Written Answers. - Wexford Orthopaedic Service.
John Browne
Ceist:
50
Mr. Browne (Wexford)
asked the
Minister for Health
the arrangements, if any, he is making to have a proper orthopaedic service provided at Wexford General Hospital; the reason the full-time orthopaedic surgeon was withdrawn from Wexford General Hospital; and the plans, if any, he has to re-appoint this person.
[7527/95]
Limerick East): A major review of orthopaedic services in the south east region was undertaken by a joint Department of Health-Comhairle na nOspidéal Review Group during 1991-92. The main impetus for the review was the general level of dissatisfaction at the organisation of orthopaedic services in the region. Waiting lists for elective orthopaedic surgery were growing because of the volume of trauma cases being dealt with in Lourdes Orthopaedic Hospital, Kilcreene. It had been envisaged that Kilcreene would be solely an elective orthopaedic hospital but for a variety of reasons the situation had developed to one where approximately 60 per cent of the workload being performed there was trauma. The review was undertaken to advise the South Eastern Health Board on the organisation of orthopaedic services for the region in the most effective and efficient manner.
The main recommendations were as follows:
—that in the best interest of patient care, elective orthopaedics in the SEHB region should be centralised in Waterford Regional Hospital. As the building programme is completed at Waterford Regional Hospital and as finances permit, the hospital should be staffed appropriately to meet the regional role envisaged for it.
—that the best interests of patient care would also be served by all major orthopaedic trauma in the south-eastern region being transported directly to Waterford Regional Hospital where the patients would be managed by a team of orthopaedic surgeons to be based there.
—that the centralisation of both elective and major orthopaedic trauma at Waterford Regional Hospital would facilitate the development of a centre of excellence of orthopaedic practice in the south-east. The review group envisaged that the centre would be staffed by six orthopaedic surgeons. A centralised orthopaedic service would provide a 24 hour service for major orthopaedic trauma producing a higher standard of care than existed previously. A higher standard of orthopaedic surgery, and consequently patient care, would result in a larger throughput of patients requiring regular practice of a wider spectrum of orthopaedic skills.
—that regular and frequent consultant orthopaedic in-put should be made to each of the three general hospitals — St. Lukes, Kilkenny, Wexford General Hospital and Our Lady's Hospital, Cashel — by the consultant orthopaedic staff based at Waterford.
—that a reorganisation of the ambulance service should take place. This reorganisation should have, as a major objective, the minimisation of additional travel impositions on patients as well as the efficient transporting of trauma cases from the scene of accidents to the regional centre.
—that the implementation of the review group's recommendations required the designation of about 60 beds for orthopaedic trauma from within the total bed complement of Waterford Regional Hospital.
—that the transfer of elective orthopaedics from Kilcreene Hospital to Waterford would require the provision of additional facilities. Pending, the emergence of such facilities, it envisaged that all elective orthopaedics for the region would continue at Kilcreene Hospital.
—that the medical benefit to patients and the economic advantages in centralising orthopaedic services outweigh the disadvantages. The review group was convinced that the opportunity existed to dramatically improve the orthopaedic service for the people of the south-east by centralising both the trauma and elective services in Waterford Regional Hospital.
The report of the review group was discussed at the general hospital programme committee of the South Eastern Health Board and subsequently at the board meeting on 11 February 1993, where a full discussion on all the issues took place. The South Eastern Health Board decided that the treatment of major orthopaedic trauma cases should be centralised at Waterford Regional Hospital. In parallel with this, a decision was also taken that elective orthopaedic cases should continue to be performed at Kilcreene Hospital.
The implementation of the decisions made by the South Eastern Health Board in relation to the re-organisation was completed in late 1994 with the centralisation of major orthopaedic trauma cases at Waterford Regional Hospital. I understand from the South Eastern Health Board that the improvement in the service has resulted in patients seeking orthopaedic services within the region who would in the past have travelled outside, mainly to Dublin.
The consultant orthopaedic surgeon has not been withdrawn from Wexford General Hospital and continues to see patients at fracture clinics and out-patient clinics. I would like to point out however, that under the existing arrangements none of the consultant orthopaedic surgeons in the South Eastern Health Board region works exclusively in any one hospital.
