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Hospital Services.

Dáil Éireann Debate, Tuesday - 21 June 2005

Tuesday, 21 June 2005

Questions (32)

Caoimhghín Ó Caoláin


53 Caoimhghín Ó Caoláin asked the Tánaiste and Minister for Health and Children the funding for capital projects for acute hospitals she has approved since she took office; the funding for capital projects that is proposed for the remainder of 2005, including projects in Monaghan General Hospital and Cavan General Hospital; and if she will make a statement on the matter. [21185/05]

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Oral answers (9 contributions) (Question to Minister for Health)

The Deputy will appreciate that, on taking up office at the end of September 2004, the bulk of the capital programme for that year had already been committed. This included prior approvals under the multi-annual health capital programme to progress major developments in the acute hospital sector. In addition, significant investment had already been approved earlier in 2004 in respect of minor capital works in acute hospitals throughout the country.

Notwithstanding the above, there remained some flexibility in regard to further capital approvals during the latter months of last year. In that time, a number of approvals issued in individual cases that ranged, for example, from €5 million approved for a new integrated imaging management system for St. James's Hospital, Dublin, to €660,000 for Waterford ambulance station. The health sector drew down all capital funding available in 2004 and funding for capital projects in the acute sector for that year exceeded €320 million.

The Health Act 2004 provided for the Health Service Executive to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes responsibility for progressing the bulk of the capital programme. Capital funding for the health service is now largely provided through the Health Service Executive in line with the capital investment framework. This amounts to €564 million in 2005, of which in excess of €250 million will be directed towards the acute hospital sector.

I am pleased to inform the House that I have written to the HSE to convey my agreement to allow for the progression of its capital programme in 2005. The capital provision for my Department in the current year amounts to €20 million. This relates directly to funding for a small number of agencies such as BreastCheck, the Health Research Board, the Health Information and Quality Authority and the Adoption Board.

In regard to the two hospitals referred to by Deputy Ó Caoláin, I can confirm that the capital investment programme makes provision for particular works to be advanced during this year. These projects are currently at planning stage and include the upgrade of existing ward accommodation in Monaghan General Hospital and the fit-out of existing space to provide for an additional 25 bed ward and a fourth operating theatre in Cavan General Hospital.

At this stage, one almost knows off by heart the section in the reply referring to the HSE. It is the standard reply we get to all parliamentary questions submitted on health-related issues.

Does the Minister recall that in September last year, just before her predecessor, Deputy Martin, left office, following a meeting with representatives of the North Eastern Health Board, he agreed to progress as a matter of urgency a range of measures for Cavan General Hospital and Monaghan General Hospital? Does she recall also that some, but not all, of the commitments of the Minister, Deputy Martin, were repeated in her reply to a Dáil question from this Deputy on 12 October? I understand some of the commitments have been fulfilled, which is welcome. However, I want to ask the Minister about the outstanding commitments. First, there were to be ten additional day beds at Monaghan General Hospital, which have not materialised. This is a cause of great concern to staff and patients. Why have these extra beds not been delivered? When will they be delivered?

In a statement following the September meeting, the former Minister, Deputy Martin, promised to provide a CAT scan facility at Monaghan General Hospital. The Minister omitted to mention this in her reply in October. I would like her to address the fact this did not follow through between the departure of the former Minister, Deputy Martin, and her taking up office. What has become of that commitment? When making further inquiries recently in regard to this matter, a staff member stated that the lack of a CAT scan facility is crucifying the hospital. This is the reality with which the staff is dealing. Is the Minister aware that an average of six patients per day, and sometimes more, many of them on ventilators, are brought by ambulance or transported by whatever means to Cavan for CAT scans? Nurses must accompany these patients, which means the complement of nurses available at Monaghan General Hospital is severely reduced on a daily basis where there is already a shortage of nursing staff. Will the Minister commit to provide a CAT scan facility, as promised last September?

Finally, the 19 additional beds at Cavan also committed to, and followed through in the Minister's statement in October, have not been provided. When will that commitment be delivered on?

The Deputy will be aware that some of the works at Monaghan General Hospital have been completed, therefore, there is a gap between the approval of funding for capital infrastructure and the use of whatever improvements take place. I must come back to the Deputy on the CAT scan question. There is no CAT scan facility in Dundalk which has a higher number of patients who travel to Drogheda. I do not know whether it is feasible for every hospital in the country to have a CAT scan facility. There are significant revenue implications in terms of staff, including radiographers and others, for a CAT scan facility. I am not in a position to comment on whether a volume of six per day is realistic. Even though it may be difficult and traumatic for the individuals involved, CAT scans are expensive. It is intended that Cavan and Monaghan general hospitals will operate as a single hospital on two sites. Because of the population in the catchment area and other factors, it is not feasible that they can operate totally independently of each other as fully functioning hospitals. There have been many discussions with the Deputy on this matter.

The commitments made last September and October are being honoured. The capital funding necessary to make these commitments a reality has been put in place. Presumably it is a question of staffing to ensure the 25 beds in Monaghan General Hospital are equipped.

On the larger emergency room to operate on a 24 hour, seven day, basis, I understand completion is expected within the next two weeks. I hope this proves to be the case and that it will be operable as soon as possible. For the Minister to make comparisons between the journey from Dundalk to Drogheda with that from Monaghan to Cavan——

The Deputy must be brief as we have exceeded the time limit.

I am being brief. One is talking about two different realities for patients on ventilators travelling for CAT scans. The Minister should make no mistake about it, there is absolutely no comparison whatsoever. It is imperative for the patients concerned to have a CAT scan facility. It is worrying that she is advising us that she has no such knowledge of the CAT scan facility proposal. I ask her to re-inform herself of the commitment of the former Minister for Health and Children, Deputy Martin, and ensure it is re-affirmed by her and delivered at the earliest opportunity.

I tabled a parliamentary question on women-centred services at Monaghan General Hospital on 10 May, which was referred to the HSE at some time, but I only received a reply yesterday, six weeks after the question was tabled. Why was there such a delay? Will the Minister answer the part of the question not addressed in the reply I received yesterday, that is, the plans for further development in women-centred services at Monaghan General Hospital, which must include the recommencement of maternity services?

The HSE is putting in place a parliamentary affairs division. The functions of the health boards only transferred to the HSE on 15 June. By the autumn, a fully resourced and well functioning division will be in place, which will provide speedy responses to parliamentarians. This was sought and discussed during the passage of the relevant legislation.

Four hospitals are located in Drogheda, Dundalk, Monaghan and Cavan, which is an area with a relatively small population, and two of them do not have CAT scanners. I accept there are issues when people have to travel but the jury is out on whether it is feasible to provide a CAT scan facility, not just the equipment, which costs between €1 million and €2 million, but the staff to ensure it functions properly and the number of patients to use it. I am not in a position to make a commitment nor am I in a position to say that maternity services will be restored at Monaghan General Hospital.

Will the Minister outline the plans for development of women-centred services at the hospital?

I call Question No. 55 because Deputy Neville is not present for Question No. 54.

Question No. 54 answered after QuestionNo. 55.