Dáil Éireann Debate, Thursday - 18 January 2024
6. Deputy Pauline Tully asked the Minister for Health the level of additional core expenditure for new developments, excluding funding for carryover and otherwise maintaining existing levels of service, which has been allocated to Cavan General Hospital for 2024; and if he will make a statement on the matter. [2071/24]
View answerI ask the Minister to outline the level of additional core expenditure for new developments, excluding funding for carry over and otherwise maintaining existing levels of service, that has been allocated to Cavan General Hospital in 2024.
I thank Deputy Tully for her question and assure her that I am fully committed to the development of Cavan General Hospital and to all of our regional hospitals right across the country. When I received the Deputy's question I asked for a note on the recent investment in Cavan hospital. It is all well and good with me saying what might happen in the future but I wanted to establish that real investment has been happening over the last few years and I have to say, the response is very encouraging. The budget in the lifetime of this Government has gone up by €16 million for last year. The full budgets for this year will obviously be agreed through the national service plan. Probably more importantly, since 2020 there has been an increase of nearly one quarter in the workforce. To me, that is always the most important bit because it is healthcare professionals, ultimately, who treat patients. That equates to 259 extra staff in Cavan hospital, which is a very clear commitment to the future growth and investment in the hospital. On top of that, the Deputy will be aware that a number of capital developments are in progress, which are going to be very important. One, of which Deputy Tully will be very aware, is the new three-storey extension block which will house a new endoscopy unit and an 18-bed ward. That is currently at detailed design stage and I want to see that progress because it will make a big difference to patient care in the area.
Recent initiatives in service expansion also include the establishment of a medical assessment unit, the feedback on which is very positive, and the further development of a geriatric assessment unit. The latter is something that we are rolling out across the country and the feedback around the country has been very good, particularly in terms of emergency department avoidance and receiving the appropriate care locally. Following the announcement of the budget allocation last year, I issued a letter of determination to the HSE. That kicks off the process for the national service plan and the detailed answer to the Deputy's question in terms of 2024 and the hospital will be available through that national service plan.
It goes without saying that the staff in Cavan General Hospital are excellent but they are under pressure. The Minister has said that there has been an increase in the number of staff and I appreciate that but there has also been an increase in the number of people using the hospital. There are insufficient numbers of front-line staff, particularly therapists. I was talking to a therapist recently who told me that her caseload for one day was 30 people. That is not sustainable. In the end, because there were only two therapists doing the job and they were each facing heavy caseloads, she ended up quite ill herself and had to take time off because she was so worn down.
Cavan General Hospital, like all hospitals, is currently facing issues because of high flu and Covid numbers. Advisories have been issued to stay away from the emergency department if at all possible and I am concerned about that. While I know the hospital is not referring to genuine emergencies, people are actually afraid to go to the emergency department even when they really do need to go. If something could be done to reduce the number of patients on trolleys and alleviate the overcrowding in the emergency department, that would be very welcome.
Morale in the hospital is quite low. I have talked to staff who feel they are under pressure and that it can be dangerous for themselves and patients when there are insufficient numbers of nurses on wards, for example. Constituents have also contacted me about cancelled or delayed appointments.
With regard to emergency departments, I am sorry I do not have the figures for Cavan. However, last year we moved to an all-year-round approach to urgent and emergency care to get away from this annual cycle of winter plans. To the great credit of our healthcare professionals, we have seen a very important reduction. I am not for a moment diminishing the fact that the numbers are still way too high and some emergency departments in some hospitals are under huge pressure. Approximately seven hospitals account for about half the number of patients on trolleys. I am sorry that I do not have the Cavan figures to hand but our healthcare workers achieved a 22% reduction in the number of patients on trolleys for the second half of last year versus the previous year. For those most at risk, namely, the over-75s who are in emergency departments for more than a day, the number has fallen by nearly 40%. We are by no means where we want to end up but, thanks to important work, things are getting better. I will ask the Department to revert to the Deputy with a note on the figures for Cavan emergency department.
I know from meeting with hospital management that they are very proactive and are trying at all times to alleviate pressures. Sometimes, constituents contact me to say they have an appointment in maybe six months for a hernia or something. When I talk to them further, it turns out the appointment is only an initial one to see the consultant. It does not take into account the time they will have to wait on a waiting list for an operation. That is too long. Some of them will end up using the cross-border directive but they should not have to do that, as it can place a financial pressure on them because they have to pay upfront for it, although I know they will recoup the money.
Another lady came to me who was threatened with a miscarriage on a Friday. She was just over three months pregnant. When she went to the hospital it was Monday before she could be scanned to establish whether she was having a miscarriage because no sonographers were there to operate the machines over the weekend. She was not the only one. The woman concerned ended up having a miscarriage. Another lady went to the hospital with a bleed but it ended up that her baby was safe. However, it is terrible to have to wait a whole weekend to establish that. That is not okay. The woman made the point to me that if men were having babies, that probably would not happen. She felt she did not get the care she deserved. She was even examined in a room that was not a ward. It was not even private; it was a storeroom.
I am obviously not familiar with the case but it does not sound right. We are in the middle of a very fundamental shift in healthcare provision in respect of exactly the situation that woman found herself in. We are moving from a five-day week service to a seven-day week hospital service. Of course, hospitals are open at the weekends but, exactly to the Deputy's point, all the services are not always available at weekends. The new consultant contract is part of that, as is the hiring of 25,000 more staff. It takes time. It is a huge shift from five days to seven days but it is essential for all the reasons that lady the Deputy described seems to have experienced. Certainly, the Deputy should rest assured we will continue investing in Cavan hospital, continue growing services and the workforce, and seek to move to, and achieve, seven days a week so that patients can get the services they need. As she said, people need that kind of care seven days a week and not just five.
