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Hospital Services.

Dáil Éireann Debate, Wednesday - 26 May 2004

Wednesday, 26 May 2004

Ceisteanna (15)

Olivia Mitchell

Ceist:

34 Ms O. Mitchell asked the Minister for Health and Children when he will release funding for interim improvement measures at the National Maternity Hospital, Holles Street, Dublin; and when he will sanction the appointment of the design team for the urgently needed new maternity hospital at St. Vincent’s University Hospital, Dublin. [15736/04]

Amharc ar fhreagra

Freagraí ó Béal (18 píosaí cainte)

Any proposal to develop services at the National Maternity Hospital is a matter for consideration by the Eastern Regional Health Authority in the first instance. My Department is advised by the authority that since the foundation of the hospital in 1894, its premises have been extended and modified as required to meet patient and clinical needs. In common with many older buildings, the infrastructural layout and configuration of the buildings are a constraint on the delivery of optimal services.

Coupled with this infrastructural issue is the growing demand for obstetric and gynaecological services over recent years. Against this background, my Department approved the establishment of a project team comprising representatives of my Department, the hospital and the authority, to examine the future role and accommodation needs of the hospital.

In light of particular concerns which have arisen in respect of overcrowding and consequential health and safety risks in some areas of service delivery, I understand that the project team is finalising a brief for interim developments which will broadly address the following key areas of concern: laboratory; post mortem facilities; out-patient clinics; patient waiting areas; pharmacy; neo-natal ICU; ward accommodation; delivery unit; physiotherapy; social work department; and theatre sterile supplies unit.

On receipt of the completed brief by the authority, it will be examined as a priority in conjunction with my Department. That is a matter on which we want to move relatively quickly. My officials met the board of the hospital recently and I am due to meet it shortly.

Did the Minister visit the hospital?

I have done so on numerous occasions.

If he had done so, he would have closed the hospital down because of the bad conditions that obtain there. Holles Street is a sorry excuse for a National Maternity Hospital. It is a fire hazard and it is dangerous. It is a disgrace that we are asking mothers to have their babies in such unsafe conditions, irrespective the best efforts of the staff to alleviate the difficulties.

Is the Minister aware of the conditions at the hospital? Corridors are blocked by laboratory and other equipment, including bins. There is virtually no access to the lifts. Acutely ill and premature babies must be brought through the staff canteen to the intensive care unit. If there was a fire, every baby and the nurses in that unit would die because there is no way they would be able to get out of the building. This matter is urgent and the Minister must take action.

The staff in Holles Street and St. Vincent's, when contacted, were of the opinion that the National Maternity Hospital would be moving to the St. Vincent's site. Is the plan in this regard progressing? The Minister's Department appears to know nothing about this plan, despite that everyone else seemed to assume that it had been agreed. When will the Minister appoint the project team and sanction the detailed design and funding of the hospital?

Is the Deputy referring to the new hospital?

Yes. I am glad that the Minister regards the interim arrangement as a priority. However, it cannot be regarded as enough of a priority. What is happening is appalling and the interim arrangement can only provide a temporary solution. The Minister is correct that the laboratory is one of the worst areas in the hospital. The conditions there are Dickensian. The laboratory is significantly under-resourced and has not benefited from investment in 30 years. Is the Minister aware that mothers are not now automatically called back for cervical screening? This service was available to their grandmothers but it is not available to them. Up to 8,000 babies will be born in the hospital this year and their mothers will not be able to avail of the services their grandmothers could avail of.

This is an indictment of the health service and we must make the required investment to improve conditions at the hospital in the short term to allow it to continue to operate until the new hospital is built. The new hospital is essential and its construction must be sanctioned. Will the Minister provide a timescale for the interim arrangement and the construction of the new hospital?

I look forward to meeting the board in respect of the new hospital because when the first national development plan was being drawn up, what is now the Eastern Regional Health Authority would have submitted its priorities for the east and it seemed to me that, at the time, the emphasis and focus was on redeveloping Holles Street on the existing site. Subsequently, there was an idea floating around to move it to St. Vincent's. When the St. Vincent's project came before us — we increased the allocation in respect of it by up to €40 million or €50 million to accommodate additionality on the campus at the hospital in terms of theatre suites, etc. — the moving of the National Maternity Hospital to that site was not on the agenda in any documentation put before me in terms of the national development plan allocation. At that time, the emphasis seemed to be on developing the hospital on the existing site.

I would have no difficulty with locating the National Maternity Hospital on the St. Vincent's campus but this would depend on the feasibility of doing so. The Hanly report recommends that ultimately, if possible, the National Maternity Hospital should be located on the St. Vincent's site. I would be responsive to any plans that come forward from the hospital and the authority in terms of what can be done to improve facilities in the interim.

We have already made significant investment in the Rotunda and the Coombe. There has been huge investment in most of the major hospitals at this stage and the lack of development is a legacy from decades of under-investment in health. In the past six or seven years there has been significant investment. I am anxious to proceed with improving the position in Holles Street and I look forward to meeting the board to see how this can be done immediately in terms of the interim solution and settling the question of relocation.

I do not believe it is fair to go back to the hospital and seek suggestions as to what can be done. It has already provided those suggestions and it knows what needs to be done. The money must be allocated so that the project can proceed.

I was perturbed by the Minister's statement that the plan regarding the possible move to St. Vincent's was "floating around". At that time, it was realised that it would not be possible to redevelop on the Holles Street site because it is too small and constrained and also that babies could not be born there during reconstruction. The thinking, even before publication of the Hanly report, was to move to a single site. St. Vincent's has a site allocated for the National Maternity Hospital in its new development. All that is required is funding from the Department which does not even appear to know about the existence of the site. I am concerned that there appears to be no joined-up thinking in the Department.

The Department knows about it.

The Minister is referring to a plan which came into existence several years ago.

There are many issues which have to be investigated, particularly the situation regarding the site at St. Vincent's and whether it is large enough to accommodate the National Maternity Hospital.

That matter has already been investigated.

Yes, and there are certain conclusions in that regard which I wish to discuss with the board.

Does the Minister understand that urgency is required?

He should visit the hospital now and he would make the decision after doing so.

I have appointed the project team and it must do the necessary work in terms of putting forward the plan for what will be done in the interim period. The team is due to report back to the authority which will come back to us with a brief.

It is money that is needed.

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