Wednesday, 14 February 1996
Seanad Éireann Debate
Mr. Maloney: My proposal asks the Minister for Health to provide more finance for Letterkenny General Hospital. The hospital embarked on a number of renovations of its casualty department in early December. It may have been the wrong time of the year to start it because it created a great degree of chaos in the hospital. Around the same time every year there is a rush of admissions to every general hospital throughout the country and Letterkenny is no  different. There is an upsurge in asthma and bronchitis problems at this time of year resulting in an undue demand on beds.
An enormous number of beds were placed in the corridors of Letterkenny General Hospital. Most of these were surgical and medical cases. On a number of visits to the hospital — which I visit quite regularly — I was set upon by staff and patients who said it was not good enough that so many beds should be in the corridors. It creates embarrassing problems for patients. Staff are overworked because no extra staff were brought in to deal with this problem. I was concerned about what would have happened if there had been a fire. Do the health and safety regulations applying to the hospital allow for the placing of beds in corridors? Beds in the corridors make it nearly impossible for people to get out in the event of a fire. I do not want to think about what might have happened if something had gone wrong.
Patients do not like to be accommodated in corridors. One old lady of 75 told me it is not very nice if one wants to go to the toilet. I raised the matter with hospital management and I was assured that beds would be provided. Two days later I was called back to the hospital by a lady whose husband was admitted to hospital suffering from meningitis. He was on a bed in a corridor and we had to make a strong case to have him put into a ward. Two wards with eight beds were opened to try to relieve the situation. I was saddened to learn that no action had been taken on assurances given to me at my previous meeting with hospital management.
When I asked why no extra staff had been employed I was told the hospital did not have any extra staff and could not get any. However I had letters from six nurses who had applied for work in the hospital and were refused. This is not good enough. I wrote to the North-Western Health Board and am still awaiting an acknowledgement.
 I looked at the budget for Letterkenny General Hospital; net expenditure was almost £17 million in 1994 and £8.1 million in 1988. Staff are asking how this budget is spent. This question must be answered. The staffing levels in Letterkenny General Hospital compared to other hospitals are not good and more staff must be provided. An explanation must be given as to where that £17 million is being spent.
Nurses are threatening action at the moment and the £20 million package for nurses in general promised by the Minister is not enough. Teachers were offered a package of the order of £65 million. I have nothing against teachers but nurses work much longer and tougher hours. The nurses are angry. The situation in Letterkenny is probably similar to other hospitals but it is particularly bad there. The staff deserve to know what is going on and how the money is spent. I ask that more funding be provided.
Mr. McGowan: I join with Senator Maloney in welcoming the Minister for Health. This kind of contact is useful. I also support Senator Maloney's request for more money for Letterkenny General Hospital if that is possible. I have been a public representative and a Member of this House for 28 years. I have been a member of Donegal County Council for 38 years. I know there is no magic wand to provide money and that the Minister is constantly under pressure but I have an obligation to answer one of the issues raised. Senator Maloney says he wrote to the North-Western Health Board and did not get a reply. He did not say that he first made a public statement, after the North-Western Health Board——
Mr. McGowan: I was present when this matter was discussed at the North-Western  Health Board. The North-Western Health Board found it necessary to make a public statement. The Minister will recognise that our health board has one of the best chief executive officers in the country. He has developed the health services at a low cost. He has been an excellent chief executive officer and has been put in charge of another district as well as his own. The management of the health services in the north-west has been excellent. I say that while supporting the proposal to provide extra funding for Letterkenny General Hospital.
Part of what Senator Maloney said is right. We have overcrowding for a period of the year but I have long experience in this area; I have been a hospital patient. I slept in the corridor of the hospital but I also got first class treatment there. If a patient is taken into hospital at 11 p.m. or midnight and all the beds are full, he or she will get very satisfactory medical care. I dispute that patients are left more than one night in a corridor. A great effort is made by the nursing staff to accommodate them in wards.
The Minister has access to this information and can establish the facts. I am describing the situation as accurately as I can. I want to put on the record that before work started on extending the casualty department in the Letterkenny General Hospital, the chief executive officer had consultation with hospital management. There was not a single objection; there was total agreement that it was necessary to extend the casualty department. That work was undertaken with the agreement of all the staff. There were no disruptions, not a single bed was displaced. I will accept the Minister's word on this and will apologise to the House if he can tell me otherwise.
Mr. McGowan: It would not be right for the wrong information to be given in the Seanad. The Minister can reply; he has an answer which I will accept. My colleague, Senator Maloney, may be a candidate in the Donegal North-East by-election. Perhaps he is playing politics with this issue.
Mr. McGowan: The Senator did not raise the question of extra funding for Letterkenny General Hospital when a colleague in his own party was a Minister. It is hypocritical to raise this matter now. I support the request for extra funding for Letterkenny General Hospital.
Minister for Health (Mr. Noonan,: Limerick East): It is easy for me to reply because Senator McGowan has already covered points raised by Senator Maloney. My comments will be relatively superfluous. I was asked to address the need to provide funding to Letterkenny General Hospital for an increased nursing staff. My reply relates to that matter rather than the other issues raised, although I will comment on those also.
The deployment of staff within ceiling and budget is a matter for health board management. Individual health boards are in the best position to determine how to deploy their own personnel, with due regard to the different priorities and  service requirements throughout each board's area of responsibility. As part of its decision in 1995 on the recruitment of public service staff, the Government agreed that recruitment could proceed in the health services in line with the parameters on overall spending, with particular emphasis on service areas due for development. As a result, 1,200 additional posts were created in the health services in 1995 and a further 600 posts will be created in 1996.
In the context of this agreement the North-Western Health Board received approval for the recruitment of 74 additional staff in 1995. Seventeen of these posts were nursing posts, of which seven were allocated to Letterkenny General Hospital. With regard to 1996, discussions are ongoing between the board and the Department concerning service developments and associated staffing. The strengthening of staffing levels must be considered by the board in the general context of balancing all service development priorities with the total amount of funding available and its total employment ceiling. In the normal course, staffing levels for individual units within each hospital are adjusted regularly to take account of service pressures.
I agree with Senator McGowan that the North-Western Health Board provides a very good service. Services in the north-west have improved enormously over the years and the chief executive officer, his staff, the management staff and the nursing, medical, attendant and paramedical staff should be congratulated. Regarding overall staff levels, between 1990 and 1994 the number of staff at Letterkenny General Hospital increased by 67 from 609 to 676. There was also an increase in 1995, so the North-Western Health Board or Letterkenny General Hospital have not been short-changed in any way.
We all agree that once builders come into a hospital, which must be run as an  ongoing concern while structural modifications are made, it leads to a situation where, even with the best will in the world, it is most difficult for staff to continue to provide a service as heretofore and cope with the disruption caused by the building work. Any woman at home will say that if a new kitchen is being built, it is not as easy to carry on with the normal work of the house while it is happening.
Regarding the question of choosing December to make the modifications, it is normal that all elective surgery is cancelled in hospitals after 8 December. There is a winding down and this also happens during the summer when consultants are on holidays. There is more scope for building work for approximately three weeks at Christmas and also in the summer during the high holiday period when elective work is cancelled. While the hospital is extremely busy — and particularly so this year as a result of the 'flu epidemic — it was possible to concentrate on emergency activity because the elective work was out of the way, as it was in other hospitals.
There was no reference in the matter raised on the Adjournment to the development of the new accident and emergency department. I cannot comment, therefore, on the level of disruption caused. However, I accept the Senator's point, because once builders come on site to extend an existing facility rather than build a new hospital, there will be disruption.
Regarding the nurses pay dispute, as Minister for Health, I would like it to be resolved on the basis of a negotiated settlement in accordance with the provisions of the Programme for Competitiveness and Work.
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