Dáil Éireann díospóireacht -
Wednesday, 28 Jun 2000

Vol. 522 No. 3

Adjournment Debate. - Hospital Waiting Lists.

Mr. Rabbitte:

I thank the Chair for permitting me to raise this important and delicate matter on the Adjournment. The people in my constituency waited for 20 years for their own hospital. During that time access to hospital care for many was problematic, inconvenient or expensive. There were great hopes for the Adelaide and the Meath Hospital, Dublin, incorporating the National Children's Hospital, known colloquially as the Tallaght Hospital. In too many cases their hopes have been disappointed and, notwithstanding the huge controversy of over a year ago, the problems continue. It would appear that the hospital simply cannot cope with the demand.

I refer to a case of a patient, a constituent of mine, who is badly in need of minor surgery to have a goitre removed. The goitre is assessed as being non-malignant but is so painful that the woman can scarcely speak or swallow. The constituent had been given dates which were cancelled in advance. She is a patient of Professor Tanner who is the consultant surgeon. Mr. Tanner, in a letter to me arising from my representations on behalf of this woman, said, inter alia:

Little has changed since we last discussed the problems of admitting patients to the Hospital in Tallaght. As things go Mrs. [naming her] will be lucky to be admitted for surgical removal of her goitre within the next 5 years! The chronic bed shortage has not been alleviated by the opening of the new 76 bed wing for as soon as this will be opened the hospital authorities intend to close 70 beds in the main hospital so as they can transfer the nursing staff to the new wing! The ridiculous situation exists whereby I see about 30 new patients in the surgical outpatient each week and on average put 6 patients on a waiting list for inpatient surgery. I would be lucky if I were to be allowed 1 (one) admission per week at present! You don't need to be a genius therefore to work out that my waiting list is increasing on a weekly basis.

I can see very little light at the end of the tunnel and on a personal note I have to say that the standard of care I can offer my patients here in Tallaght, compared to what I would offer them in the Adelaide & Meath Hospitals, is below my own personal standards. I have therefore taken the decision to retire from active surgery in two years time and let someone else get on with the fighting! As highly paid professionals we should be able to come in and do a days work effectively without wasting our time on these sort of administrative headaches.

It is simply unconscionable that this should continue. Professor Tanner's remarks are sobering to such an extent that I am concerned about quoting them publicly because I know there are cancer sufferers in my constituency who cannot get a reliable date for necessary surgical procedures. This is intolerable whatever the reason. In a country with a huge budget surplus, nothing can forgive the pain, stress and uncertainty caused by the Government's inability to address these problems. Something has to be done to tackle the residual problems at Tallaght Hospital. It is not acceptable that the people of my constituency, which has a catchment population of a quarter of a million and who have waited 20 years, cannot get access to hospital care. I present this case to show the gravity of the situation and I look forward to the Minister of State's response.

Minister of State at the Department of Health and Children (Dr. Moffatt):

I thank Deputy Rabbitte for raising this matter. As he may be aware, the provision of hospital services including those referred to by the Deputy is now a matter for the Eastern Regional Health Authority or ERHA. I am advised by the regional chief executive of the authority that the person referred to by the Deputy was placed on the waiting list for treatment on 10 February 2000 and is scheduled for admission on 11 July 2000. This is at variance with what has been said.

The authority has advised me that while there have been some delays in admissions to Tallaght Hospital for certain types of procedure, it is incorrect to state that there is a serious bed shortage in the hospital. Tallaght Hospital is the most modern and well-equipped hospital in the State and has recently completed a private wing of 75 beds. In addition, it has had direct access to step-down facilities on the site of the old Meath Hospital.

Patients requiring non-urgent procedures may have experienced a delay in some instances in accessing the services they require. This is due in part to the increasing demand for services at the hospital in general and to the increasing number of patients attending the accident and emergency department who require admission to the hospital. However, it is a function of management to ensure hospital beds, both in-patient and day care beds, are managed in an optimum fashion. The Deputy may wish to note that for patients who require admission to hospital, the shortage of sub-acute beds has caused problems in that some acute hospitals have not been able to discharge appropriate patients in sufficient numbers and quickly enough to cater for new patients seeking the services of our acute hospitals. This problem has direct links to the ageing of our population. Many elderly patients require acute hospital care initially, but much of their recovery period could be spent in step-down or sub-acute accommodation.

My Department has already provided additional funding of £5 million in 2000 to provide more than 200 alternative care beds in the eastern region. These beds are a combination of sub-acute, convalescent and long stay places and will provide appropriate accommodation for patients who have finished the acute stage of their care and who require accommodation in a non- acute setting. My Department is committed to reducing waiting lists and waiting times for patients requiring admission to hospital. The Minister for Health and Children has already allocated an additional £5 million to the authority to enable hospitals within their region to maximise available capacity and to enable additional procedures to be performed. I am advised by the authority that Tallaght Hospital is participating in the initiative, which will result in the reduction of the hospital's general surgical waiting list and waiting times for patients requiring such surgery.

The Deputy may also wish to note that my Department is currently undertaking a national review of acute and non-acute bed capacity. This review is critical to assess the capacity of the hospital system to manage periodic surges in emergency admission and the reduction of waiting times for elective treatment. It is intended that the findings of this review will inform decisions which will be taken in the context of the Health Estimate for 2001. I am confident the measures under taken by my Department, the authority and the hospital concerned will result in the provision of services in an enhanced and more efficient manner.

I would seriously doubt the tone of Mr. Tanner's remarks in his letter.

The Dáil adjourned at 10.55 p.m. until 10.30 a.m. on Thursday, 29 June 2000.