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Dáil Éireann díospóireacht -
Wednesday, 8 Dec 1999

Vol. 512 No. 4

Hospitals Building Programme.

In March this year a report was produced by Betty Brady, the Director of Nursing Studies in Dublin City University. The Health Services Employers Agency recommended that she compile the report. The study highlighted the urgent need for extra funding, staffing and equipment for the hospital, which provides care for almost 300 geriatric patients, many of whom are seriously ill.

I had to invoke the Freedom of Information Act to gain access to this report. Even then, I was only permitted to see the executive summary. It is appalling that the findings of such a study are not freely available. What is the reason for that? With £4 billion swelling the Government's coffers, it is unbelievable that an urgent need for funding and facilities at a hospital such as St. John's can be ignored. The executive summary of the report makes it clear that urgent action is required if patients are to be adequately cared for. However, the health board has put little funding, with the exception of £100,000, into St. John's to date.

I appeal to the Minister to provide for stage two, the development of the day centre at St. John's Hospital. This development consists of a day hospital which is long overdue. The facility available at present was adequate for the needs of 1989 when there were 20 patients attending the day hospital. At present, there are 80 patients attending.

The services provided in the hospital include a doctor on duty, physiotherapy, occupational therapy, eye testing clinic, dental clinic, chiropodist, speech therapist, social worker, pastoral care and dietician. There are also aids and appliances available for patients. The patients attend the services from 9 a.m. to 4 p.m. and can avail of a bath, a shower, music and bingo. They have their lunch there and there are a range of activities.

The service, which was designed for 20 patients in 1989, is inadequate for current needs. The stage one development was completed four years ago with a state-of-the-art foyer, shop and reception area. This completely transformed the hospital, but what is urgently required is funding for stage two which is essential for the care of patients attending the day services. It is an invaluable facility which is under huge pressure catering for its 300 patients.

I appeal to the Minister to take on board the main recommendations of the Betty Brady report. Its conclusion states:

It is important to highlight in conclusion, that the staff of the hospital have demonstrated throughout this study process a very high degree of commitment. It is evident from the ward audits, comment sheets and consultations with staff on the ground, that there is a great sense of caring for the patients. However, it is clear that they are being asked to work under extremely difficult conditions.

The WLI and acuity levels within the hospital are very high. Staffing is inadequate. Facilities, maintenance and equipment fall short of expected standards. There is an urgent need to begin to address in a systematic way the resolutions of these problems and the implementation of the recommendations in this report.

The report also states:

There is a need for greater communication from the health board to staff regarding priorities and management planning. . There is a need for a review of transport arrangements . There is a need for a review of the role of voluntary agencies in the area in areas such as the visiting and entertaining of patients, provision of social and educational stimulation. Links with local community groups, businesses and educational establishments can produce a significant support network for the hospital which can act as a significant supplement to the work of the staff employed in the hospital.

Because of the significant shortage of staff and the high levels of dependency, there is a lack of a holistic approach to the caring of the patients. There have been many developments in the care of the elderly in recent years, particularly in the stimulation of the various senses and enlightened approaches to the treatment of confused mobile patients. Staff within the hospital are aware of these developments but cannot implement them because of the shortage of staff.

I appeal to the Minister of State to take on board the Betty Brady report and provide funding for stage two of the day centre which is urgently needed.

The North Western Health Board, which has responsibility for the maintenance of St. John's Community Hospital, Sligo, has informed me that a development control plan was prepared for the hospital in August 1996. Phases one and two have now been completed with the provision of a new entrance foyer, including coffee dock, shop and visitors' toilets, and 30 bed dementia unit.

Phase three of this development control plan provides for the extension of the day hospital to address the following deficiencies. The day room-dining room area is too small, resulting in significant overcrowding. Average daily attendance is 55 clients, giving an annual attendance rate of over 13,000. The toilet and shower facilities are totally inadequate. Clinic treatment and bath room facilities open off the central public corridor. Rear access to the facilities is difficult and unsatisfactory.

The development of the day hospital will have a direct impact on other services bordering this area, such as physiotherapy, occupational therapy, religious services and staff facilities. The overall cost of the phase three development is approximately £1 million. My Department has received no formal proposal for the provision of this amount of capital funding for the extension of the day hospital at St. John's but, should it do so at a future date, I will give it careful consideration. I am aware of the benefits accruing from a well run day hospital in the overall care plan for older people.

I have been able to allocate additional capital funding to services for older people since I came into office and work in this area is proceeding in all health boards. In the north-west, a new community nursing unit is in the final stages of construction at Killybegs, County Donegal, and should be open in the second half of next year.

I hope to provide even more capital funding to services for older people over the coming years but the demands are enormous. A large number of new community nursing units and hospital units are required in locations where there are none at present. Old, unsatisfactory workhouse type accommodation must be replaced with modern buildings and equipment. New day care centres are required in many areas while day hospitals are required in or adjacent to all acute hospitals where specialist geriatrician led services are provided.

No doubt the North Western Health Board will receive a share of whatever capital funding becomes available, but progress on phase three at St. John's Hospital, Sligo, will depend on the level of funding available and the internal priorities of the board, in so far as services for older people are concerned.

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