Seanad Éireann debate -
Wednesday, 7 Jul 1993

Vol. 137 No. 6

Adjournment Matters. - University College Hospital, Galway.

Mr. Fahey

I thank the Minister for Health, Deputy Howlin, for coming to the House to debate this issue on the Adjournment.

The Minister will be aware that the situation in the University College Hospital, Galway, is serious. The hospital was built in 1956 and no significant capital investment has been made since. The Minister, in his short term at the Department of Health, has significantly reduced hospital waiting lists, etc. I realise that the difficulties experienced by University College Hospital and other hospitals throughout the country have nothing to do with this Minister. These difficulties have arisen under successive Ministers, including some from my party. I acknowledge that fact at the outset.

We have two acute hospitals in Galway, the University College Hospital and Merlin Park Regional Hospital. During the past 20 years University College Hospital has been the main acute hospital in the Western Health Board area. It is recognised by the Department of Health as one of the most efficient hospitals in the country with a high level of cost effectiveness. However, no significant investment has been made since its construction in 1956.

Nursing staff are under severe pressure because of inadequate facilities. Nurses coming on and off duty must change in toilets. There are no changing facilities for them. The Western Health Board, under the direction of Mr. Eamonn Hannon, has done its utmost to provide the necessary resources for adequate nursing staff. The nursing staff is overstretched and is under considerable presure day in, day out. I ask the Minister to consider improving the facilities for the nursing staff and the staffing levels.

I want to refer to the condition of the hospital. During the week the main building was described by one of the leading consultants who is not prone to exaggeration as nothing more than an industrial building. No significant maintenance work has been carried out over the past 25 years. If one attempts to open a window it is liable not to open. There are inadequate facilities throughout the hospital and it is in need of basic maintenance, such as painting. In other words, the hospital is in need of a major overhaul and for this funding is required.

There is need for a significant capital investment in the hospital. During the past ten years a major development plan has been on a shelf at the Department of Health. This plan, if implemented, would enable the hospital to carry the workload of the western region. However, that plan has gathered dust over the years and no work has been carried out. I blame my party for their lack of action in implementing this development plan. In 1956 the hospital had 700 beds. This figure has now been reduced to approximately 400. There are waiting lists in all the major surgical and medical areas. New theatre and diagnostic facilities, a new casualty department and extra beds are urgently required. A medium-term plan has been submitted to the Department for the provision of those facilities and I urge the Minister to make available, as a matter of urgency, the capital required.

As a member of the Western Health Board, the Leas-Chathaoirleach has campaigned for improvements to this hospital. Often people spend up to five hours in the casualty department before going to the diagnostic unit. They are admitted or sent home. This is unacceptable in this day and age. We have a casualty unit which is grossly inadequate. We lack the necessary consultant staff in the casualty unit to ensure a level of efficiency which is not there at present. We have a diagnostic unit which has not been developed of improved to any significant degree since 1956. We need scanning equipment because the existing equipment is completely outdated. We received one C/T scanner three or four years ago and that C/T scanner was no sooner installed than it became obsolete. There is a need for diagnostic equipment which would be capable of meeting the present needs of the western region.

The important point is that it can be cost efficient if we put this equipment in place because we are sending hundreds, if not thousands, of people out of the Western Health Board region each year to be treated outside the region. It is costing a fortune to take these people out of the region because we cannot treat them in Galway.

I know there are waiting lists all over the country, but in Galway, because we agreed to rationalise with Merlin Park Hospital by bringing a number of their consultants into University College Hospital, the hospital is now bursting at the seams. We have extra consultants in disciplines like urology. We had one urologist in Merlin Park Hospital with 30 beds. That discipline was moved into University College Hospital, a second urologist was appointed and now the two urologists have 15 beds between them. It is not possible for those consultants to operate under those conditions.

The same situation applies right across the board in all the different consultancies. The hospital was built to accommodate the situation in 1956 when 35 or 40 doctors worked there. There are now 200 doctors, between senior consultants and junior hospital doctors in University College Hospital, Galway, and we now have a much lower bed capacity than we had then.

I compliment the Minister on the super job he has done to date, but I put it to him that Galway is now the most urgent location in the country for his immediate attention. I ask him to come to Galway to talk to the medical and nursing staff, the consultants and the health board officials, and see for himself that we have the number one hospital in the country in terms of its efficiency and its cost effectiveness. We have probably the best hospital in the country in terms of the medical attention given to its patients, but we have a team who are working against all the odds in their efforts to provide an efficient health service. I want to assure the Minster that this is not a political issue, but I ask him to come to Galway to talk to those people. He will see for himself that money must be provided before the end of this year to proceed with the medium-term development. I ask him to take the major plan off the shelf, put it in place and commence the long term development of this hospital.

An Leas-Chathaoirleach

Thank you Senator. Before I call on the Minister I wish to endorse the sentiments expressed by Senator Fahey. As a member of the Western Health Board I can assure the Minister that what he has said is true.

Minister for Health (Mr. Howlin)

Thank you, a Leas-Chathaoirligh. I thank Senator Fahey for the cogent case he has made for the development at University College Hospital in Galway, and you, a Leas-Chathaoirligh for your endorsement and for giving me the opportunity to a say few words on the matter.

I have visited Galway but I have not had the opportunity to visit the hospital. I am mindful of the invitation and I look forward to an opportunity to visit the hospital. University College Hospital, Galway, is the flagship hospital of the Western Health Board and provides an excellent hospital service to patients in the health board area. I am aware that the hospital has been dealing with continuous exceptional demands for services. With a view to addressing the problems associated with these demands, the Western Health Board made a number of proposals to my Department for improvement of ward accommodation, additional theatres, improved accident and emergency facilities and additional X-ray requirements which it proposes to fund through sale of lands at Merlin Park which are surplus to its requirements.

Following consideration of these proposals a joint working party consisting of representatives of my Department and the Western Health Board was set up to examine the priority requirements of the hospital, to outline ways in which these requirements can be financed and to ensure that the developments proposed for the short and medium term will not jeopardise the long term development plans for the hospital. I expect to have a report from the group in the coming months.

I understand that there have been problems with delays at the accident and emergency department of the hospital in recent times. The Senator will appreciate that delays are an inevitable part of busy casualty departments which have a large throughput of patients. Each patient must be assessed to determine their medical priority and urgent cases must be attended to promptly. This necessarily means that the more routine patient will experience some waiting time. I am pleased to say, however, that the hospital authorities have recently increased the level of medical cover at the accident and emergency department in University College Hospital, Galway, with an anticipated consequent reduction in waiting times. The existing accident and emergency accommodation is generally considered to be inadequate for the numbers of patients attending. The accommodation problem in this department is one of the items being examined by the joint working group.

In relation to staff accommodation, and nursing staff in particular, the hospital authorities have been making ongoing improvements notably in the out-patients department, the day surgery area and maternity department. It is the intention of the hospital authorities to continue with improvements to staff accommodation and facilities according as the opportunities arise and suitable accommodation becomes available.

For my own part I will continue to provide additional funds as resources allow for the improvement of services at University College Hospital, Galway. I recently gave approval to the Western Health Board to proceed to tender for a replacement C/T scanner for the hospital at an approximate cost of £500,000. Senator Fahey has already referred to the major initiative on waiting lists. I recently announced that the Western Health Board received an allocation of £2,192,600 under this initiative, which was the largest allocation to any health board; £1,312,600 of this additional funding will be used at University College Hospital, Galway, and will reduce average times in the specialities of ENT, ophthalmology, plastic surgery and urology.

I am mindful of the Senator's invitation and I hope to be in a position in the not too distant future to see the facilities at first hand. I have had deputations from the area and have met many of the consultants about specific issues and I am always impressed by the degree of professionalism they have brought to their delegations.

Mr. Fahey

I appreciate the Minister's reply. The fact that he has provided so much money to help reduce the waiting lists in Galway is much appreciated.