patients have a right to expect a decent standard in both hospital care and medical attention. Staff have a right to expect and receive a good medical support system, decent working conditions and an environment that allows them to continue to perform their medical duties with confidence, professionalism and satisfaction. Not content with putting into action the infamous election slogan "Health cuts hurt the old, the sick and the handicapped", it now looks as though this Coalition Government is determined to hurt staff as well.
Responsibility for staffing levels at Manorhamilton hospital is a matter for the North-Western Health Board. It is the board's view that Our Lady's Hospital is adequately staffed. However, ongoing discussions have been taking place with the staff organisations in the hospital in relation to the most appropriate mix of staffing for the unit.
Our Lady's Hospital fulfils an important role in the board's community hospital network and is also the regional centre for a consultant staffed rheumatology and rehabilitation unit which serves all the board's catchment area. The hospital also has a physiotherapy department, occupational department and a very active day hospital.
The report of the working party on services for the elderly, "The Year Ahead" provides a blueprint for the development of services for the elderly. The recommendations of the report have been adopted by Government and are being progressively implemented. In 1990 and 1991 the Government allocated substantial additional funds to the North-Western Health Board. These funds amounted to £590,064. During this period the board used the funds to enhance community services for the elderly in line with the Minister's priorities. The elderly in the north-west benefited from increased levels of home help, home nursing, day care and the provision of a department of medicine of the elderly at Letterkenny General Hospital.
The home nursing and home help services in the community are supported by a network of residential centres for the elderly, day care centres and day hospital services. Last year there was a total of 58,637 attendances at the board's 13 day hospitals located throughout the region with 458 new patients attending. There were over 6,000 attendances at Our Lady's Hospital, Manorhamilton, which had 148 patients on the day hospital register at the end of 1992, 36 of whom were new patients in 1992. This investment in services for the elderly has led to a substantial improvement in the level of care for the elderly which I hope will be maintained.
Regarding community hospital services, Our Lady's Hospital has developed a full role in serving its locality. The matron of the hospital is assigned as district co-ordinator for services for the area which range from short term care, continuing care, active respite care programmes, out-patients, day services, advice care and support, terminal care, etc. Services at the hospital were augmented by the addition of a day hospital in 1985 which has proved to be most active and successful.
The regional rheumatology unit provides a comprehensive service in rheumatology and rehabilitation to Counties Sligo, Leitrim and Dongeal. As the Senator is aware, a new extension incorporating a gymnasium and specialised hydrotherapy facilities was opened in 1987. The hydrotherapy pool is probably one of the best, if not the best, facility of its kind in the country.
There has been a fair share of positive action in so far as services for the elderly in the North-Western Health Board area are concerned. I ask the Senator to accept the ongoing commitment of this Government to the development of services for the elderly in the North-Western Health Board area as shown by the generous additional funding for services in the last few years.
In addition to her duties in Manorhamilton hospital, the matron also acts as district co-ordinator for the north Leitrim area. The hospital has the following staff:
|
Management/Administration |
6.30 |
|
Medical/Dental |
7.20 |
|
Nursing |
31.40 |
|
Paramedical |
6.00 |
|
Support Services |
31.30 |
|
Maintenance/Technical |
3.00 |
|
Total |
85.20 |
The Seanad adjourned at 8.25 p.m. until 10.30 a.m. on Thursday, 20 May 1993.