Written Answers. - Hospital Services.
Richard Bruton
Ceist:
143
Mr. R. Bruton
asked the
Minister for Health and Children
if his attention has been drawn to the fact that the Mater Hospital, Dublin 7, is unable to deal with any coronary by-pass patients on the elective list and admissions for surgery are solely from those already in hospital due to serious deterioration in their condition; and the proposals, if any, he has to deal with the shortage of nurses to provide theatre and intensive post-operative care which has resulted in this crisis.
[5423/99]
The Mater Hospital is funded to provide 1,000 cardiac procedures per annum. I have recently been advised by the hospital that patients on the elective waiting list for cardiac surgery are not currently being admitted due to the unavailability of skilled nurses in its intensive care unit and operating theatres. However, the hospital continues to supply its emergency cardiac surgery service within available resources.
The Deputy will wish to know that officials from my Department met with the hospital authorities in January 1999 to review the outcome of the 1998 waiting list initiative and to discuss arrangements for dealing with the national cardiac waiting list during 1999. A further meeting regarding this issue has been arranged for later this week between officials from my Department and representatives from the three public sector adult cardiac centres. In the context of this meeting, it is intended to discuss the particular difficulties being experienced by the Mater Hospital, their proposals to resolve these difficulties and potential options which may be available to address these problems across all cardiac surgery sites.
The Deputy will be aware that in 1998 I allocated funding of £2.3 million under the cardiac surgery waiting list initiative, with the specific aim of reducing the national cardiac surgery waiting list for adults and children. Despite the difficulties at the Mater Hospital in recent months, referred to above, the impact of the 1998 cardiac surgery waiting list initiative was to reduce the overall numbers waiting – adults and children – at the end of September 1998 by 349. This represents a reduction of 22 per cent on the figure for September 1997. In 1999, I have made provision for the allocation of £4 million under the cardiac surgery waiting list initiative and I am confident that this funding will build on last year's success in reducing the total number of adults and children on the waiting list.
As Minister for Health and Children, my priority is to achieve an average six month waiting period for patients on the national cardiac surgery waiting list. I am confident that the development of additional adult public cardiac surgery facilities at St. James's Hospital, Dublin, and University College Hospital, Galway, will help achieve that objective. The proposed additional target activity levels are in the region of 450 procedures annually at St. James's Hospital and 300 procedures at UCHG, which represents an increase in the existing adult public cardiac surgery capacity of over 50 per cent. Last week, I was pleased to announce that I have approved the acceptance of tenders for the new cardiac unit in St. James's Hospital at a total cost of £6.1 million. This development is scheduled for completion by the end of this year. I am also developing additional children's cardiac surgery capacity at Our Lady's Hospital for Sick Children, Crumlin, in association with the national cardiac unit, Mater Hospital, to provide for up to an additional 100 cardiac procedures for children. This additional activity will increase existing paediatric cardiac surgery capacity by up to 40 per cent. Pending the completion of this infrastructural investment, I intend to use waiting list initiative funds to target those patients who have been waiting in excess of 12 months.
I am very conscious of the need to ensure that there is a pool of skilled staff available to the cardiac units when they are operational. To this end, in July 1998 I approved a programme of training for nurses and perfusionists at a cost in the region of £500,000 over a period of two years and this training is now under way at the Mater Hospital.
The problem of nurse shortages is an issue which has become more apparent in recent times. While the recruitment of nurses is primarily a matter for individual employers, the overall issue of the availability of nurses is being kept under review by the Health Service Employers' Agency – HSEA. The HSEA established a task force in 1998 to examine the full nature of the difficulties in recruiting nursing staff and to make recommendations on appropriate action.
The Deputy will be aware that I launched the competitions for places on this year's nursing diploma programmes on 20 January 1999. I also announced an increased annual maintenance grant of £3,250 payable to nursing students and the provision of funding of £350,000 to An Bord Altranais, which now manages the nursing careers centre, and various schools of nursing for a recruitment campaign, at both national and local level, aimed at attracting more young people to enter nursing. The closing date for applications for nurse training was last Friday 19 February. I am pleased to note that approximately 6,000 applications have been received which represents a 50 per cent increase on 1998. I am hopeful that a full uptake of all the available training places will result from this increased level of interest.
It should be pointed out that Ireland is not in a unique position in relation to the shortage of nurses. The reality is that the United States, the United Kingdom and most other European countries are also experiencing a shortage of nursing personnel. Nurses with specialist qualifications in areas such as cardiac care are particularly sought after. Arising from the work of the task force, the HSEA outlined to the nursing unions in November 1998 a number of initiatives to address the shortage, including the standardisation of overtime rates and full incremental credit on permanent appointment for relevant previous nursing experience both at home and abroad. The response of the nursing unions to these measures has been positive. In addition, the HSEA has agreed to the introduction of more flexible working arrangements for nursing staff. The HSEA expects to be in a position to announce details of this scheme shortly.
Having regard to the difficulties being experienced by hospitals in recruiting nurses, it should be noted that my Department engaged a nurse researcher in late 1998 to specifically study nurs ing needs for the coming years and to carry out research on the reasons why nurses are leaving their profession. When this research has been completed, my Department will be in a better position to further address the issue of nursing shortages.
The Deputy will be aware that the Labour Court recently recommended significant improvements in existing allowances for nurses working in specialised areas, including theatre and intensive care, and who hold special qualifications. The court also accepted that there are grounds for improvements in the pay of ward sisters and higher grades to reflect the new roles proposed for those grades in the report of the Commission on Nursing and recommended that the parties enter into discussions immediately on implementation of that report, those discussions to be completed by 1 May 1999 at which stage the parties are to report back to the court.
I announced on 10 February that the Government was prepared to accept the Labour Court recommendations. The Deputy will be aware that discussions between the HSEA and the nursing unions began last week. I am confident that the process which is now under way provides a way forward for implementing the report of the Commission on Nursing which sets out a coherent framework for the future development of the nursing profession and contains a large number of wide-ranging recommendations designed to address the real underlying problems within nursing.
