Deputy Lee gave me notice of his intention to raise on the Adjournment the lack of physiotherapy service on the north side of Dublin.
Adjournment Debate. - North Dublin Physiotherapy Service.
I sincerely thank you, A Cheann Comhairle, for giving me the opportunity of speaking on this matter. People may not generally know that on the north side of Dublin, despite what we may hear later, general practitioners do not have direct access to physiotherapy services. Less than a month ago the Minister for Health informed the Dáil that dental services were not working properly and I am sure he will agree that the same applies to the physiotherapy services.
For a patient with a simple condition such as arthritis of the knee or hip or indeed a common condition like a slipped disc or a sports injury, he or she must first attend a general practitioner in his surgery. In many cases the doctor has to refer these people to a rheumatologist or an orthopaedic surgeon and it takes approximately nine or 12 months to get an appointment. When the patient arrives in the hospital, in many cases the surgeon or the rheumatologist will refer them for physiotheraphy. Because of the present cutbacks and the lack of physiotherapists in the hospitals, this takes a further six weeks. In many cases simple physiotheraphy is vital to the mobility of a patient but it can take a year or more before the patient is back at work.
About a month ago a patient of mine was involved in a very serious road traffic accident and, unfortunately, lost a limb. Physiotheraphy was essential for the rapid recovery of this young man but, unfortunately, he was being treated by a physiotherapist in the Mater in an improper fashion. I am in no way implying that the physiotherapist was negligent but she was only newly qualified and because she did not have sufficient expertise or indeed supervision this patient was being rehabilitated improperly.
I will give another example of a patient of mine last year who had a stroke and needed physiotheraphy. The patient is 62 years of age, a diabetic, and has not had any physiotheraphy. The hospital told me last week that because they had so few physiotherapists the in-patients in the hospital were getting priority. They said that the patient to whom I referred would have to wait a further three months before his case would be considered. That is a waiting period of 15 months in total; this person has a very poor quality of life and is immobile
Last week alone the Mater Hospital cancelled their physiotheraphy out-patient service on two afternoons because they did not have sufficient staff. These incidents are commonplace throughout the health service. Perhaps the fault lies partly with the administrators, maybe the hospitals or the Department of Health are to blame but, ultimately, the Minister is responsible. The buck stops with him and he is responsible.
In addition the Government brought in a panic measure during the general election of extra finances for the health service but they failed to make provision for extra resources within the hospital services and there are not sufficient physiotherapists to go around. Unless the Minister, his Department and hospital administrators come together and find a rational solution based on common sense, with the rehabilitation of the community in mind, they will bear a heavy responsibility. I sincerely ask the Minister to provide this vital service for the people of north Dublin immediately. During the general election we also remember that the Taoiseach said he was unaware there was a health crisis and that there was so much sickness and suffering. He was also unaware that the health cuts were having such a profound effect on families and children.
For the first time in the history of the State there is a horrific development where the rich become healthier and the poorer sections of society which, by the very nature of their economic and social circumstances, are more vulnerable to illness and need to attend hospital more frequently, have been relegated to the status of second class citizens. I ask the Minister to look at what is happening on the north side of the city, at the administrators of the hospitals and to provide this very necessary services. It is ludicrous that when I have to refer a patient to a specialist it take nine months to get an appointment. It takes a further six weeks to get physiotheraphy when an intern who is qualified for one week can refer a patient for physiotheraphy. There is something wrong somewhere and I ask the Minister to look into this matter.
Deputy Lee made an allegation that the Taoiseach said during the election campaign he was unaware that there was a health crisis. The Taoiseach did not say that, he said he was unaware of the feelings on the doorsteps about the health services. Having listened to Deputy Lee, who was a candidate in the election, I am not surprised that there was so much hype. The Taoiseach became aware of this. Deputy Lee said that there is no out-patient physiotheraphy services available on the north side of Dublin.
If the Minister would like to come with me I will show him——
I am glad the Deputy raised this question in the House. Indeed I thank him for allowing me the opportunity to set the record straight. The Deputy's statement was to the effect that there is no out-patient physiotherapy service available on the north side of Dublin. That is not correct.
On referral by general practitioners.
Deputy Lee has had his say. He will please restrain himself and listen to the Minister's reply.
The true extent of the service can be appreciated. There are eight hospitals on the north side of Dublin involved in providing out-patient physiotherapy services. Each year approximately 15,000 patients receive out-patient services in hospitals on the north side of Dublin. Generally speaking, referrals for physiotherapy to the north Dublin hospitals are done by way of consultant appointment. This position has pertained at hospitals like the Mater since 1976. Nothing changed since I assumed office except for the better. We shall come to that in a moment.
I fully realise the importance of back-up services like physiotherapy in out-patient departments. It is a most important element in the rehabilitation process, especially for those in the older age group, who should be kept as active as possible.
There are 76 people employed in the provision of physiotherapy services in north Dublin, representing an increase of three on the figure when I assumed office in 1987. This is a substantial number and represents a huge investment in terms of pay costs. It also represents a significant improvement in the quality of life of the many hundreds of patients using the facility.
There is also a physiotherapy service attached to the Eastern Health Board's mobile hospital which provides a service to parts of north County Dublin and was launched by me since I came to power.
Perhaps it would be no harm to mention that right beside the Deputy's home in the Incorporated Orthopaedic Hospital in Clontarf, so far in 1989, 363 patients have received physiotherapy treatment. This translates into 1,334 actual treatments and the hospital accepts patients referred from local doctors in Clontarf. Sometimes we tend to forget the positive side of a service and concentrate on the negative side only.
I would also like to draw the Deputy's attention to a recent development on the north side of Dublin with the opening of a major new extension last week at the Mater Hospital. A new hydrotherapy pool is being commissioned there. I have authorised an additional physiotherapist for its operation. This service will be of benefit to very many patients over the coming years.
How come the out-patients was cancelled twice last week?
The Deputy is credited with saying some time ago that the Mater Hospital has no physiotherapy service at all. I should say that, in relation to the £15 million provided by the Government — mentioned by the Deputy — any requests for physiotherapy appointments from that allocation were acceded to by my Department.
This year alone 15,754 treatments have been given at the out-patient department at the Mater where the waiting time is only a few weeks. There are in fact only 86 people awaiting treatments in circumstances in which 3,500 people have been treated already this year. At in-patient level another 1,600 treatments have been provided. There are 25 physiotherapists employed at the Mater Hospital. Therefore, I simply cannot understand how anybody could say that this level of activity could be mistaken for no service.
The Dáil adjourned at 5.25 p.m. until 10.30 a.m. on Friday, 24 November 1989.