Dáil Éireann díospóireacht -
Tuesday, 12 Dec 1995

Vol. 459 No. 6

Adjournment Debate. - Mullingar (Westmeath) Neonatal Service.

Mrs. O'Rourke

I ask the Minister to examine the potential closure of the neonatal unit at Mullingar General Hospital. It has been vital in the midlands area served by Mullingar hospital as the nearest service available is in Dublin. The Minister may tell me, as the health board has told me, that there is no neonatal unit in Mulingar General Hospital. However, I have visited it and seen the dedicated nursing care expertly given to the babies there, and to say there is not such a unit is to play with words. It has evolved over the last four years and has played a vital role. The infants can be brought to Dublin by ambulance but that takes time and a few minutes can mean the difference between life and death.

I visited the unit last September and spoke at length to parents who were sitting with their infants. It was of great comfort to them that a unit providing such care was available in Mullingar. The Department and the Midland Health Board are not taking this issue seriously. I understand the Midland Health Board made an arrangement last May with the nurses organisation that it would give proper staffing to the unit. That fell through because of an embargo on public service recruitment. The Midland Health Board now says some of the extra staffing which it and the INO is looking for may come from the unit. The Minister may say that if the health board prioritises the neonatal unit he has no difficulty but the board does not have the funds to do that.

Over the years the MHB has been a good manager. When I was in the Department of Health for three months I met the chief executive officer and chairman of each health board, we went through all the budgets and I presented the Estimate for the Department in that period. It struck me that the MHB was the most careful health board with its money — it comes within or close to its budget each financial year — yet health boards which overrun their budgets get the same pro rata allocation as it does. It may be that because the board is such a good manager it does not get any special treatment.

I will not stray into the issue of industrial relations within the Midland Health Board as there will be other debates on that. I am here to speak about the neonatal unit. I do not agree there has never been such a unit there — I visited it three months ago, so it did exist. It is a matter of public record in the INO annals that staffing commensurate with the work being carried out was promised. That fell through because an embargo was placed on recruitment. The issue has raised its head again and has been cynically used by the MHB and Department of Health. The Minister will say that if the MHB prioritises it can have the nursing staff and put them into the unit.

There are three general hospitals in this vast area — I am concerned with a small unit which is a valuable and valued resource. I ask the Minister to ring-fence special funding and staffing for the neonatal unit in Mullingar General Hospital. I pay tribute to all those who nursed and cared for young babies there. We pay lip service to being prolife and to care of children, infants and families — this is a chance to put what we all believe into practice and to give it proper funding.

Mr. Noonan

(Limerick East): With your permission, a Cheann Comhairle, I will give some of my time to Deputies McGrath and Penrose.

An Ceann Comhairle

That is satisfactory.

Mr. McGrath

I thank the Minister for giving me some of his time. The paediatric unit in Mullingar general hospital opened in 1990 and since then a tremendous level of care has been developed within it. It provides excellent care for new-born babies and those in extreme difficulties. A neonatal unit has evolved and developed quite slowly over the past four years — the nucleus of such a unit exists there at present. We are happy to have that unit in our area and hope it can be nurtured and developed. The Midland Health Board is the only one in the country without an official neonatal unit and this must be put right. I ask the Minister to use his good offices to liaise with the MHB to ensure a proper neonatal unit is established in that area.

Mr. Penrose

I too thank the Minister for sharing his time. I stress the importance of the neonatal unit to Mullingar General Hospital and ask the Minister to instruct the Midland Health Board to ensure the continuance of this important facility. It has served a role in the provision of crucial maternity services in the MHB area and particularly for the people of Westmeath. The MHB must immediately set about giving priority to the provision of the necessary complement of staff so that the neonatal unit is allowed to continue to provide the excellent care and services it has to date, to which we have become accustomed and which has been in existence since 1990.

The Midland Health Board has been extremely prudent in controlling its budget and has often paid the price for this prudence. Many steps were taken by the board over the last decade but these do not appear to have been rewarded. I ask that an extra allocation be made available to it so that the staff may be provided.

Mr. Noonan

(Limerick East): I am pleased to have this opportunity to outline the arrangements which have been made for the development of paediatric services in the Midland Health Board area and, in particular, to provide details of the developments at Mullingar General Hospital.

The development of the paediatric unit at Mullingar hospital has taken place in the context of a major upgrading of paediatric services generally in the Midland Health Board area. The unit at Mullingar is one of two consultant-staffed paediatric units which have been established at Portlaoise and Mullingar general hospitals during the past ten years. Both these units provide a broadly similar level of care for new-born infants in conjunction with the maternity units at those hospitals. The level of care required by new-born infants can vary considerably, depending on the condition of the child. This can range from routine post-natal care to extremely specialised neonatal intensive care, requiring a dedicated unit under the direction of a neonatologist and possibly requiring the involvement of other paediatric sub-specialists.

In common with most other paediatric units around the country, the highest level of neonatal care is not provided at Mullingar or Portlaoise. However, the level of service provided at Mullingar caters very well for the vast majority of cases which present there. This is reflected in the small numbers of new born babies transferred from Mullingar to the more specialised units. A similar level of care for new-born infants is provided at Portlaoise and the criteria for the transfer of children to other units are similar to those which apply at Mullingar.

The paediatric unit at Mullingar will continue to provide the agreed level of service for which funding and staffing was provided when the unit was established in 1990. Should the Midland Health Board wish to consider expanding the service to include a higher level of neonatal care, the matter will be examined having regard to its overall priorities for development of acute hospital services in the Midland Health Board area and the accepted criteria for the development of specialised neonatal services.

In conclusion, I confirm there is no question of closing any facility associated with the paediatric or maternity units at Mullingar. The issue which the Deputy raises concerns the level of specialist care to be provided and I have explained that the agreed level of service will be maintained.