Léim ar aghaidh chuig an bpríomhábhar

Dáil Éireann díospóireacht -
Wednesday, 3 May 1995

Vol. 452 No. 3

Adjournment Debate. - Enniscorthy (Wexford) Hospital.

(Wexford): I thank you, Sir, for giving me an opportunity to raise this important issue. St. John's Hospital, Enniscorthy, has been long regarded as one of the best geriatric hospitals in the country, with excellent nurses and general staff. It covers a wide hinterland catering for patients from all over County Wexford. The hospital has moved with the changing needs of the elderly. It provides geriatric services, day care, rehab and outreach facilities as well as meals-on-wheels. Every aspect of the needs of our senior citizens is catered for excellently by St. John's Hospital. Those services are being provided while staffing levels are totally inadequate, much below that required for the proper provision of such facilities.

St. John's Hospital has a total of 190 patients at night time and the nurses' organisation has informed me there is a shortfall of some 18 nurses in the hospital. Ten nurses are urgently required to provide proper night duty care. At present nine wards are covered by five night nurses when at least one nurse per ward is required. Night nurses must look after the needs of 50 patients, both upstairs and downstairs. They spend their time moving from ward to ward and going up and down stairs. It is difficult for them to provide proper care and attention to the 50 patients they are looking after. In other wards there is one nurse taking care of 23 patients during the day. There are 16 patients in the rehab unit, many of whom are very ill and have been sent from Wexford and Ardkeen hospitals to recuperate following hip and other limb operations. One nurse takes care of those 16 patients on a daily and nightly basis.

The demands on the staff of St. John's Hospital have increased dramatically in recent years. The hospital caters for geriatric and cancer patients, people suffering from senility, recovering from many types of limb operations and ailments as well as providing day care and many other services to the wider community. The staff have done their best to provide a decent standard of care against all odds and have lobbied in a peaceful manner up to now, but to date have been ignored by the health board and the Department of Health. The health board recently offered the hospital two additional nursing posts. This is an insult to the excellent nursing staff at the hospital.

The nurses are not prepared to take any more and are certainly not prepared to continue lobbying in a peaceful manner. They have decided to take a tougher stand and from 12 p.m. to 2 p.m. on Monday next they will take strike action and will not provide services at the hospital. They have had many meetings with the South-Eastern Health Board, but have been offered only two additional nursing posts. There appears to be much passing of the buck, the South-Eastern Health Board is blaming the Department of Health and the Department of Health is blaming the South-Eastern Health Board. This is no way to treat the 190 patients and the excellent staff at St. John's Hospital. They deserve better.

I appeal to the Minister of State, who is from the south east region and is well aware of the excellent services provided by that hospital, to make the necessary staff available. As the hospital provides a service for the whole of County Wexford it is important that the nurses are at their posts. They have remained at their posts for a long time despite being overworked. Will the Minister intervene between the South-Eastern Health Board and the nurses' organisation to ensure that the necessary staff is made available as quickly as possible so that we can avert the strike action the nurses propose to take on Monday next?

I thank Deputy Browne for raising this matter and for giving me the opportunity of clarifying the position.

The Deputy will, of course, be aware that the provision and management of services at St John's Hospital, Enniscorthy, are matters in the first instance for the South-Eastern Health Board. Decisions on the level of resources available to St John's Hospital are taken by the board, having regard to its service priorities within the overall financial resources available to the board. It is also a matter for the board to determine the appropriate staff mix in its various hospitals including nurse staffing arrangements.

In terms of overall resources available to the board, the board's original non-capital allocation has increased steadily from £104.715 million in 1991 to £160.563 million in 1995. This represents an increase of 53 per cent over the five year period.

In the context of implementing the recommendations on services for the elderly contained in the report, The Years Ahead — A Policy for the Elderly— substantial additional funds have been allocated over the years to the South-Eastern Health Board. The extra funding has enabled the board to expand home nursing services, provide day care centres and day hospitals, increase the number of physiotherapists and speech therapists in the community and develop services for the elderly mentally infirm.

Furthermore, I should add that the introduction of the Health (Nursing Homes) Act, 1990 has provided the South-Eastern Health Board with another option to help meet the needs of the dependent elderly locally. Since the Act came into effect on 1 September 1993, a total of almost £31 million has been made available to the health boards to fund subventions under the Act. At 31 March 1995, 43 nursing homes in the South-Eastern Health Board area had been registered and 420 nursing home subventions had been approved.

In recognition of the priority attached to services for the elderly, an additional £2.2 million has been made available in the current year to further enhance and develop such services. Of this total, the South-Eastern Health Board has received £273,000 which will be used to fund the department of medicine for the elderly in Wexford General Hospital and to continue the development of community care services for the elderly.

The 1995 financial allocation to the board includes specific funding for additional nurse staffing posts at St. John's Hospital, Enniscorthy. In the context of negotiations with the Irish Nurses' Organisation in relation to nurse staffing levels at the hospital, the board has indicated that on foot of the additional funding provided, it proposed an increase of two posts to alleviate the nurse staffing problem. The outcome of the subsequent ballot of members of the Irish Nurses' Organisation was rejection of the board's offer and a vote for industrial action. The action is of a limited nature and will take the form of a lunch time picket commencing on Monday, 8 May 1995. The board does not anticipate that the action will affect patient services and is keeping the situation under review.

In the context of future developments in relation to services for the elderly in the South-Eastern Health Board area, it should be noted that discussions are currently taking place with the Department on proposals which should assist in alleviating overcrowding in St. John's Hospital.

I ask the Deputy to have regard to the commitment of the Government to the continued development of services for the elderly in the South-Eastern Health Board area and express my hope that it will be possible to reach an early solution to this problem.