Dáil Éireann díospóireacht -
Tuesday, 12 May 1992

Vol. 419 No. 5

Adjournment Debate. - Dundalk (Louth) Hospital Ward Closure.

Mr. D. Ahern

I should like to share my time with my colleague, Deputy McGahon on the other side of the House because the closure of a ward in Louth County Hospital is an issue about which we feel very strongly. It involves 28 beds and five cots in the male surgical ward in that hospital.

Circumstances arose recently in which members of the North-Eastern Health Board were not informed — I want to protest about that fact here in the only forum available to me — as to what was proposed. That was not right and we should have been informed at the first available opportunity.

As I understand it the saving being made by a ward closure, according to figures given to me some time ago, in one month is £20,000. I find it ludicrous that a ward should be closed with the consequent trauma created in the minds of the public, particularly in the minds of people who feel that in some way the hospital is being downgraded. If the saving involved amounts to £20,000 only then it should be ascertained whether there is a better way of saving such money rather than taking this drastic step.

Deputy McGahon and I have been approached by people in recent weeks who are concerned about what is happening in the hospital. For example, over the past weekend a woman came to me whose husband had been rushed to Louth County Hospital. Her husband's life had been saved in that he had been in a life-threatening condition. That woman remarked that it would be awful if the hospital was closed, the perception being that, because the ward is being closed, albeit for a number of months, ultimately the hospital will be closed.

I thank the Minister for coming to listen to what Deputy McGahon and I have to say. A number of people are extremely worried and the case I instanced is just one example. I have heard of another case, perhaps the most ludicrous of all, of a VHI patient who was willing to pay — she was due to have an urgent hysterectomy — having to go across the Border where that operation was performed today in Newry. That patient could not obtain a bed in Louth County Hospital. She was quite willing to pay for a bed, she could not get one which meant the VHI money went outside this State to Newry.

I appeal to the Minister to examine this matter carefully. I know he is aware of the position and will come to Louth in the near future to discuss it. On previous occasions the Minister admitted that the North-Eastern Health Board incur the lowest per capita spending on health nationwide. We should like to know why. I am told there is a historical reason.

Mr. McGahon

I appreciate Deputy Dermot Ahern sharing his time with me, which is a measure of the concern we feel about the shadow hanging over Louth County Hospital.

Perhaps Deputy Dermot Ahern and I are at cross-purposes to some extent in that he referred to the male surgical ward which has been closed whereas my concern is at the postponement of hysterectomy operations in that hospital. I do not have to tell the Minister that many hysterectomy cases carry the inherent threat of cancer. There are now waiting lists of three months duration which, in the case of some people, maybe too late.

I have great hopes in the present Minister because of his radical approach to circumstances prevailing in the medical services generally. I appeal to him to re-examine the circumstances prevailing in the poorest town in Ireland which has double the national average unemployment with many thousands of poor medical card holders whose hospital is overshadowed by the glamorous hospital in Drogheda and has suffered as a result. It is my belief that Louth County Hospital is in the process of being closed by stealth. The position is that gynaecological patients have had to wait for three months which is totally unacceptable. Indeed, in the days when the British ruled this country, people had less to live on but were at least assured of a hospital bed.

I ask the Minister to examine the overall position in Louth County Hospital and upgrade that hospital. If the day comes about when I will be a member of a party in Government I will vote against that party if they do not give an assurance that Louth County Hospital will be saved and, indeed, upgraded.

Mr. D. Ahern

I too.

Minister for Health (Dr. O'Connell)

I should like to thank Deputies Dermot Ahern and McGahon for raising this matter and affording me an opportunity of clarifying the position. Of course, the Deputies will be aware that the provision of services at Louth County Hospital, in the first instance, is a matter for the North-Eastern Health Board.

The board receives an annual allocation from my Department for the provision of health services for their catchment population. This year the board received an overall revenue allocation of £72.472 million, representing an increase of £8.6 million or 13.5 per cent over the 1991 original allocation or £63.9 million.

The allocation of resources between individual programmes within the total provision made available by my Department is a matter for the North-Eastern Health Board. I understand that the board's budget for their general hospital programme for this year is £25.6 million compared to a 1991 budget of £22.9 million, representing a very significant increase of 11.8 per cent.

In relation to Louth County Hospital, which is funded as part of the board's general hospital programme, the budget for 1992 is £5.6 million as against an original budget for 1991 of £4.9 million, the increase being 14.7 per cent. It will be apparent from these figures that the allocation made available for services at Louth County Hospital for 1992 compares favourably with the resources allocated for the board's general hospital programme generally.

With regard to the ward closures at the Louth County Hospital, I wish to say that there is nothing new in these arrangements. Seasonal closures are a normal occurrence for almost all acute hospitals. Last year, for example — as I am sure Deputies are aware — 34 beds were closed at the Louth County Hospital during the summer period, that is from the beginning of June to the beginning of August. This did not have an adverse effect on the service provided at the hospital. In fact, despite the seasonal bed closures last year, the number of admissions increased by 3 per cent over the previous year from 6,101 admissions in 1990 to 6,283 admissions in 1991.

With regard to the current year, I understand the North-Eastern Health Board agreed that the timing and arrangements for seasonal closures should be left to the local management of the individual hospitals concerned.

In the case of the Louth County Hospital, the decision has been made at local level to close 28 surgical beds from 3 May for a two month period, to be extended for a further two week period, if appropriate, depending on service needs. The timing of the closures has been chosen to coincide with staff holidays and also to have the least possible effect on the service needs of patients. I understand that the hospital will be providing day surgery for three days per week, including one day for gynaecological work during the period of the seasonal closure of the beds. This will help to lessen the impact of the closures. The situation will be constantly monitored by the board to ensure that no undue hardship is caused as a result of the seasonal closures. However, I should stress that, as in the past, all emergencies will continue to be received and treated by the hospital during the period of these seasonal closures.

In the context of the seasonal closures — this is the information available to me — it is important to point out that there are no waiting lists at the Louth County Hospital at present and there were none during the period of the bed closures last year.

Mr. McGahon

Nonsense.

Dr. O'Connell

This conflicts with the Deputy's information.

Mr. McGahon

It is propaganda by the health board.

Dr. O'Connell

The Deputies can rest assured that the North-Eastern Health Board and the local management at the Louth County Hospital are adopting a very sensible and responsible approach to these seasonal closures and that the impact on the service will be kept at a minimum.

I will be visiting Louth County Hospital in the near future and I will keep the Deputies informed of everything that takes place. I will also have the position in the hospital monitored by my Department and if any problems arrive or any inconvenience is caused to patients, I will look at the matter immediately and rectify it. I should like to assure the Deputies that I will keep in touch with them. I hope I will meet them when I visit the Louth County Hospital.