Dáil Éireann Debate, Wednesday - 15 May 2019
4. Deputy Louise O'Reilly asked the Minister for Health if the necessary staff have been recruited to ensure that the paediatric outpatient department and urgent care centre at Connolly Hospital can be operational from 8 a.m. until midnight, seven days a week, as was previously committed to. [20933/19]
Amharc ar fhreagraLike my previous question, this relates to staffing. It concerns commitments given that the paediatric outpatient and urgent care centre for Blanchardstown will open from 8 a.m. until midnight. I want to know if the requisite staff have been recruited because, at this stage, these are probably people who are already in the system or, hopefully, coming from abroad, so they will have given notice. We know the centre is due to open in a couple of weeks. These people are either on their way or, if not, I would prefer if the Minister was honest and told us it will not have enough staff to open at the requisite time.
I thank the Deputy for this important question. Children’s Health Ireland has advised that recruitment is well under way to secure the required staff for the opening of the outpatient urgent care centre at Connolly Hospital and that the majority of staff have been recruited, with start dates over the forthcoming weeks and, in some cases, months. A total of 13 consultant posts are required and, to date, I believe ten of these positions have been filled - six paediatric emergency medicine consultants and four general paediatric consultants - and recruitment is ongoing for the remaining posts. As we said, there are recruitment challenges nationally and internationally in certain specialties, such as radiology. I am assured by Children’s Health Ireland, which I met in recent weeks, that plans are in place to ensure Children’s Health Ireland at Connolly will open at the end of July 2019.
Children’s Health Ireland has also advised that all nursing positions have been successfully filled and, as the Deputy rightly said, these are generally nurses working within the health service agreeing to move to the new facility. Health and social care professions and administrative posts are also being filled internally. The delivery of services at the centre will be provided on a phased basis based on community need and patient volume, and the initial hours of operation are still being determined. Children’s Health Ireland will make an announcement on the initial hours of opening. I too asked it that question in recent weeks. Very good progress is being made in regard to recruitment.
During the initial opening phase from July to December 2019, two specialties - general paediatrics and orthopaedics - will deliver outpatient services at Connolly. Importantly, this will provide an additional 3,600 fracture orthopaedics and 2,750 general paediatric outpatient appointments, which means more than 6,000 additional children will be treated between July and December as a result of the opening of this new facility. When fully operational, it is projected that Connolly's urgent care centre will provide 33,000 outpatient appointments annually, contributing to significant reductions in waiting times and waiting experience, as well as 25,000 urgent care assessments, 30,000 X-rays and 6,000 ultrasounds.
It is still intended to open the facility at the end of July. The operating opening hours will be decided by Children’s Health Ireland in the coming weeks and announced. It has made very good progress with recruitment.
It is clear the centre will not open from 8 a.m. until midnight, although perhaps the Minister can confirm to me that he expects it to open at those times.
With regard to consultants in paediatric emergency medicine, paediatric radiology, histopathology, haematology and orthopaedics, those are areas where, if we do not have the requisite number of consultants, we will not be able to run the service. Equally, if are taking those consultants from either Temple Street or Crumlin hospital, what we are effectively doing is taking that service away and shuffling people around. We will still have backlogs, waiting lists and intolerable working conditions for consultants.
I met the consultants who are sceptical about the level of recruitment. The Minister cited a figure of six consultants in emergency medicine. I do not believe that number will actually start and my estimate is that it will be closer to four. If those consultants are taken from the other hospitals, effectively, we are just shuffling around the deckchairs but there will be no improvement in service. I fully respect the projected figures but, in truth, and I know the Minister will not disagree with me on this, they will be nothing but a pipe dream if we do not have the staff to deliver them. I do not believe the staff will be there and if the plan is to take them from the other hospitals, I do not believe we will see any material difference.
Specifically, will the Minister tell me if he has confidence that this service will open from 8 a.m. until midnight? A lot of downgrading of services will happen in the other hospitals, which are depending on this service being open from 8 a.m. until midnight.
I have no doubt this service will see additionality from July in regard to paediatric healthcare. I take the points the Deputy makes that if we are just taking a doctor from here to there, that is not additionality. I genuinely have no doubt it will bring additionality in terms of extra appointments for children. I outlined in my last answer the volume I expect as a result of this centre opening, which is roughly 6,000 additional appointments for children in the Irish healthcare service between July and December of this year compared with last year.
I can only take people at their word. I met Children’s Health Ireland recently and I also met the consultants, perhaps the same ones the Deputy met. In any case, I have had similar conversations and that is one of the reasons I scrutinised this a bit further. Children’s Health Ireland has told me it has filled ten consultant posts, six of them in paediatric emergency medicine and four of them in general paediatrics. What it has said in terms of the initial opening hours is that it wants to look at community need and patient volume before deciding what are the best hours to open the service. That is what it has told me and it has said it will revert to us in that regard.
The Deputy is quite correct to make the point about radiology and the like. It has plans in place in that regard, be it locum cover initially or the outsourcing to imaging services, should that be required and I not saying yet that it will be required. I am confident it has plans in place, including contingency plans, to ensure this facility will open in July.
All I heard from that was locums and outsourcing.
I thought that might be the case.
I will disregard much of the rest of the fluff. The Minister said ten consultant positions have been recruited. How many of those are coming from the other hospitals? Are they all coming from abroad? Are they all new entrants into the system? Will they provide the additionality the Minister says will be provided? We have just agreed that without additional staff, there will be no additionality.
There was a commitment to operate seven days a week from 8 a.m. until midnight. When will we know what the opening hours will be? Obviously, people need to plan. The health service does not run on a 24-hour cycle and it needs to plan in advance. The other hospitals will also need to know. When does the Minister believe we will know whether the opening hours will be as committed to, namely, from 8 a.m. until midnight seven days a week, or, as I suspect, office hours and only five days a week? I sincerely hope I am proved wrong on that but I do not have confidence at this stage. The Minister might tell me how many of the ten posts are whole-time equivalent and how many are coming from other hospitals.
I expect we are likely to know in the month of June but I will confirm that with Children’s Health Ireland and write to the Deputy. The Deputy is entirely correct that this requires a lot of planning. I make the point that, thanks to the legislation passed in this House, which the Deputy co-operated on and supported, we now have Children's Health Ireland, which is one hospital structure, albeit operating over three facilities, so there is already joined-up thinking.
There is one chief executive officer for Children's Health Ireland, which takes in Crumlin and Temple Street hospitals, as well as the paediatrics aspect of Tallaght Hospital and that helps significantly with the planning. Often when a new facility is opened there are a number of hours on day one and, a couple of weeks or months later. Those hours have been expanded. That is a matter for Children's Health Ireland to decide as the statutory board with responsibility for children's health in Ireland and it will make that known as soon as its plans are finalised.
I am satisfied, based on what I have been told, that there is serious additionality here for children. We are talking about 3,600 additional fracture orthopaedic appointments and 2,750 general paediatric outpatient appointments for our children in Connolly Hospital between July and December as a result of this new facility. We have had a lot of debate about the cost of the new children's hospital and this is a really tangible example of the benefit. I will check for the Deputy where those ten consultant posts have come from because I do not have that information available. I will write to her.
