Jack Wall (Kildare South, Labour)
Link to this: Individually | In context

I thank the Ceann Comhairle and the Minister of State for taking this very important matter, which concerns a six month old baby born under an emergency section procedure. This resulted in trauma for the family, the grandparents and the parents. Like myself, the Minister of State is a grandparent and the concerns one has in such cases cannot be overstressed. The child must have a number of operations. The family lives in Kilkenny, which is two hours away from Our Lady's Hospital, Crumlin. Arrangements were made for the operation to take place on 9 February.

The procedures in place for such operations meant that the family had to leave home at 7 a.m. and the six month old child had to fast from 3.30 a.m. The family arrived in the hospital and met the medical operation team. Suddenly, at noon, it became obvious that there was a problem with the availability of a surgical bed for this case. The family was informed that there was no bed available and the two procedures had to be cancelled. The family lays no blame on the medical team and stresses the help and guidance the medical team provided and the effort it made to facilitate the family.

Only one of the procedures will take place on Thursday because of the unavailability of one of the consultants. This leads to an added cost to the HSE. In the first place, there were to be two operations but now there will be one on Thursday and we do not know when the second will take place. One can see trauma for this young couple with one other child, for whom they must care as well as the child with health difficulties. Cathal needs attention but the beds are not available. Could beds have been made available in an emergency situation? Surely we cannot have a child fasting from 3.30 a.m. only for the family to be told at noon that the bed was unavailable. It was nearly 1 p.m before the child was fed. Surely we have a sense of responsibility that matters such as this cannot happen in the future.

I ask the Minister of State to provide a guarantee to the family that, on the next occasion they leave Kilkenny to come to Crumlin, beds and facilities will be available and the two operations can take place to allow the child the comforts of life and to allow the family to know that every effort has been made to ensure the child progresses.

Kathleen Lynch (Cork North Central, Labour)
Link to this: Individually | In context

I thank the Deputy for raising this matter, which is not just urgent and crucial but also sensitive for parents and relatives. I will respond on behalf of my colleague, the Minister for Health, Deputy James Reilly.

Our Lady's Hospital, Crumlin, wishes to apologise for any discomfort for patient and parents caused by the need to reschedule this child's surgery. The Deputy will be pleased to know that the hospital has confirmed a proposed admission date for the child tomorrow, 15 February 2012. The hospital has indicated it will take into account the previous cancellations when allocating beds within the hospital tomorrow.

Our Lady's Children's Hospital, Crumlin, in common with its sister hospitals, the Children's University Hospital, Temple Street and AMNCH incorporating the National Children's Hospital, is currently experiencing a surge in attendances to its emergency department and a corresponding surge in admissions through its emergency department. These admissions have a knock-on impact on elective surgeries in that the clinically indicated admissions must take priority. The Dublin paediatric hospitals work across the three sites in order to ameliorate a number of pressures on elective surgery and have put mitigating mechanisms in place.

The clinical director, a joint appointment across all three hospitals, works with the hospitals to ensure patients are given the right treatment in the most appropriate location. When bed pressures occur, the clinical director clinically reviews patients and, where necessary, redeploys patients across the hospitals in order to minimise the impact on elective surgery.

In addition, a one-stop-shop is being created for paediatric intensive care beds, supported by an ICT infrastructure to streamline the process. Consultant paediatricians from around the country with patients requiring access to paediatric intensive care beds will be able to contact a low call number. The consultant will then access the ICT support and provide the patient details for review. Based on this information, the appropriate bed is designated and the admission procedure takes place.

The hospitals also have a number of cross-site working groups in place including nursing, theatre utilisation, ICT, waiting list review groups and a CEO group, all focused on conjoint working to improve access, quality and resource utilisation for patients. Paediatric hospitals remain cognisant at all times of the challenges facing their young patients and the need to support families. They work with the families whenever possible to ensure the least possible disruption to the patient.

In addition to the mechanisms already in place within the three Dublin paediatric hospitals, the special delivery unit, SDU, was also established last year to unblock access to acute services by improving the flow of patients through the system. It is working with the HSE, NTPF and hospitals to minimise patient waiting times in emergency departments and reduce waiting periods for inpatient and day case elective surgical care.

Again, the hospital wishes to apologise for the unfortunate need to postpone surgery in this case. The Minister is determined to ensure the steps now being taken will minimise the likelihood of having to do so in other cases.

Jack Wall (Kildare South, Labour)
Link to this: Individually | In context

The problem is that it took so long to make a decision. If it had been made early in the day, the child could have been fed. The decision was not taken until noon, which meant the child was not fed until 1 p.m. The child has major problems and has to be peg fed, which has associated problems. There was pressure on the family. There was a major flaw with the case. There were two surgeons in place to carry out two different operations, as well as a team, and they were also disappointed.

Was a bed available that could have been used? If emergencies arise rules must be broken. A bed should have been made available in this case because of the importance of the operations and the fact the team was put together. None of the trauma the family is now experiencing would have happened. The family is now wondering what will happen.

Kathleen Lynch (Cork North Central, Labour)
Link to this: Individually | In context

The child was acutely distressed and in need of medical attention before reaching the hospital. Everyone can understand that. The Deputy asked a very relevant question. Crumlin hospital advised the HSE today that it has had an increase of 25% in GP referrals of late, thus putting additional pressure on its emergency department at a time when it is historically busy with normal respiratory illness.

The Deputy asked whether, in the even of an emergency occurring, a bed was available. There was but the difficulty was that emergencies occurred. Unfortunately they occurred at a time when the child concerned should have been prepped and sent to theatre. Clearly, the beds that were available were in use and no downstream bed was available when the child came out of theatre.

I hope it will never happen again but I can understand how it did happen. That does not take away from the distress that not just the parents but the child felt. We all know it is not just about getting to hospital, rather parents psyche themselves up for the fact that a child will have invasive surgery. I hope tomorrow's procedure will go ahead as planned and will be successful.