I am grateful to the Deputies for giving me this opportunity to clarify the situation regarding the closure of the Adelaide, Meath and National Children's Hospitals and the opening of the new hospital in Tallaght.
As the Deputies will no doubt be aware, 21 June 1998 was set last year by the board of the Adelaide and Meath Hospital, Dublin, incorporating the National Children's Hospital as the opening date of the new hospital in Tallaght. Since agreement was reached on the development of the new hospital in Tallaght, it has always been understood that the three constituent hospitals would close when the new hospital is opened. The obvious major concern for people in the area is the continued provision of accident and emergency services. The Eastern Health Board has been involved in a major exercise of mapping the geographical patterns of patient flows into accident and emergency Departments, the purpose of which is to provide information and make recommendations on the requirements of the south inner city area for accident and emergency ambulance purposes.
The factors which determine levels of attendances at accident and emergency departments are complex and difficult to predict, and it is likely that clearer patterns will emerge in the six to nine months following the new hospital's opening. The shift in the pattern of accident and emergency attendances, including paediatric attendances, will be carefully monitored by the Eastern Health Board and any subsequent recommendations will be fully considered in the Department.
What is clear is that when the new hospital at Tallaght opens, it will greatly relieve the pressures on St. James's Hospital and will generate capacity in St. James's and in St. Vincent's Hospital, Elm Park.
More than 20,000 accident and emergency attendances at St. James's come from areas which will be served by the new hospital at Tallaght. This is greater than the existing accident and emergency attendances from the inner city areas at the Meath Hospital. A similar situation exists with regard to outpatient attendances.
I am satisfied that St. James's, which is a fine modern hospital, will be able to meet the acute hospital needs of the south inner city following the opening of the hospital in Tallaght.
As Deputies will be aware, the Adelaide, the Meath and the National Children's Hospitals are voluntary hospitals and as such have full ownership of their sites. When the services transfer to Tallaght, the hospital sites will be sold as the premises will no longer function as acute hospitals.
The plans for the closure of the hospitals and the transfer of services are as follows: The Adelaide Hospital started winding down activity on 25 May and is scheduled to close tomorrow, 12 June, when all remaining patients will transfer to the Meath Hospital; the National Children's Hospital, Harcourt Street, started winding down activities on 7 June and will close on 21 June when all remaining patients — approximately 12 — will transfer to Tallaght; the Meath Hospital started winding down activity on 29 May and will close on 21 June when all remaining acute patients will transfer to Tallaght. Approximately 30 patients who do not require acute hospital services will remain in the Meath Hospital under the care of the Eastern Health Board; acute psychiatric facilities currently provided at St. Loman's Hospital will transfer to the new hospital at Tallaght as soon as possible after 21 June.
My Department, together with the Eastern Health Board and the hospitals concerned, has been examining the broader health service needs of the south inner city catchment population following the transfer of the acute hospital services to Tallaght. The Eastern Health Board's Working Group on the South Inner City Primary Care Needs Assessment identified the problems likely to arise following the relocation of existing services to Tallaght. It recommended the establishment of a primary care centre and the enhancement of general practice and community services in the south inner city, with the primary care centre acting as a central focus for the organisation and delivery of services encompassing the full range of health care and administrative needs for primary care services in the area. The Eastern Health Board is currently examining a number of options for the provision of these services including the possibility of acquiring the Meath Hospital campus.
Apart from the need for a primary care unit, it is accepted that there is an immediate need to enhance general practice facilities in the area to enable general practitioners, especially those in the immediate vicinity of the Meath Hospital, to fill the vacuum created by the absence of the accident and emergency facility at the Meath Hospital. The cost of such improvements is estimated at a minimum at £500,000 and developments are taking place in this area.
The Eastern Health Board has also identified the need to provide secondary rehabilitation, extended care and day hospital facilities for older people living in the area surrounding the Meath Hospital. The possibility of acquiring the Meath Hospital campus for these and other primary care services is being examined by the Eastern Health Board.
In addition, the Eastern Health Board is providing a range of services for older people in the south inner city. A 25 bed community nursing unit which has respite, extended care and day care facilities, is operating at Sir Patrick Dun's Hospital. A 50 bed community nursing unit which provides similar services is located at the South Circular Road and will be officially opened on Monday next. In addition, St. Monica's, a 40 bed long-stay unit at Belvedere Place in the north inner city has come on stream. The Eastern Health Board is also developing proposals to provide secondary rehabilitation, extended care and day hospital facilities for older people living in the area surrounding the Meath Hospital.
Agreement has recently been reached between the board of management of the new hospital at Tallaght, the Eastern Health Board and the Department of Health and Children which will involve the Eastern Health Board providing and managing, in an inner city location, a 60 bed extended care facility for mainly older patients who have been medically assessed as in need of long-term care or who have completed the acute phase of their medical treatment but require convalescent type care before being discharged home. This facility is additional to existing services in the city. Thirty-five of these beds will be available in the Meath Hospital on 21 June to cater for such patients who would otherwise transfer to Tallaght. These beds will be available until August 1999.
While I can understand people's apprehension at the transfer of the Adelaide, Meath and National Children's Hospitals to Tallaght, I can assure Deputies that the Eastern Health Board and St. James's Hospital will ensure that the needs of the locality are met.
The Dáil adjourned at 5.30 p.m. until 2.30 p.m. on Tuesday, 16 June 1998.
