Tuesday, 23 November 2004
Dáil Eireann Debate
Dr. Cowley: I am very grateful for the opportunity to raise this important matter on the Adjournment. There is a limit on the recruitment of whole-time equivalents, WTEs, such that the health board is confined to a certain number of staff and not in a position to go above the ceiling that exists. This is arbitrary and unfair. It is very regrettable to have insufficient staff when the work to be done is a matter of life or death. I ask the Minister of State to consider this issue and lift the embargo.
The embargo has affected many parts of the health service in recent years. This is particularly the case in Mayo, where the failure to recruit four extra staff needed to have an extra shift in the Mayo dialysis unit means that seven people have to travel all the way to Galway to receive essential treatment that they should receive in their own county, even though there is a state-of-the-art dialysis unit in Mayo General Hospital. This problem can only be resolved by lifting the ban on employing nurses. This is a very important and simple resolution and I ask the Minister of State to take it on board. It is not a question of money.
The seven people who have to travel to Galway are all very ill. In explaining the rationale behind my request to lift the embargo, it is important to discuss the background. For many years the people of Mayo have worked very hard to have a dialysis unit in their county because the distance from parts of Mayo, such as Belmullet or Blacksod, to Galway is almost the equivalent of that from Dublin to Galway. It is a long way to have to go for essential services. The campaign to have a dialysis unit in Mayo involved all sorts of activities and led to a state-of-the-art unit with a capacity of 24 patients. It currently has 26 patients and thus it is already exceeding its capacity. Although the number of patients in the unit has doubled in the past year, the number of nurses has remained the same.
Consider the operation of every other dialysis unit. In Beaumont Hospital’s dialysis unit, there are four shifts and in that of University College Hospital, Galway, there are three. There are but two in the dialysis unit in Mayo and, therefore, the seven very ill people who need dialysis to stay alive are required to take a round trip to Galway, which, in some cases, amounts to 2,000 miles per week. It takes three and a half hours to get to Galway from one end of Mayo and the same to get back, amounting to seven hours of the day. This is in addition to four hours on a dialysis machine, resulting in a total of 11 hours per day. Elderly people have to make this lengthy trip. Only one third of people receiving dialysis are suitable for a kidney transplant and, therefore, the remaining two thirds must have dialysis for life. They are condemned to making the aforementioned journey, which takes 11 hours per day, three times per week, on Monday, Wednesday and Friday, for example. It takes 33 hours of a patient’s week to travel to the dialysis unit and back and to receive treatment. That is horrific.
Despite the humanitarian aspect of requiring someone to make such a journey, the cost must also be considered, whether it be the cost to the health board of taxis or that of an ambulance if the patients are ill. One of the patients to which I refer is 74. He lives on the outskirts of Castlebar and is at present in hospital in Galway. He will be discharged tomorrow but will be required to travel from home to Galway three days per week although he is not fit to travel. He is condemned to death unless the Government removes the recruitment embargo and allows four nurses to be hired. I implore the Minister of State to do this.
Minister of State at the Department of Health and Children (Mr. T. O’Malley): There is no Government embargo on the recruitment of nurses. The chief executive officer of each individual health board has responsibility for the management of the workforce, including the appropriate staffing mix and the precise grades of staff employed within that board, in line with service plan priorities, subject to the overall employment levels remaining within the authorised ceiling.
The Health Service Employers Agency undertakes a quarterly national survey of nursing resources. The most recent survey reported that the recruitment of additional nurses continued to be a prominent feature of activity, with a net increase nationally of 563 nurses in the system in the year ended 30 June 2004.
My Department wrote to the CEO of the Western Health Board on 21 September approving the provision of funding and authorising the following increases in the employment ceiling to allow for the commissioning of new units in the board’s area: University College Hospital, Galway — an adjustment in the employment ceiling of 140 additional posts to allow for the transfer of orthopaedic trauma and the commissioning of intensive care beds; Mayo General Hospital — an adjustment in the employment ceiling of 95 additional posts to allow for the full commissioning of orthopaedics and a further adjustment of seven staff for the unit for the elderly; Portiuncula Hospital, Ballinasloe — an adjustment in the employment ceiling of ten additional staff to allow for the development of a stroke care unit and the commissioning of ICU beds; and Roscommon County Hospital — an adjustment in the employment ceiling of 40 additional staff to expand the emergency department and for a new medical assessment unit.
It is clear from these figures that the Government is committed to the continued development of services in the Western Health Board and that recruitment of nurses and other health service staff remains a priority.
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