Dáil Éireann Debate, Tuesday - 23 October 2018
68. Deputy Gino Kenny asked the Minister for Health the steps he will take to restore the services of a paediatric consultant that previously provided clinical paediatric oversight to the services in the National Rehabilitation Hospital but is now on long-term leave; the impact this has had in terms of closure of in-patient services for children; and if he will make a statement on the matter. [43452/18]
View answerDeputy Gino Kenny is ill today so I am asking this question on his behalf. Six beds closed in the National Rehabilitation Hospital in Dún Laoghaire in August, meaning, scandalously, that 12 beds have closed in that hospital. The other six have been closed since the end of 2017 due to staff and other resource shortages.
In August, however, six paediatric inpatient beds were shut as a result of the inability of the consultant who works out of Crumlin hospital to provide paediatric cover because they apparently went on unplanned leave.
The National Rehabilitation Hospital, NRH, in Dún Laoghaire, Dublin, provides complex, specialist rehabilitation services to patients who, as a result of an accident, illness or injury, have acquired a physical or cognitive disability and require specialist medical rehabilitation. Services include a paediatric programme which is delivered by a paediatric team based on the campus with clinical oversight provided by a consultant paediatrician who is based off-campus at another hospital. Up until recently, this consultant paediatric oversight was provided by a consultant paediatrician at Our Lady’s Children’s Hospital, Crumlin, whose contract includes a seven-hour clinical attachment to the NRH.
I am advised by the HSE that the consultant paediatrician in question recently went on unplanned long-term leave and, arising from this unforeseen development, Our Lady’s Children’s Hospital is not currently in a position to provide consultant oversight to the NRH’s paediatric programme. In light of this, the NRH has reluctantly closed its inpatient paediatric service on the basis that it is not possible to appropriately assess and triage new paediatric referrals and medically manage paediatric patients without consultant paediatric input. The suspension of this service is impacting on existing inpatients, those on the waiting list for admission, and those who are newly referred to the services and are awaiting assessment by a consultant.
The Children’s hospital group has confirmed that officials are actively working to identify another consultant paediatrician with an interest in disability to fill the vacancy to provide appropriate clinical paediatric oversight to the services provided at the NRH. In the interim, the paediatric team at the NRH continues to offer outpatient and outreach services to children. The NRH and HSE will continue to work closely to seek a solution to this matter.
The NRH provides incredibly important services in brain injury, spinal-cord injury, prosthetic and limb absence rehabilitation, as well as paediatric rehabilitation. The human consequences of not having these beds open are severe. Today, I spoke to Deputy Gino Kenny's constituent who contacted us about this issue. The individual’s daughter had a brain tumour and surgery in Temple Street hospital in April. She has been left with serious weakness on her left side and needs serious rehabilitation. However, she is now unable to go to the NRH for treatment because of the closed beds. Early intervention in serious situations such as this is important. This is the human consequence of this.
Will the Minister of State explain why we cannot recruit a consultant to provide the cover which will allow these beds to be reopened, given the suffering endured by people who really need it? We need an explanation.
I welcome the Deputy’s comments on the great work the Children's hospital group and the NRH do. The reality is that we have an issue with consultant numbers. Earlier, we had a discussion about the problem with the shortage of doctors. That is a problem with which we are trying to deal. We have seen an improvement in recent months with the return of many people from abroad. I have seen this with speech and language and occupational therapy services. We still have an issue with staffing. We need more consultants.
The NRH remains committed to resuming its inpatient services as soon as the resolution to the current issues around the consultant paediatrician cover is found. The NRH and the HSE will continue to work closely to seek a solution to this matter. The Government recognises the excellent programme which the NRH delivers and its excellent patient outcomes. We have to deal with the issue of staffing on which we are strongly focused.
There is no doubt about the excellent work the NRH does. However, 12 beds were closed at the end of 2017. The hospital managed to get funding to get six of them reopened but then another six were closed because it could not get the paediatric consultant cover. If it is related, as discussed earlier, to the sort of apartheid new-entrant levels of pay for consultants as a result of austerity cuts, then it has to be addressed. This situation cannot go on with the girl I just mentioned who needs this rehab urgently, as well as the many others who need rehab. It is unacceptable.
We need to sort this out. We need to provide necessary resources to recruit the consultants to do this vital work.
I take the Deputy’s important points. We have to strongly focus on this issue.
The hospital has made a submission to HSE’s National Hospitals Office on the reopening of the six closed beds. The office supported the NRH submission within the context of the Estimates process for 2019. The HSE’s operational service improvement division has also sought to reopen the six beds for the winter planning process for 2018 and 2019. However, such considerations will only be concluded by October and November this year. If successful, the beds will be reopened after this date.
However, the HSE continues to liaise closely with the hospital on the bed capacity issue. I will strongly focus on this because I accept the Deputy’s arguments on the need for services for children with disabilities.
