asked the Minister for Health the present position concerning the closure of the eight hospitals as announced on 30 January 1986.
Ceisteanna—Questions. Oral Answers. - Hospital Closures.
32.
The following is the position concerning each of these hospitals.
Longford Surgical: This hospital is now closed.
Roscrea District Hospital: Discussions are taking place with the Mid-Western Health Board on the arrangements which are required to enable this hospital to close. The closure will be completed with the placing of five residents in the more appropriate accommodation and I appreciate the co-operation of the board in this matter.
Carlow and Castlerea Mental Hospitals: There have been lengthy discussions and correspondence between my Department and the Eastern, South-Eastern and Western Health Boards on the arrangements to be made to facilitate the closure of these hospitals as psychiatric hospitals. Agreement has been reached on a number of these arrangements. The main outstanding issue is the location of acute administration facilities in Carlow and in Roscommon. This matter is still the subject of intensive negotiation between my Department and the South-Eastern and Western Health Board.
St. Patrick's Infants Hospital, Blackrock: Agreement has been reached with the authorities of the hospital on its closure on 27 June 1986. The permanent staff have been guaranteed continued employment in other health agencies.
Sir Patrick Dun's Hospital: This hospital will close on 29 August 1986. Discussions are taking place with the hospital authorities, with representatives from other Dublin hospitals, the Eastern Health Board and all of the staff organisations on the relocation of services and staff.
Cork Eye, Ear and Throat Hospital: ENT services will transfer from this hospital to the South Infirmary/Victoria Hospital complex by the end of August. Ophthalmology services will transfer to the Cork Regional Hospital and a project team is at present preparing detailed plans to enable this to happen.
Killarney Isolation Hospital: This hospital has now closed as an isolation hospital. The buildings will in future be used to provide an integrated geriatric service, in full amalgamation with St. Columbanus' Hospital.
Will the Minister state if there is agreement with the various agencies that these hospitals should close? I presume it is now accepted that all of them will not close by the end of June as originally envisaged. Will the Minister state if there is agreement with Sir Patrick Dun's Hospital to close on 29 August this year? Further, in relation to Carlow and Castlerea mental hospitals, will the Minister say if there is agreement that patients who have been in those hospitals for many years will be moved out? Will he accept that these hospitals will not close in the current year?
There have been a number of meetings with the authorities of Sir Patrick Dun's Hospital. We are confident we will be able to achieve closure on 29 August.
Do they agree to that?
They have agreed to it but many arrangements have to be made with consultants and with nursing staff and we have had individual discussions with each of the trade unions concerned. As the Deputy will understand, it is a complex and difficult exercise but the hospital will close on that date. I am anxious to provide in that area some other health facility, notably a health centre, because the inner city is increasing in population and a health centre would be very useful. The hospital is totally unsuitable and is very old. With regard to the hospitals at Carlow and Castlerea, we have made considerable progress. The remaining issue in both hospitals is the precise location and the type of facility we want to introduce for the acute admissions in the psychiatric sector. These discussions are ongoing. I have had lengthy discussions with the principal trade unions concerned and I think they have a full appreciation of our efforts to implement the Government decision. We are going down that road quite rapidly.
Will the Minister state if the trade unions concerned have actually agreed to the closure of the hospitals and if the two health boards involved have also agreed? What does he propose will be the future of the patients who have been in the hospitals for many years? Does he intend to take them out and place them elsewhere? Will he not accept this would be most unreasonable to people who have made the hospitals their home for the past 20 years?
In the two hospitals concerned a substantial number of the patients are over 65 years and many are over 75 years. Specific agreed areas of the hospitals will be redesignated as geriatric accommodation.
Therefore, they will not close?
They will be closed as psychiatric hospitals and it is important that they should never again be reopened as such. It is important that the Deputy or whoever is my successor should not have the prospect of so doing, although in fairness to the Deputy I do not anticipate he would change the decision. Part of St. Dympna's Hospital will be redesignated as a geriatric unit to cater for the elderly persons who will require geriatric care and part will be redesignated as a unit for mentally handicapped persons who are now in the hospital. Those are only two of a large number of decisions relating to the area.
For example, a number of domesticscale residences will be acquired in County Carlow, day-care facilities in Carlow will be developed further and an acute admission facility will be provided in Carlow while we are developing the proposed unit in Kilkenny. I can confirm there is still disagreement between the health board and the Department as to the precise location of the acute admission unit in Carlow and I hope I will be able to resolve that issue. I do not wish to go into the services we are providing in County Kildare which is in the catchment area for Carlow but we are substantially down the road with regard to that matter.
33.
asked the Minister for Health if he is aware that a large number of hospital wards will be closed for long periods during the current year; if he is concerned for the implications for patients needing hospitalisation; and if he will make a statement on the matter.
I am aware that some hospitals will close wards for periods during the current year. It is normal practice to close some wards during holiday periods, especially in the summer months, when patient demand tends to be at a lower level than at other times of the year and consultant and other hospital staffs are on annual leave. Temporary closures are also necessary to enable essential maintenance and repairs to be carried out at minimum inconvenience to patients.
Such closures may result in some patients having to wait a little longer for elective admission to hospital, but I can assure the Deputy that adequate arrangements will be available to treat emergency cases.
Surely the Minister is not suggesting that the closures being announced in every health board area and in the voluntary hospitals are the normal closures for maintenance associated with the summer holiday period? I will take just one example, namely, the Mater Hospital where the cardiac surgery unit will close for the month of August and where 50 beds are closed for the remainder of the year. Surely the Minister accepts that this is not a normal pattern of behaviour in Irish hospitals.
Since the Deputy mentioned the Mater Hospital, a widely publicised letter was issued by the chief executive officer of that hospital. I do not want to sound harsh about this but that letter will be the subject of a very critical discussion with the representatives of the Mater Hospital when my officials meet them tomorrow to discuss this issue for the first time. Meanwhile, officers of my Department have been meeting some of the officers from the Mater Hospital and we are coming up with some rather interesting information, including the fact that not one of those proposals was even costed.
I can assure the Deputy that there will not be any closure of the cardiac services in that hospital in the month of August. I am certain of that. If the Deputy has any difficulties finding out the facts, he can consult the Deputy in his party who is in the employment of that hospital. He will know that a lot of what happened in relation to this incident is very disturbing not least in terms of the role of the consultants — and I am not necessarily holding them responsible for that decision. I believe the decision will be dramatically changed, but it is all part of a major campaign to try to screw an extra few million pounds out of the Minister of the day without the slightest shred of justification. A couple of consultants, quite rightly, blew the gaff on the board. I am grateful that they exposed what was a most distasteful and undesirable effort on the part of the hospital, which has a very good budget of £25.4 million. The cardiac unit in that hospital was running well to budget this year and, if the Deputy wants to ask the consultants how that unit was running, he can easily get that information.
The way hospitals have deliberately politicised their budget problems is almost unique to these islands. I am not for one second suggesting that the Deputy is in any way involved, but his good offices and his good sense in relation to the Mater might have been taken for granted.
On what does the Minister base his categoric statement today that these proposals were not costed? Why did he issue statements that consultations had not been held with officials of his Department when apparently consultations have been held on a number of occasions and letters have been written to the Department pointing out what cut-backs would be involved?
There are ongoing discussions with the Mater Hospital but the decision of the board to publish a letter — and I am going on memory because I do not have the letter in front of me — on 28 May to the general practitioners of the catchment area, and I think it was notified to the Department on 6 June, was taken without consultation with the Department. This decision was taken quite deliberately with a view to stirring things up.
The Minister issued a statement that there were no consultations between his officials and the representatives of the Mater Hospital. He is now saying that the savings were not costed. What if I said that the savings for closing the cardiac unit for a month would be £200,000——
The costings were not made available to the Department of Health. To the best of my knowledge the only information made available to the Department was a copy of the notice issued to the general practitioners in the area. I want to stress that at the meeting with the general practitioners when the board representatives were asked what would be the savings under those headings, the board were unable to answer. All they indulged in was cheap abuse of myself and the Department.