Dáil Éireann díospóireacht -
Wednesday, 30 May 2001

Vol. 537 No. 3

Adjournment Debate. - Hospital Services.

Mr. Deenihan

I thank the Chair for allowing me to raise this matter on the Adjournment and acknowledge the presence of the Minister for Health and Children.

There is widespread concern in Munster and among disability organisations about the continuing delay in implementing agreed plans for a rehabilitation hospital for Munster. There is a very strong need to progress this project which enjoys widespread support, including in County Kerry. There are constant requests as to when this facility will open from people with disability, their families, carers and health care professionals. In view of the highly publicised waiting lists in acute hospitals, the lack of rehabilitation beds in Ireland and the very real needs of many people with disability, there is grave concern that such a worthy and much needed project is unnecessarily delayed. The development of a comprehensive rehabilitation facility would be an important development for Munster, addressing a clearly identified need.

Many people have to travel long distances to the country's only specialist rehabilitation hospital in Dún Laoghaire for treatment, and many more have to wait for very long periods due to long waiting lists. I urgently want to know when work can commence on the project, especially when at least three different announcements have appeared in the national press both from the Minister and the Taoiseach. The Taoiseach announced this project at the opening of the Jack Lynch Tunnel. As far back as 18 June 2000 the Sunday Business Post carried an article by Margo O'Connell, then political correspondent, which stated that Deputy Mícheál Martin, the Minister for Health and Children, was embarking on a £100 million plan for the development of hospital services in Cork, including the provision of a new rehabilitation unit for victims of stroke and serious accident.

The article went on to state that the Minister claimed there was a need to develop medical rehabilitation services similar to those available in the National Rehabilitation Centre in Dún Laoghaire in Dublin and that he had asked the Southern Health Board to consider the development of a consultant-led medical rehabilitation service in Cork. In the Irish Independent in July 2000 it was stated that the Minister for Health and Children, Deputy Martin, had intervened to end the row over control of the country's second £40 million rehabilitation hospital and that, under a proposal brokered by Deputy Martin, the NRB would run the new hospital while the Southern Health Board would handle all related acute rehabilitation cases at the existing St. Mary's Orthopaedic Hospital. This caused some consternation at the time.

A report in The Irish Examiner on 16 February 2001 by Eoin English stated that rising costs delayed a decision on whether to locate a £40 million rehabilitation centre to serve the entire province of Munster in the mid Cork town of Ballincollig and that the proposed facilities, similar to the Central Rehabilitation Clinic in Dún Laoghaire, which would provide up to 350 jobs were earmarked for the site in Ballincollig. The report goes on to state that the Minister for Health and Children recently admitted in Cork that costs had soared way above initial estimates and that failure to agree had dogged the project so far. It stated that sources in Ballincollig had expressed amazement that at a time of record health spending the project had been delayed over cost concerns.

The last item I saw on this matter was on Tuesday, 4 April, when Deputy Batt O'Keeffe made an announcement and the same journalist said it now looked certain that a £40 million rehabilitation hospital to care for people with chronic brain and spinal injuries would be built in the centre of Ballincollig. The journalist said the newspaper had also learned that the Minister for Health and Children, Deputy Martin, was to enter into direct discussions with the Minister for Finance, Deputy McCreevy, with a view to securing funding for the project, which would provide 350 jobs in the mid-Cork town.

Speaking in Cork last February, the Minister, Deputy Martin, said the decision on where to locate the rehabilitation hospital to serve the Munster region was delayed because costs associated with the project had soared. Ballincollig based Deputy Batt O'Keeffe, however, confirmed in April that the Minister had advised him that Cork County Council should proceed with the zoning of the land in the Army barracks for the rehabilitation hospital. This indication from the Minister, Deputy Martin, coupled with the news that he has taken up the issue of funding with the Minister for Finance seems to secure Ballincollig as the eventual location for the hospital.

Will the Minister make a statement on when the hospital will get the go ahead and whether the money will be available for it? It is most important that it should proceed as soon as possible.

Minister for Health and Children (Mr. Martin)

I thank the Deputy for the opportunity to set out the position on the proposed development of rehabilitation services in the Munster region. The Deputy should not believe everything he reads in the newspaper. The last few articles were news to me.

The issue of rehabilitation services is a matter in the first instance for the health boards. I am aware that St. Mary's Hospital is the preferred site for the acute rehabilitation unit to serve the Cork and larger Munster region. A project team has been appointed for the development of St. Mary's Hospital and its brief includes the acute rehabilitation unit. It is estimated that the overall development at St. Mary's Hospital, when completed, will cost in excess of £25 million.

It is proposed that this new consultant led medical rehabilitation unit will provide start up rehabilitative in-patient services for patients who require 24 hour medical observation. It is envisaged at this stage that the unit will contain 25 to 30 beds to complement the existing and future development of services planned for the hospital. The unit will provide a service similar to that currently provided at the National Rehabilitation Centre at Dún Laoghaire.

Individuals with an acquired injury form part of a larger client group known as the young chronic sick. The need to provide rehabilitation services to deliver ongoing therapeutic programmes and to make the transition from hospital to the community for the young chronic sick on discharge from acute hospital care or medical rehabilitation has been identified as a priority service for development. For those individuals, for whom the severity of their condition is such that they are unable to return to or remain at home, there is a need for the provision of appropriate residential care providing constant nursing care. Such specialised units would also provide respite care. Needless to say, because these conditions are generally acquired in adolescence or early adult years, significant psychological strain is placed on the family and the ongoing care and support required by the individual and his or her family needs to be addressed within the community support services.

I have provided just over £92 million under the national development plan for services for people with physical and sensory disabilities, including the development of rehabilitation and long-term care service for people with acquired injury. Proposals for the development of a comprehensive rehabilitation centre in the Cork area which would provide both in-patients and out-patients rehabilitation programmes and services will be the subject of discussions between Rehab Care and the health boards in the Munster region. The aim is to provide a comprehensive leading edge rehabilitation service which will facilitate early intervention and a continuum of rehabilitation services from the acute medical phase through to the fullest restoration possible of independent living for the patient.

The need for additional rehabilitation beds has been identified in the national review of bed capacity. This review is at an advanced stage and the findings will be brought to Government in the near future. I accept that there is a need to provide facilities which can meet the particular needs of patients requiring access to rehabilitation services. These include selected groups such as the young chronic sick and older people with specific conditions who require continuing care in a setting appropriate to their needs. The overriding objective will be to ensure that all individuals are treated in the most appropriate setting.