I congratulate the Minister on his appointment. I have no doubt that he will be a very effective Minister. I would like to thank him for taking the time to come to the Seanad to answer this debate.
The conditions at University College Hospital, Galway, have now reached an intolerable situation. The inadequacy of the casualty and x-ray departments, theatre facilities and the shortage of beds have led to a crisis situation arising at regular intervals. For instance, 17 patients were detained in casualty overnight awaiting accommodation in the hospital last week. This is now a normal feature of hospital procedure during periods of overcapacity.
University College Hospital, which caters for counties Mayo, Galway and Roscommon, and indeed for patients from the wider western and north-western areas, was built in 1955 and has had no major extension or refurbishment since then. It is not possible for a facility which was built 40 years ago to cater for today's modern medical requirements and the increased catchment area in the west.
Successive Governments have refused to recognise the plight of University College Hospital, Galway. My party, Fianna Fáil, must stand indicted for not giving priority to the hospital over the past five years. I want to emphasise the point that I am not being political in regard to this problem; it is now far too serious. Fianna Fáil and the Labour Party have failed so far. Therefore, I want to be clear that I am not being political in this debate. The Department of Health officials do not seem to appreciate the inadequacy of the hospital facilities and the urgency of proceeding with the proposed first stage of a development plan which has already been approved. The plan, which has been in discussion for the past five years, involves the construction of a new casualty department, the expansion of x-ray and theatre facilities and the addition of 80 new beds. Additional staff are required to operate existing equipment, which is under-utilised due to staff restrictions.
I want a committment from the Minister this evening that the interim development plan which has been approved will be included in the 1995 work programme. I would like the Minister to give the estimated cost of the work and if he would indicate to us when it is proposed to put the project to tender. I am also anxious that the Minister would give us a committment on the planning of the major development plan for the hospital, which it is estimated will cost over £50 million. This planning process, which will take a few years, should commence immediately. University College Hospital has the distinction of having the highest bed occupancy in the country and the shortest turnover of patients, which indicates a very high level of efficiency. However, we have major problems at this point in time. It is for that reason that I have asked to raise this issue this evening.
University College Hospital has no emergency theatre during daytime. If there is an absolute emergency, a surgeon has to leave a theatre free for the emergency. Other emergencies must wait until the elective list has been completed. This means that three to five emergency cases are dealt with each evening and late into the night. Surgery on cases such as hand and facial injuries and cancer melanoma should be carried out once they are ready for theatre and should not have to wait for several hours before a theatre becomes free. To cater for the workload of University College Hospital, a suite of ten new theatres should be made available. The interim development plan provides only for two new theatres. At present, theatre No. 3 has to be completely renovated and so, in effect, there is only one new theatre being provided for. I want to emphasise that this is only an interim plan to deal with the emergency situation. A far larger development is needed for the long term.
A major problem at present is the number of cancellations for elective surgery each day. I am informed by consultants in the hospital that they calculate that surgery for up to 20 to 30 patients per day are now being cancelled. This is because there is not sufficient theatre and x-ray facilities or because consultants do not have the intensive care facilities for special care which is required after theatre. Morale among the medical staff is now at an all time low. They continually have the situation where operating lists are ready, special tests have been carried out, patients have been taken off drugs for their operations and all the preparations have been made for surgery but they have to be cancelled. This leaves the medical staff frustrated and the duplication of work and time involved in rescheduling operations is causing much distress.
In the past three to six months the situation has become more difficult and is now reaching the point of being impossible. I have been informed by a number of consultants that their patience is coming to an end. They are concerned that patients are now becoming irritated by the number of cancellations and delays. It is clear that the community in Galway will not accept for much longer the crisis at University College Hospital. For example, because of the smallness of the intensive care ward, a number of operations for ailments such as cancer of the stomach are continually being cancelled because there are no beds available in intensive care. This makes patients feel that their lives are being threatened and they are in an extremely distressed state.
The coronary care unit is far too small and inadequate. One cardiologist located in the west is far from sufficient. Only one dermatologist serves the whole of the west, including the hospitals in Galway, Castlebar and Sligo. There is a shortage of radiologists and consequently special x-ray equipment, which I mentioned earlier, costing £120,000, which is used to break down a stone in the kidney, can now only be used three hours each week. Consequently, the two consultants in this area can only use this machine for an hour and a half each per week because there are no radiologists there to use it for the rest of the time. Having this machine installed is a great waste of money.
The casualty department is totally inadequate. As I said earlier, patients must now stay in casualty awaiting beds almost every night; some 17 people were in casualty one night last week. The most recent development is that the ambulance trolley has to be left in casualty until a bed becomes available in the casualty unit while the ambulance waits outside until the trolley can be taken back out. That is intolerable. I wonder what would happen if we had a major disaster or catastrophe in Galway or the West given the situation in which the hospital is working at present.
There is need for aftercare for geriatric patients who are not in a medical condition to be sent home. Geriatric afterbeds must be opened immediately. I ask the Minister to take some initiative whereby some beds can be opened in Galway to deal with this urgent situation now. We cannot wait until the plan I am asking to be put into place is completed, which will take a year to 18 months. It is necessary that beds are opened immediately. The feeling in the hospital is that unless beds are opened immediately in Galway, pending the construction of the interim development, the quality of health care will be seriously jeopardised.
I now come to my final point, which is very important. I welcome the appointment of Deputy Noonan as Minister for Health because he is a good man who will get things done. However, I and many people in Galway were concerned recently after reading a recent interview with the Minister in The Irish Medical Times, in which he said the development of Limerick Regional Hospital would be completed during his term of office. He mentioned that he would like to bring it up to the standard of Galway and Cork. He should make sure he takes it to a higher standard than Galway. I understand that this development is likely to cost £10 to £12 million. While I wish Limerick the services it deserves, I am most anxious to hear from the Minister that Limerick will not get priority over Galway that the schedule of development which was in the Department will continue, that Galway will be given the top priority it had, that he will give a commitment that we can have this interim development which, I understand, will cost £4 to £5 million immediately, that we will get a commitment that it will start this year and that the planning for the major development can proceed, as it has been stopped for some time.
