Vol. 244 No. 4
asked the Minister for Health if he will state for any one convenient year the number of admissions under the following headings: (a) acute appendicitis with or without perforation, (b) strangulated hernial or other acute bowel obstruction, (c) perforated gastric or duodenal ulcer and (d) acute haemorrhage to the surgical hospitals listed on pages 133, 134 and 135 of Outline of the Future Hospital System; and the mortality rates for each condition.
5.
asked the Minister for Health if he will state for any one convenient year the number of admissions under the following headings: (a) acute appendicitis with or without perforation, (b) strangulated hernial or other acute bowel obstruction, (c) perforated gastric or duodenal ulcer and (d) acute haemorrhage to the surgical hospitals listed on pages 131 and 132 of Outline of the Future Hospital System; and the mortality rates for these conditions.
With your permission, a Cheann Chomhairle, I propose to take Question No. 4 and Question No. 5 together.
The detailed information sought by the Deputy in each of these questions is not at present available. A hospital in-patient survey is however being undertaken by the Medico-Social Research Board. The survey which is at present in the early stages of development will provide a wide range of information, including that sought by the Deputy, concerning the general and specialised hospitals. Four hospitals have so far been included in the survey and it is intended that, over a period, it will be extended to include all hospitals.
Would there be any proposal to implement the suggestions in this outline before this research body makes its report?
Any proposal to?
To implement the suggestions in the Outline of the Future Hospital System without the information that would be made available from this investigation?
In reply to the Deputy, the final proposals in regard to the FitzGerald Report will take a very considerable time to examine and to evaluate. This report will be of use in that connection but we already have a great deal of information not only in the Department but from the FitzGerald Report which would enable us to take some decisions without necessarily having to rely completely on the evidence to be found in this particular examination.
6.
asked the Minister for Health if any information is available to his Department regarding the effect which delay, long distance travel, surgical skill and size of hospital have on prognosis of an acute surgical patient who must have an operation; and if it is proposed to carry out such an investigation in this State.
Statistical data relating factors such as delay, distance travelled, surgical skill and size of hospital to the outcome of operations are not at present available. It is doubtful if it would be possible to measure some of these factors in a way that would enable meaningful deductions to be made. For example there are many aspects of the problem of delay and an attempt to measure the initial delay in calling on medical advice is not likely to give reliable results. Surgical skill would obviously be very difficult to quantify.
The hospital in-patient survey, which is being undertaken by the Medico-Social Research Board, will provide a wide range of information about hospital in-patients including data such as distance of the hospital from patient's home and the size of the hospital. At present this survey is in its early stages of development. When it is more fully developed it will provide information of great value in many directions but particularly for the purpose of research into many aspects of morbidity and mortality.
Can we take it, therefore, that the FitzGerald Commission did not take into account long distance travel for emergency cases when they made their report to the Minister?
Oh, yes, indeed they did. They took great account of long distances.
The Minister suggested in his reply they did not seek this information and as a matter of fact the Minister said he did not think such information would be worthwhile or available.
The information this will bring is for the purpose of research into many aspects or morbidity and mortality.
Does the Minister not agree that this sort of information should have been sought by the FitzGerald Commission before they made the suggestions in their report with regard to the location of regional hospitals?
There is a great deal of evidence already available that makes the conclusions of the FitzGerald Report absolutely valid in regard to the services that can be performed for a patient who requires a number of consultants and a considerable amount of para-medical equipment and skill in order to ensure that the patient will be treated adequately and cured as promptly as possible. There is any amount of evidence to show that. There are reports on hospital organisation coming from a number of modern countries where the health service are being developed and which agree completely with everything that has been said in the FitzGerald Report. The FitzGerald Report is not an innovation. It is not something that is a pioneer document. Other documents of similar kinds are emerging from other health authorities all over Northern Europe.
It is clear and it is inferred here by Deputy Dr. Gibbons that they did not take into account those things that they should have.
I could not agree that they did not take them into account.
They were all specialists.
Did the Minister say there was a survey being carried out at the present time by the Medico-Social Research Board?
Yes. I have replied to two questions on that already.
It is easy to see that Deputy Dr. Gibbons knows his stuff, anyway.
