Vol. 511 No. 6
267 Mr. Allen asked the Minister for Health and Children his views on the involvement of general practitioners in accident and emergency units and in the hospital sector in general; and if he will make a statement on the matter. [24995/99]
The Deputy will be aware that in recent years I have provided significant additional funding for the enhancement of services in accident and emergency departments including additional funding of £2 million provided in 1999 as follows:
1. Public Education
Continuation by the EHB of public education campaign, £105,000
2. Initiatives in Accident and Emergency Departments:
(a) AMiNCH
Introduction of measures aimed at reducing pressure from A&E services on acute hospital beds, £100,000:
(b) Beaumont
Continuing physical upgrade to the A&E Department and and the provision of additional staff, £200,000:
(c) Mater Hospital
Towards the conversion of a Day Unit to provide conventional beds to be utilised to alleviate pressure on A&E Department, £210,000:
(d) St James's Hospital
Continued development of rapid diagnostic systems for patients, creation of a patient discharge waiting area/lounge for patients awaiting transfer home, thereby releasing inpatient beds at the earliest opportunity, £210,000:
(e) St Vincent's Hospital
Recruitment of additional staff and the purchase of appropriate care facilities in step down accommodation for patients no longer requiring acute hospital services, £210,000:
(f) The Children's Hospital, Temple Street
Provision of additional staff, £50,000
(g) Our Lady's Hospital for Sick Children, Crumlin:
Improved services in A&E Department, £50,000
(h) Incorporated Orthopaedic Hospital, Clontarf
Provision of step down facilities, £75,000
(i) Western Health Board
Improved nursing and medical cover, £350,000
3. Temporary Acute Beds:
Provision of 20 additional acute hospital beds at James Connolly Memorial Hospital during the winter period aimed at reducing pressure from A&E services on acute hospital beds, £440,000
At St. James's and St. Vincent's Hospitals an attending general practitioner is a feature in the provision of accident and emergency services at these hospitals. The extension of the use of general practitioners to work in conjunction with accident and emergency departments in other hospitals is to be the subject of discussion with the hospitals concerned regarding continuing improvements to accident and emergency services. These discussions will take place in the context of each hospital's service plan for 2000.
268 Mr. Allen asked the Minister for Health and Children if his attention has been drawn to a recent submission by the IMO to the medical manpower forum that a community triage system be set up which could direct patients to accident and emergency departments or general practitioners surgeries as appropriate. [24996/99]
269 Mr. Allen asked the Minister for Health and Children if his attention has been drawn to the recent statement made by the Irish Hospital Consultants Association that maternity units and accident and emergency units were functioning at dangerously low levels of consultant manpower. [24997/99]
278 Mr. Allen asked the Minister for Health and Children his views on the recent IMO recommendation that the concept of shift work be introduced for medical staff in an effort to solve the problem of long working hours and heavy workloads; and if he will make a statement on the matter. [25006/99]
I propose to take Questions Nos. 268, 269 and 278 together.
The staffing of hospitals is a matter for local management in the first instance having regard to the level of service to be provided. The appointment of consultants is a matter for the health boards and voluntary hospitals in association with Comhairle na nOspidéal. The broader question of medical staffing in hospitals is being examined by the medical manpower forum which aims to ensure that high quality and safe hospital services are available to patients at all times; ensure that a fully trained doctor is available to all hospital patients as necessary at all times; ensure that there are sufficient doctors with appropriate training and expertise employed in relevant specialties and disciplines to meet the needs of the patients in the public hospital medical system at any given time; provide for comprehensive teaching, training and research opportunities for public hospital doctors to continue to reach and maintain appropriate standards of professional competence; recognise the important role played by hospitals in the provision of training for primary care and the need to continue and accommodate such training; ensure a professionally satisfying career structure which is capable of attracting and retaining sufficient doctors to meet the ongoing needs of the hospital medical system; develop flexible training, career and employment structures which meet the needs of both male and female doctors; facilitate and support continuing medical education so as to keep abreast of developments and maintain competence; and develop an appropriate employment and superannuation structure designed to support change and flexibility.
270 Mr. Allen asked the Minister for Health and Children if hospital obstetric units in Monaghan and Dundalk are operating with no consultant paediatric rota in place while anaesthetic cover in many hospitals is inadequate. [24998/99]
The provision of hospital services to eligible persons in Monaghan and Dundalk is the statutory responsibility of the North-Eastern Health Board in the first instance. The board has informed me that the Cavan-Monaghan hospital has a complement of three consultant obstetricians-gynaecologists and two paediatricians who provide services within the hospital group. The Louth-Meath hospital has a complement of four consultant obstetricians-gynaecologists and three paediatricians who provide services within the group. Paediatric cover is available at all times in each hospital group. All of the board's hospitals have a full complement of consultant anaesthetists and appropriate junior staff.
