Wednesday, 11 November 1998
Dáil Éireann Debate
Mr. Shatter: For October, November and December of this year an average of 460 hospital beds will be closed in acute hospitals throughout the country. This works out at approximately 1,400 beds over a three month period. These bed closures are being effected due to the failure of the Minister for Health and Children to allocate adequate funds for acute hospital services this year.
The bed closures are occurring at a time when hospital waiting lists continue to increase. It is estimated that the current waiting list exceeds 36,500. Incredibly, in the Estimates for Public Services published today, the Minister forecasts that his Department will spend £32 million less this year on non-capital services than was originally provided for at the start of the year.
In simple terms the Minister has allowed hospital waiting lists to dramatically and indefensibly rise and hospital beds to close while he fiddles the sums in a Department and sits on a treasure chest of £32 million allocated to him at the beginning of the year by the Department of Finance. His behaviour is quite extraordinary, even more so when one refers to the criticisms voiced by the Minister of State at the Department of Health and Children, Deputy Fahey, with regard to the hospital in Galway when he questioned the wisdom of the management decision to save £250,000. We question the wisdom of the Minister in seeking to effect savings of £32 million when in the short period of his stewardship waiting lists have grown to a degree that is unprecedented.
Tullamore General Hospital, the local hospital in the Minister's constituency, is one of the hospitals which will close beds in early December. In excess of 40 beds are scheduled to close in the hospital on 5 December. The hospital has a substantial public waiting list for ENT and orthopaedic procedures, including hip and knee replacements. As of 30 June 1998 there were 559 adults and 533 children on the public waiting list of the hospital for ENT procedures. As of that date 580 patients were awaiting orthopaedic care, 119 awaiting total hip replacement and 24 total knee replacement. As of 30 June 1998 a total of 1,737 patients were on the waiting lists of Tullamore General Hospital, an increase of almost 200 in the Minister's first year in office. It can correctly be predicted that when available the new waiting list figures as of the end of September 1998 will show the figures have further increased.
In the early 1990s Tullamore General Hospital had two orthopaedic surgeons and regularly operated two theatres for orthopaedic operations such as hip replacement. Today the hospital has three orthopaedic surgeons but only one theatre is available to them for surgery purposes. The second theatre should be made available for orthopaedic surgery.
I am demanding that the Minister take appropriate action not just in relation to Tullamore General Hospital but in relation to other hospitals across the country and that he immediately allocate the additional moneys required to prevent further closures of hospital beds in November and December to enable our acute services tackle the waiting lists which have escalated during his term of office. If he does not do so he should explain to his constituents why he believes it is acceptable for hospital beds to close, for essential elective surgery to be further delayed and for his constituents to continue to suffer pain, distress and ill health.
Mr. Flanagan: I support the call of Deputy Shatter for the Minister for Health and Children to take appropriate action in the Midland Health Board area, with particular reference to the orthopaedic unit in Tullamore General Hospital. The Minister is as aware of the situation regarding waiting lists as I am. The reality is that almost  500 children in the Midland Health Board area, the bulk of whom come from the Laois-Offaly constituency, require urgent tonsillectomies. There are 170 adults awaiting hip operations in the Midland Health Board area where the average waiting time is now almost 20 months.
The news announced last week that 48 beds in Tullamore General Hospital are to close for an extended Christmas holiday period, lasting from 5 December to 4 January, is totally unacceptable to the people of the midlands and in particular the Minister's constituents. How can it be that an effort on the part of the board to reduce the waiting list is giving rise to a situation where it takes almost 20 months for a hip replacement to be carried out in the Midland Health Board area? In what state will these waiting lists be on 5 January when the hospital reopens after an unprecedented and totally unacceptable Christmas break?
Minister for Health and Children (Mr. Cowen): I am delighted to have the opportunity to respond in this debate. It is well known that bed management forms a normal part of budgetary management strategy which must be examined in the context of actual hospital activity. It should be noted that the Midland Health Board plans to carry out some necessary refurbishment during the period in question. The board submitted a service plan to my Department which specified the amount of activity in respect of in-patient, out-patient and day procedures for the year, outlining the activity targets of the two hospitals, namely, Longford-Westmeath General Hospital and Tullamore General Hospital.
On the basis of current trends and activities the board will have exceeded its baseline activity and will have met its waiting list initiative targets by the end of the year. In this regard, I draw to the attention of the House the fact that this Government substantially increased the financial allocations to both hospitals over the allocations provided by the previous Administration. In 1998, Longford-Westmeath General Hospital received £12.1 million from this Government compared to £10.5 million in 1997 from the previous Government. Tullamore General Hospital received £14.788 million in 1998 compared to £13.472 million in 1997. In total, both hospitals received an increase in their allocations of £2.916 million in 1998 from this Government compared to the funding allocated in 1997 by the previous Administration.
In the final weeks of the year, between 5 December and 5 January, the board proposes to scale down activity in two of its hospitals, Tullamore General Hospital and Longford-Westmeath General Hospital, Mullingar. I stress again that activity will have exceeded targets set out in the service plan in relation to baseline activity and will have met targets in relation to waiting list activity. It is important to emphasise that the hospitals concerned will deal with all emergency and urgent cases. The board will assess the situation  on a daily basis and if the level of emergency and urgent cases dictates, additional beds will be opened as required.
Contrary to what Deputy Shatter might have us believe, there is no question of any person who may require medical treatment not being given adequate care and attention. The Government is committed to providing a high quality acute hospital service in the Midland Health Board area. I am confident the level and quality of service being provided by the board will continue to be delivered to the people living in the catchment areas of Tullamore General Hospital and Longford-Westmeath General Hospital. I will visit both Mullingar and Portlaoise this Friday. I am committed to an enhanced capital development programme which obviously has increased revenue implications in the long term for the delivery of services in the Midland Health Board. The commitment of this Government has shown we have an ability to provide more services in that health board area than was the case with my predecessor.
It will always be the case that Deputies will come into this House seeking additional funding regardless of budgets or allocations. We had a three hour debate which concluded tonight calling for more services in community based services such as mental handicap. I agree with that but the Deputies have come back into the House tonight calling for more services in acute hospitals. They want more services in every area of activity despite the fact that the allocations being made by me are greatly in excess of those they provided when in Government.
Deputy Quinn made an extraordinary statement this evening to the effect that this was the first time we had an opportunity to provide resources. As Minister for Finance, Deputy Quinn brought in three budgets totalling £40,000 million yet he has the gall to come in here and say this is the first opportunity we have had to provide for the development of services.
I assure my constituency colleague, Deputy Flanagan, that during the course of my tenure in office he will see greatly enhanced development in the Midland Health Board area. I point out to him that half of the total money available to me last year for the commissioning of new units went to Mullingar — £1.2 million out of an allocation for the whole country of £2.4 million. I look forward to opening the hospital next Friday in Mullingar.
Mr. Cowen: ——but not one penny went to the people of Portlaoise. There will also be an announcement shortly in relation to Tullamore General Hospital. I look forward to continuing my work on behalf of the people of my constituency and my neighbouring constituency for many years to come.
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