Thursday, 13 March 2008
Seanad Eireann Debate
Senator Alan Kelly: I wish to raise the matter of the need for the Minister for Health and Children to outline if the Government is fully committed to providing funding for the operation of the CT scanner that has been lying idle in Nenagh General Hospital for almost a year and to provide an indicative date for the commencement of its use.
This is one of the biggest farces of the HSE, and all involved in politics in my part of the country accept it is a farce. The CT scanner in Nenagh hospital was announced with great fanfare in April 2006 by two of the Minister of State’s colleagues, including the current Minister of State at the Department of Health and Children, Deputy Máire Hoctor. This new scanner would mean approximately 500 patients would not have to be ferried to Limerick for scans. It is now March 2008 and the CT scanner is still sitting in its own unit in Nenagh hospital with the plastic on it. It has never been used.
The work on the CT unit was completed in June 2007, but there has been no movement since. I visited the hospital with my party leader Deputy Eamon Gilmore. The issue, however, is such an embarrassment to the HSE that it would not permit us to view the new unit, despite the fact we had journalists and photographers with us. We were barred from seeing the new CT scanner in case we photographed. I pointed out that I could download a similar photograph from the Internet and use it, but that made no difference. The CT scanner is an embarrassment to the hospital.
This issue has a wider impact than the matter of whether scans are provided in the hospital. It has a significant impact on the service being provided by the ambulance service, a matter I have raised in the House previously. The ambulance service is stretched for a number of reasons. It is now down to one stretcher and capacity is halved. The same ambulance service, which can operate only one ambulance in the evening, ferries people in and out to Limerick. If there is an emergency on the N7 or nearby, the ambulance may be doing the job of ferrying people to Limerick for scans, despite the fact there is a scanner lying idle in the hospital to which the ambulance is attached. This is ridiculous.
I understand from the HSE that when the manager of Nenagh hospital applied to get eleven people to run the unit, he was told Bantry hospital could do it with 6.5 people. I understand the hospital in Ennis got approval through the National Hospitals Office for 6.5 people to run a scanner, despite the fact it does not have one. Nenagh got no approval, although it does have a scanner. I pointed out this several times previously.
The budget for Nenagh hospital is approximately €22 million for 2008, an increase of approximately €75,000. Medical inflation runs at 10% and with the way general inflation is going this is an effective drop in the budget of 12%.
Senator Alan Kelly: With medical inflation included, the budget is effectively reduced by 12.5%. This means Nenagh hospital was under funded for this year, but it has always spent over the allocated funding. The manager has been told he must fund the CT scanner and the people to operate it from current funds. That is impossible for him. He already has approximately 35 people employed who, according to the HSE, should not be employed. How then is he meant to provide for the scanner?
The hospital already suffers from the fact that the elderly care unit was closed over Christmas. A team work report is due and it will consider the role of the hospital. Many of us are worried that report will have an impact on accident and emergency services and on the clinical area. The hospital has already closed many of its wards and now provides just 75 beds.
We have been told that in order to run the CT scanner the hospital needs specialist radiography staff and a clinical nurse specialist. I understand that. However, the response to the situation from the HSE is laughable. It does not come back with a response to queries for days. When it does come back with an answer, it is so generic it is useless. The hospital manager provides as much up-to-date information as he can at his forums, which I attend but which are not usually attended by the Minister of State with responsibility for the elderly, Deputy Hoctor. However, information from the manager is not the issue. The problem is we cannot get an answer from the HSE as to when it will put in use this badly needed scanner that is sitting idle. Its operation would also have a dramatic impact on the ambulance service in the area.
The HSE has stated that all options are being explored at present in order to commence this diagnostic service at the earliest possible date. That is complete and utter waffle. It should provide an indicative date. It should give us a date for which the hospital manager can budget. Perhaps the date could be provided before the publication of the team work report relating to Nenagh hospital and other small hospitals which is due in April. It is an indication of the lack of joined-up thinking if it is provided later.
The situation is an embarrassment for the HSE, the Government and local government representatives in the area, Deputies Hoctor and Lowry. I look forward to a response.We need to know when it will be opened and we need an indicative date. We need to know if the hospital will get the funding. A sum of €22 million to run that hospital simply will not work. I beg the Minister of State not to begin his response by saying that this is a matter for the HSE.
Deputy Michael Ahern: I will be taking this Adjournment on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. Senator Kelly does not want to hear it but the facts are that the provision of services at Nenagh General Hospital and across the mid-west region in general is the responsibility of the Health Service Executive. The Government is committed to providing a high-quality service to all patients. Nenagh General Hospital, which has 81 beds, provides a range of acute services for the people of north Tipperary.
The HSE advises that the staffing and budget of Nenagh General Hospital has increased significantly over recent years. The revenue budget for the hospital has more than doubled from €8.5 million in 2000 to €20.5 million in 2007. Staffing levels at the hospital have increased from 182 in 2000 to 248 in 2007. The additional staffing includes the appointment of four dedicated emergency care physicians providing round the clock medical cover for the accident and emergency department. On the capital side, €2.74 million has been invested to facilitate new developments and upgrades in the accident and emergency department, the laboratory department, the X-ray department and the development of CT scanning
The HSE acknowledges that additional staff are required to facilitate the introduction of a CT scanning service at Nenagh General Hospital. The commissioning of services flowing from the capital developments completed in the recent past, including the CT scanner, will be considered by the HSE within its overall budget. Various options are being explored at present to commence this diagnostic service at the earliest possible date. The HSE will continue to do all it can to ensure the provision of a high-quality, patient-focused service to the people of north Tipperary.
Senator Alan Kelly: I have a great deal of respect for what I hope the Minister of State is trying to do in the area of innovation. However, both he and I know that what he had to read out was a load of waffle. He did not even have the spirit to read it in a good tone.
I have a very simple question. Could the Minister of State pass on to the Minister for Health and Children a request that this be dealt with one way or another before the publication of the Teamwork report? Otherwise, there will be no joined-up thinking. Can we have an answer one way or another before the expected publication of the Teamwork report in the first week in April? The report could be published later on in April. If we do not get an answer, the Teamwork report could override it, which would be a war in itself. There will then be concerns about whether this is outside or inside it. We need a date and to know whether it will be opened. It is an embarrassment. We need to know whether the scanner and its facilities will be used because people see this as a symbol of how the hospital is treated and whether this Government believes it has a future. By not opening it, a clear signal is being given that, unfortunately, the Government does not have faith in maintaining the hospital in the future, which is something we all must fight.
Deputy Michael Ahern: I will raise that matter with the Minister. In respect of the Senator’s comment about not maintaining the hospital, a few years ago, I listened to the debate on Nenagh General Hospital and arguments that it was to be downgraded. When one sees the extra staffing and funding for the hospital, one can see that the Government intends to ensure the hospital continues and provides a better service to the people of the Senator’s area.
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