Wednesday, 2 February 2000
Dáil Eireann Debate
I have great respect for my colleague from Mayo, the Minister for State, Deputy Moffatt, who is present, but am sorry the rising star from Cork, the Minister for good news and good photographs, is not present. If this involved good news and a good photograph, I am sure Deputy Martin would be here. Last night I listened to him from my office and my blood boiled when I heard him tell the House about the wonderful health service.
I will tell the House about the health service in the Western Health Board area. A constituent of  mine, mentally prepared for an operation which would cure him, came to the hospital on 4 October 1998, and was sent home. He returned to the hospital on 17 January 1999, and was sent home again. On 13 June 1999, he was sent home again. He received a letter from the health board which stated that his operation would take place on 27 June, but he was sent home again. On 27 July he was called again and told his operation would take place but he was sent home again. On 2 October 1999, I rang the health board and was told that the operation would definitely take place. I even received a letter, signed by a well paid official from the health board, telling me that the man would not be sent home again and wishing him well on his recovery from his operation. This is the year 2000, and I have received a further appointment for him on 19 February.
We listened to the debate on the health service. We heard the Minister telling us about the wonderful health service. We have a great service if one has money. In that case, one will be called to any hospital for whatever operation is required, but that is not the case for medical card holders. This case concerns an elderly person who worked all his life and served the State well. The person is depending on an operation and when he is called for it he should be able to obtain it instead of getting bad news. Yesterday an answer to a parliamentary question stated that 10,021 bed nights were lost per month. The figure for Castlebar was 25 bednights and in Merlin Park it was 48. Many more people could be operated on if the service was being properly run by the Minister for Health and Children. If people within the service were doing the jobs they are paid to do I would not have this upset and distressed man at my constituency clinic, waiting for an operation yet having to return home without having had one on six different occasions. I do not want the Minister of State to say that it was on only three different occasions, because the figure of six has been confirmed by the person's doctor who was outraged. The same official who said it was three times wished the man well for a speedy recovery from his operation. It is time the Minister took on these health board officials and if they cannot do the job there are many others who will.
I do not want this man back in my office on 19 February saying that he was sent home again. I want him to have his surgery instead of being mentally prepared for an operation and travelling from Castlebar to Galway, but having to return home that night without having been operated upon. The operation had better be done because if not, I will be up on my feet every single morning on the Order of Business to highlight the matter to the Minister for Health and Children and the Taoiseach. If this is the kind of service we have, God help the poor and weak who are on medical cards.
Minister of State at the Department of Health and Children (Dr. Moffatt): I thank Deputy Ring for raising this matter on the Adjournment. The provision of hospital services in the Western Health Board area is a matter for that health board in the first instance. I have, however, made inquiries of the chief executive officer of the board about this case. I understand from the Western Health Board that the person in question is scheduled for admission, as has been said, on 19 February 2000. I further understand that the person was scheduled for admission on a number of previous occasions, five or six in total as the Deputy has said, and that the admissions were cancelled as a result of emergency admissions and bed availability problems. The board has expressed regret for the inconvenience and distress caused to this person as a result of the cancellations and has undertaken that every effort will be made to ensure that treatment will be provided on 19 February.
As regards the pressures that may be experienced at University College Hospital, Galway, as a result of emergency admissions, I assure the Deputy of the Government's commitment to developing services and infrastructure at the hospital. As the Deputy will be aware, the Government is at present investing unprecedented resources in the transformation of acute hospital services in the west. The phase one development of UCHG, which expands the theatre and bed capacity of the hospital through the provision of four additional theatres and 50 additional beds, is now being commissioned. In addition, a further phase of development, at a projected cost of £70 million, is out to tender.
Taken with the major capital development under construction at Mayo General Hospital, the works being planned for Roscommon County Hospital and the works under completion at Portiuncula Hospital, this will result in a major enhancement of the quality and range of acute hospital services available to patients in the west.
On the broader issue that this case raises in relation to the scheduling of elective admissions, the Deputy will appreciate that the level of elective activity in the acute hospital system is planned by local management over a 12 month period having regard to anticipated levels of emergency admissions and the overall resources available. This forms a central part of the service planning process which is required of health boards under the Health (Amendment) Act, 1996.
The unpredictable nature of activity generated by emergency admissions means that cancellations of elective procedures are inevitable from time to time as the system tries to cope with unexpected peaks. As part of the service planning process, it is a matter for agencies to attempt to take account of these peaks and troughs when planning their elective activity levels over a 12 month period. It is important that cancellations of elective procedures are viewed in the context of overall levels of activity delivered in the acute hospital  sector against agreed service plans for the 12 month period. In this context, it should be noted that the total number of discharges, both in-patient and day-patient, for all hospitals in the Western Health Board for the first nine months of 1999 was 54,164, which compares with a figure of 48,787 for the same period in 1998. In other words, the development of services in the region in 1999 meant that treatment was delivered to 11% or almost 6,000 more patients in that period.
I appreciate fully that these statistics are cold comfort to individuals who have had unsatisfactory personal experiences at the hands of the hospital system, as the person in the case raised by the Deputy has clearly had. It is important to outline them, however, to provide an overall context. I hope the Deputy will appreciate the major efforts, which I have outlined, being made by the Government to improve acute hospital services in the west.
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