Bernard Allen
Ceist:246 Mr. Allen asked the Minister for Health and Children the number of cardiac surgery cases performed in the Mater Hospital, Dublin 7, in each of the years from 1996 to 1998. [22250/99]
Written Answers. - Hospital Services.
Bernard Allen
Ceist:249 Mr. Allen asked the Minister for Health and Children if he will make a statement on the fact that the number of cardiac surgery cases performed at the national cardiac centre at the Mater Hospital, Dublin 7, was down by almost 200 in 1998 due to a shortfall of theatre and intensive care unit nurses. [22254/99]
I propose to take Questions Nos. 246 and 249 together.
The following number of cardiac surgery procedures were carried out in the Mater Misericordiae Hospital in each of the three years from 1996 to 1998. For comparative purposes the national cardiac surgery procedures figures for the same period are also included.
|
Mater Hospital |
National |
|
|
1996 |
1,021 |
1,551 |
|
1997 |
978 |
1,660 |
|
1998 |
882 |
1,534 |
I have had inquiries made of the Mater Hospital regarding this matter and have been informed that the reason for the decrease in the number of cardiac surgery cases performed in 1998 is due to a shortage of skilled nurses in theatre and the intensive care unit. The hospital management is actively involved in trying to recruit specialist nurses for this area and have put a number of initiatives in place. These include conducting interviews for nurses in the UK; improving car parking arrangements for nursing staff; providing study leave for approved courses; facilitating flexible working hours and putting educational facilitators in place to address issues regarding post registration nursing.
The principal difficulties relating to the recruitment and retention of nurses are concentrated in the Dublin area. While some nurses have always moved from Dublin to other parts of the country, investment in hospitals and the development of regional specialties over recent years have increased demand for nurses outside the Dublin area. Within Dublin, issues such as housing costs, traffic problems and lack of car parking facilities have been cited as disincentives to the recruitment and retention of nurses. However, these issues are not unique to nurses or to the health service.
While the recruitment of nurses is primarily a matter for individual employers who take their own initiatives in this regard, a range of initiatives have been taken or are being progressed with a view to stabilising the situation and where possible improving it. These initiatives include the following: arrangements have been agreed with the nursing unions to allow more favourable assimilation arrangements on to pay scales for nurses taking up both permanent and temporary appointments; a significantly improved regime of allowances in respect of nurses working in specialised areas such as operating theatres and intensive care units is being introduced; discussions with the nursing unions are continuing in relation to the introduction of more flexible working arrangements for nursing staff; standardised overtime working arrangements have been introduced following agreement with the nursing unions; health service employers have been asked to examine the possibilities in relation to the introduction of term time working as an option for staff with family commitments; the availability of return to working courses for qualified nurses who have been out of the work force is being reviewed with a view to maximising uptake; the Department of Health and Children is currently engaged in discussions with health agencies in relation to the provision of specialist nursing courses at centres outside Dublin; an anti-bullying policy has been prepared and agreed with the nursing unions and is due to be published shortly; the promotional structure within nursing, including the introduction of a clinical career pathway, is being significantly improved on foot of the recommendations of the Commission on Nursing; a "Study of the Nursing and Midwifery Resource" by the nursing policy division of the Department of Health and Children commenced last year with the primary purpose of forecasting future nursing and midwifery resource needs; almost £400,000 was allocated this year to underpin a recruitment campaign, at both local and national level. This was a success as more than 5,500 applications were received this year, an increase of over 40 per cent on the 1998 figure; the annual maintenance grant for nursing students, which is not subject a means test, has been increased from £2,500 to £3,250 since 1997. The grant now is almost double the maximum grant for which other third level students may qualify; the range of leaving certificate subjects that may be presented by an applicant for admission to the nursing diploma programme has been expanded; and the requirement to have a foreign language in the leaving certificate has been removed.
The changes outlined, together with the national and local recruitment campaigns which I funded, have resulted in a highly successful outcome to this year's competitions for training places on the nursing diploma programmes. A total of 1,215 training places have been filled: 812 in general nursing, 254 in psychiatric nursing and 149 in mental handicap nursing. This is the largest number of direct entrants to nurse training for several years and proves that there continues to be considerable interest among young people and others in nursing as a career. I also made available funding for some 100 extra training places in general and psychiatric nursing this year and these have been offered to applicants who successfully came through the competition. A further 300 training places will be made available from next year.
In relation to cardiac surgery waiting lists in general, 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. 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. The cardiac surgery waiting list initiative has a positive impact on the public cardiac waiting list. The total number of public patients awaiting cardiac surgery has reduced from 1,619 in September 1997 to 1,106 in June 1999, representing a reduction of 32 per cent.
As Minister for Health and Children, my priority is to address the existing cardiac surgery waiting lists and the ultimate objective is to achieve an average six month waiting period for those on the lists. 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 reduce the waiting lists which exist at present. Target activity levels are in the region of 450 procedures annually at St. James's Hospital and 300 procedures at UCHG. This additional activity will increase existing adult public cardiac surgery capacity by over 50 per cent. 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.