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Dáil Éireann díospóireacht -
Thursday, 15 Mar 1990

Vol. 397 No. 2

Adjournment Debate. - County Dublin Hospital Waiting List for Tonsil Operations.

This case relates to a child who has spent two years waiting for a tonsil operation at St. Michael's Hospital, Dún Laoghaire. Indeed, this child has also been on the waiting list of the Children's Hospital in Crumlin. During that time 19 courses of antibiotics have been prescribed to ease that child's pain.

I understand that a bed has now been offered to the child in the Children's Hospital, Crumlin. Nevertheless this case raises a number of serious questions about children who are waiting for tonsil operations in the Dún Laoghaire area. I am aware of another child for whom doctors had to prescribe repeated courses of antibiotics. The problem is that there is a two year waiting list for tonsil operations in St. Michael's Hospital, Dún Laoghaire. I understand that 117 people are awaiting operations and that the consultant concerned can only operate on one or two patients per week.

It is a scandal that young children in pain should have to wait for such operations. Very often the parents of these children stay with them until the early hours of the morning to ensure they are so exhausted they will fall asleep. Their doctors are concerned about having to prescribe repeated courses of antibiotics in the first place and their teachers are concerned about the consequences of them missing school and the effects on their schooling.

This was not always the case in the Dún Laoghaire area. Before the closure of Monkstown Hospital it was possible to get a tonsilectomy within a couple of weeks of being referred by a doctor. The problem that has arisen is as a direct result of the cutbacks in the health service. Monkstown Hospital was closed and was a huge loss to my constituency. On top of that the number of beds at St. Michael's Hospital has been reduced from 145 in 1987 to 95 at present. This is one of the reasons why children like the one I have referred to have difficulty in getting in for operations because even if they are booked in somebody may come in on a casualty case and the bed may be taken up when they are due to have their operation.

The third reason there is a problem in St. Michael's Hospital in Dún Laoghaire is that the children's ward was closed about two years ago. I do not think it is desirable that the only way a child can get into hospital to have an operation is if a TD manages to raise the issue on the Adjournment. I certainly do not want to find myself having to raise repeated individual cases of children who are waiting for operations. The only way this can be avoided is if the children's ward in St. Michael's Hospital is reopened. There is a long waiting list for tonsilectomies. Most of the 117 patients are children and this is a direct result of the closure of the children's ward.

Quite apart altogether from the effect on the waiting list of having the children's ward closed, it is undesirable that young children going in for an operation which is a traumatic experience for them would be put into adult wards. I have spoken to parents with children who are going into hospital and who have told them that there will be a special children's ward, that they will have other children with them, an opportunity to play and so on and have found that the child is then admitted to an adult ward. It is a traumatic enough experience for a child to have to go into hospital without having to meet the unexpected as well.

For two reasons, therefore, I am asking the Minister of State to, first of all, examine the waiting list for tonsilectomies in the Dún Laoghaire area, specifically for St. Michael's Hospital and, as an immediate measure, to have the children's ward reopened. There were 16 beds in that ward originally. Even if it were reopened on a partial basis that waiting list could be reduced. The necessary resources should be provided to St. Michael's Hospital to enable them to do that. It is not acceptable that we should have such a long waiting list and young children in pain, their parents worried about them, doctors having to prescribe repeated doses of antibiotics for them all resulting from the reduction in the number of beds in the hospital and the closure of the children's ward.

I am pleased to have an opportunity to reply to Deputy Gilmore on this matter. I am aware that there are difficulties at present with the waiting list for children's ENT cases in St. Michael's Hospital, Dún Laoghaire.

If in any individual case the patient or parents of a patient are concerned that their condition is worsening they should contact their general practitioner with a view to having the consultant review the priority attached to the case.

The Minister, Deputy O'Hanlon, recently met representatives of St. Michael's Hospital and discussed the present financial position of the hospital with them. He has asked the hospital to review their service plan in the light of these discussions and to submit new proposals for activity in the remainder of 1990. On receipt of these proposals, the Minister for Health and I will be examining the hospital's total service plan, in the light of the known needs of the hospital's catchment area.

I should like to point out that an extra allocation of £100,000 was made to the hospital sometime ago to assist with its financial situation. As Deputy Gilmore has pointed out there is a total of 117 patients on the waiting list for ENT inpatient treatment. These include 110 children and seven adults. I should point out that sometimes when people go to their GPs and are referred to the hospitals they expect that they will then automatically be called. In any case, after the referral there must be an assessment by the consultant who will prioritise based on the gravity of a situation and decide when that patient should be called for surgery.

The ENT surgeon post became vacant about four years ago when the then holder of the post retired. The post is now filled on a locum basis by another consultant who does two sessions per week, one operating session and one outpatient session. In the light of the difficulties being experienced at present in the ENT service for children at the hospital, my Department will be paying special attention to possible strategies for improving the situation.

Deputy Gilmore referred to cutbacks in the health services. Let me point out to him that this year the Government allocated £1.4 billion, 21.5 per cent of total Exchequer expenditure proposed for 1990. This is the highest allocation for any Department and is proof positive of the commitment of the Government to maintaining a modern health care service for our people. The Minister for Health also announced recently that two major initiatives are being taken. One is the Dublin hospitals initiative under the chairmanship of Mr. David Kennedy, the former Chief Executive of Aer Lingus, who will be examining the totality of services in the Dublin acute hospital services, the admissions and the proposals for rationalisation and equalisation of services across the Dublin area where massive amounts of money are being spent, particularly in the acute hospitals. We also have a second initiative where Mr. Noel Fox and an efficiency audit group are examining the efficiency of all the acute hospitals in the country because we believe it is vitally important to give the best service possible and get the best value for money so that people do not have to wait very long for necessary services.

I hope these two initiatives and the prioritising of particular cases by various consultants will ensure that people who need emergency treatment will get it quickly. We will, as Deputy Gilmore has requested, review the whole ENT situation in St. Michael's.

What about the children's ward?

That is a matter for the hospital based on its own allocation of resources, but we will consider the whole ENT situation and see what we can do.

The Dáil adjourned at 4.20 p.m. until 12 noon on Wednesday, 21 March 1990.

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