I wish to share my time with Deputy Connolly.
Adjournment Debate. - Hospital Services.
Is that agreed? Agreed.
I thank the Ceann Comhairle for giving me the opportunity to again raise the issue of Monaghan General Hospital. I also thank the Minister for attending the House at this late hour to listen to the debate. There is an urgent need for the Minister to intervene in the Monaghan General Hospital saga, where, in spite of his commitment to me on 27 June 2002 that everything was all right and that services would continue, the hospital was taken off call on 2 July.
At one stage patient numbers were reduced to 13 but they have now increased to approximately 70. This has caused chaos all over the region, especially in Cavan General Hospital. It is extending the waiting lists and putting tremendous pressure on families, especially the very young and the elderly.
Last December the Minister promised me he would request someone to intervene between the different groups and the health board executives. He again agreed to this when he met me with my Oireachtas colleagues on 4 July. There have been many protests, thousands of words have been written and there has been heated debate on radio and television, yet the people of Monaghan, especially the sick, suffer.
The Minister saw fit to intervene in the Western Health Board when jobs were at stake. Surely the lives and health of the patients of Monaghan should be of at least the same importance. I and two of my party colleagues had a useful meeting with the chief executive officer and two of his colleagues this morning. However, the clear message I received was that little or nothing has happened to bring about realistic dialogue between the executives, consultants and other management at the Cavan-Monaghan Hospital Group. Another forum has been established and it is supposed to report by 30 November. Review groups are the order of the day, but nothing is being done to restore confidence at either staff or patient level.
From my discussions this morning with the chief executive officer I believe there could, and should, be a future for Monaghan General Hospital. The people of Monaghan, including those who own their own businesses, need and deserve an accident and emergency service that will meet most of the needs of the area. A service is needed for heart and stroke cases within the immediate area if lives are to be saved.
Between forums and review groups 31 December will be upon us but no junior doctors will have been appointed. That will be the final nail in the hospital's coffin. It is difficult to explain or understand how high profile patients, such as Mr. Taylor from Northern Ireland, can have operations at Monaghan General Hospital, yet Monaghan people cannot avail of the hospital services. Senator George Mitchell was brought in to broker a deal in Northern Ireland by acting as a mediator and I believe that is what is necessary in the Cavan-Monaghan hospital group. If the Minister cannot act himself or find someone to do the job then he must consider his position because this is an extremely urgent matter.
I had personal faith in the Minister and he is aware of that. I tried to work with him for the best possible future of Monaghan General Hospital, however, his failure to deliver on what he promised last January and his failure to take a hands-on approach to the ministry and Monaghan General Hospital, in particular, begs major questions.
The restoration of the boiler was necessary and welcome but it is a long way off the promised €7 million. Consultants feel they have to negotiate through The Irish Times, others through the local radio and newspapers, yet hospital staff fear for their jobs and patients fear for their lives. Imagine a heart attack victim having to travel 75 miles on poor roads on the first week in January 2003. That prospect is staring us in the face.
I call on the Minister for Health and Children to intervene directly in the situation which prevails in Monaghan General Hospital. As he is aware it has been taken off-call from 7 July which has created quite a number of problems for us in Monaghan. A critical date is rolling forward and come 1 January we are going to have very severe difficulties in Monaghan.
About ten days ago I called on the Taoiseach to establish a forum. Some positive steps in that direction were made at the last meeting of the North-Eastern Health Board but unfortunately I believe that it will not happen at this stage. A number of minor adjustments need to be made to it. Dialogue is the only way forward. We must bring the stakeholders face to face to thrash out a plan that will give a future to the hospital.
So far we have had the executive drawing up plans in isolation and the medical board in the hospital devising their own plan. They reject each other's plans. I urge the Minister to consider having another look at the possibility of a forum in order to get the concerned parties talking. We may need to look at the balance of numbers, a critical issue from what I have heard from hospital consultants to date.
I thank Deputies Crawford and Connolly for their contributions. The fundamental responsibility for the provision of services at Monaghan General Hospital rests with the North-Eastern Health Board as it is the statutory authority in the area. It is a matter for the board ultimately to determine the nature and level of service provision at the hospital consistent with the board's commitment to the provision of a high quality, efficient and cost effective service.
I have met with almost every party involved with Monaghan General Hospital. I met with Deputy Connolly before he was a Deputy when he was on the hospital action committee. I met with Deputy Crawford on a number of occasions, as he has said. I visited Monaghan General Hospital earlier this year and met about 12 delegations. We made commitments then that I have honoured in terms of sanctioning posts. We had discussions with the hospital management, staff and representatives. I have had further discussions with interested parties.
The hospital has been taken off call and there has been an interruption of services. That was not my decision nor that of the board. Deputy Crawford did not refer to that in his contribution, but he knows full well, as does Deputy Connolly, that a decision taken by the Royal College of Anaesthetists with regard to accreditation was the critical factor in what transpired there. I assure Deputy Crawford that we did intervene at that stage and we asked the college to look at the situation with the health board to see if they could rearrange things to allow for proper accreditation to take place in order for services to be resumed. The North-Eastern Health Board has advised me that it has sought to resolve these difficulties. The board and I took the view that we could not bring about a resolution without the input of the relevant professional bodies, including the Royal College of Physicians, the Royal College of Surgeons, the College of Anaesthetists and the Medical Council as well as Comhairle na nOspidéal. They are the statutory bodies with specific responsibilities for key areas on this issue. Another key element is the co-operation of the clinical staff of the Cavan-Monaghan hospital group. I cannot order a resolution of this problem. We can try and be helpful, which we have been, and I maintain that we have endeavoured to be helpful with regard to seeking a resolution but our proposals have been rejected. Deputy Connolly has suggested that it may have been rejected because of the methodology or the mechanism of the exchanges – the way people are passing various sets of proposals to each other.
The people are not talking to each other.
There was a proposal on the table which may not have given everybody what they wanted but it would certainly have brought back 70% of the surgical activity to the hospital straight away if it was accepted. We have tied up development arrangement on other sites, such as between Naas and Tallaght hospitals in the area of accreditation two years ago to ensure that junior doctors would be appointed. We have done it in other areas across the country where two hospital campuses have been used as a basis for rosters or programmes to facilitate junior doctor training which allows for the concerns of the accrediting body and the Medical Council in terms of safety and standards. There are ways around these issues that would meet everybody's concerns. We must always be mindful of the concerns of those who are charged statutorily by this House in terms of safety standards and so on. These are issues that we cannot simply gloss over. Where there is a will, there is a way and I believe the bodies concerned have certainly been willing to be helpful in terms of finding a solution but it does need everyone else to come on board as well.
Both Deputies are aware of the project teams that have been recently established to advise on development of all five acute hospitals in the North-Eastern Health Board area, including Monaghan General Hospital. The primary role of the Monaghan hospital project team is to prepare an outline planning brief for the development of the hospital site. I recently issued approval for funding of the boiler plant upgrade for the amount of €473,000. My Department has approved a number of new services at Monaghan Hospital in recent months. When I was there I said the Department would sanction new consult ant posts in dermatology and in geriatric medicine, which we have done.
Other developments recently approved include additional investment in consultant-led surgical and anaesthetic services. Approval has also issued to the board for the recruitment of five additional medical support staff. Comhairle na nOspidéal is looking at some of those issues and I do not have any control over that body. It is a statutory body which regulates the appointment of consultants. It is about time we told people the truth. It is the easiest thing in the world to try and blame the Department or the Minister for Health and Children for everything but we have statutory authorities to whom this House gave certain responsibilities. We might not like the decisions taken from time to time but these structures govern how we do things. There is no point in trying to allocate blame: we need to try and ensure that through working with the bodies and the interested parties we can arrive at solutions to the issues.
Over the past three years in excess of €4.064 million has been allocated to the hospital in respect of various capital projects. That money would not have been spent if the intention was to close it. I wish somebody would tell me if that is the objective of the North-Eastern Health Board. We would not have put £1 million into the modular surgical theatre there. I visited it and it is a fine facility which we should be using to reduce waiting lists. That is my position as Minister for Health and Children; I want to see that facility used.
So do I.
I do not see why it cannot be used with a bit of common sense all around if people come out of their entrenched positions. The main projects completed included the refurbishment of the female medical ward. A major equipment replacement programme costing almost €1.27 million was undertaken throughout the hospital, which included specialist cardiology and patient monitoring equipment. More capital investment is proposed in the short term. Plans have been advanced by the health board for the upgrading and development of the high dependency unit at the hospital in addition to substantial upgrading and refurbishment of ward accommodation, the development of the emergency treatment unit and the development of a midwifery led unit. The associated capital costs for all these is about €7 million.
On 16 January last I announced the immediate commissioning of an additional 709 beds in public hospitals nationwide. This is the first phase in the provision of an additional 3,000 acute hospital beds by 2011. The North-Eastern Health Board said it could provide 38 of those beds this year, ten of which will be in Monaghan General Hospital – I refer to revenue spent to commission ten extra beds. This combined investment represents tangible evidence of my commitment to the continuing development of services in the region. I have sanctioned these developments and have allocated funding to the health board to carry them out.
My Department received proposals from the North-Eastern Health Board today for the establishment of a Monaghan General Hospital forum. I understand from the correspondence, which I only saw after tea, that people indicated at a board meeting last night that they might be in favour of this. I am open to suggestions as to how that mechanism can be developed and to discussing it with the Deputies if they feel it may be a vehicle for breaking the logjam. We will consider it in the Department. There is a suggestion to have an independent chair.
The North-Eastern Health Board has consistently advised me and assures me that it is committed to the future provision and development of services at Monaghan hospital. I reiterate what the Deputies have said. It is essential that all parties involved play their part to resolve the present difficulties. I know the feelings of the people in Monaghan on this issue. We have seen the protests. The energy should now be applied to devising a formula which resolves these issues and gets the hospital back into running order.