Seanad debates
Tuesday, 28 February 2023
Nithe i dtosach suíonna - Commencement Matters
Health Services
12:30 pm
Martin Conway (Fine Gael)
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I welcome the Minister of State, Deputy Rabbitte, to the House. I am delighted she is here to take this matter. As we know, there is an increased number of people in this country on dialysis. We have seen the figure increase exponentially in recent years. This is partly due to people living longer and there being better healthcare options and opportunities available.
There are quite a number of people in County Clare receiving dialysis. Some of them are in the west of the county, down on the Loop Head Peninsula and around Kilkee. The Minister of State is familiar with the area. Those people must go to either Limerick or Galway to get their dialysis. It takes the bones of an hour to get from Loop Head to Ennis and then another half an hour to get to Limerick. It therefore makes absolute sense for a dialysis unit to be opened on the grounds of Ennis Hospital. This would achieve a number of things. It would dramatically reduce the time people in Clare must travel three or four days a week to get dialysis. For example, rather than a person in Ennistymon receiving dialysis travelling a minimum of an hour to get to Limerick and the same to get back, a unit in Ennis would mean a journey time of just 25 to 30 minutes each way. From a quality of life perspective, this would make an enormous difference to the daily and weekly lives of people in Clare who require dialysis. Having to get dialysis every week of every year is traumatic enough without the trauma of having to travel into Limerick while battling traffic jams and so on.
This would also take the pressure off University Hospital Limerick, UHL. It makes sense to have services like this in a more localised setting. We have all seen, heard and spoken about the challenges at UHL. Those challenges are not at the dialysis unit but the more capacity that is freed up the better. It would be better for people from Limerick going into UHL for dialysis if there were fewer people in the unit because people were being looked after in Clare. That would extend to people from north Tipperary availing of dialysis.
An investment like this makes sense. There is much talk about the opening of a dialysis unit in Ennis but the purpose of this Commencement matter is to clarify what exactly the thinking of the Government, the Minister and the HSE is. I want to know what kind of timelines we are looking at. Is this imminent or just aspirational? If it is just aspirational can we make it imminent? Can we fast-forward a decision? Can we make happen what we all want to see, which is to have as many primary care supports and services at community level as possible? That is the ask. I look forward to the Minister of State's reply.
Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Senator for giving me the opportunity to address the House on behalf of the Minister for Health, Deputy Donnelly. I am aware this is an important issue for the people of Clare and the mid-west. The Senator referenced north Tipperary and I would say south Galway would also benefit.
Anne Rabbitte (Galway East, Fianna Fail)
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I assure the Senator the Government remains fully committed to improving patient services and ensuring patient-centred care across the country. That commitment can be seen in the unprecedented level of new resources the Government has provided to the HSE over the past three years. This investment is benefiting a huge number of patients accessing care and will ensure hospitals can continue to develop the services they provide, including in the mid-west region. In the context of dialysis services at Ennis General Hospital, the University of Limerick, UL, Hospitals Group has advised that patients from County Clare currently receive their care either in the renal department at UHL or in UHL’s satellite centre, which is located on the Dock Road in Limerick city. However, the UL Hospitals Group is fully aware of the need for the establishment of a kidney dialysis service in Ennis. In that regard, it has advised the Department of Health that a tender specification document for a dialysis service in Ennis is being finalised. This tender document will be issued to the HSE’s national procurement office in the near future. The UL Hospitals Group is seeking to establish a contract for the provision of a haemodialysis service with a suitably qualified renal provider for a contracted satellite haemodialysis unit service in Ennis. This would be similar to the existing satellite service on the Dock Road in Limerick.
It is envisaged that a designated consultant nephrologist from the renal unit at UHL would provide overall clinical governance for the Ennis service and that the new satellite facility would provide the following services: consultant-directed medical care for chronic haemodialysis patients; haemodialysis delivered-supervised by nurses and care with regular consultant-led reviews; regular dietetic review and support; other clinical supports as required, such as pharmacy services; and administrative support.
As the Senator will appreciate, the development of the unit in Ennis would allow patients to benefit from better quality of life by being able to avail of treatments closer to home. The development of this unit would also help to ease pressure on the renal department at UHL and on the existing satellite unit. Although work is under way to progress the development of dialysis services at Ennis General Hospital, this work is at an early stage and will be subject to the HSE’s procurement process. The Department continues to work closely with the HSE to ensure that the UL Hospitals Group and the mid-west region in general are fully supported in the delivery of healthcare services.
I take on board what the Senator stated with regard to the timeline. The HSE already has a blueprint in the form of the satellite unit on the Dock Road. As stated, the clinical governance will be provided by UHL. We now need to know the timeline for delivery and the ring-fencing of the funding in order to put a team in place. In addition, we need to know when the tender and procurement processes will open up in order that those who can provide the satellite service are given the opportunity to do so and that the pressure on the people on whose behalf the Senator is advocating will be relieved.
Martin Conway (Fine Gael)
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That is great news. It is not aspirational; it is imminent. Clarity is needed in respect of the timelines. I encourage the UL Hospitals Group to finalise its tendering process as soon as possible. I hope the Minister of State and her officials in the Department will fast-track the funding in order that the service can be rolled out. It would be great if we could get this over the line in quarter 2 or quarter 3. That would be a reasonable timeline. It is not that additional people will be getting dialysis; it will just be that the services will be better spread geographically. I appreciate the fact that it is another unit which requires clinical governance. That all seems to have been taken into consideration. Let us make this happen. It will be good for medicine in the mid-west, people who have to get dialysis on a weekly basis and healthcare in County Clare.
Anne Rabbitte (Galway East, Fianna Fail)
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It would also be good from the point of view of patient-centred care. Receiving their care in the community and close to home, as opposed to being stuck traffic trying to get to the hospital, would be good for patients.
As already stated, the UL Hospitals Group has made progress recently in seeking to develop its dialysis services and extend them to Ennis. The group’s plan would see a comprehensive, locally available dialysis service providing a range of care to patients from across County Clare and beyond. This would include consultant-directed care, where appropriate, and supervised haemodialysis services. I welcome the group’s commitment to working with all relevant stakeholders to ensure the delivery of the unit.I will bring Senator Conway's ask to the effect that he would like to see this become operational in quarter 2 back to the Minister.
Jerry Buttimer (Fine Gael)
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I welcome students from the renowned St. Mel's College in Longford to the Public Gallery. I also welcome their teachers, Mr. Clarke and Ms McGuinness - I hope I have got the name right - and Deputy Joe Flaherty, who is their host. I hope they have a very educational and beneficial day here i dTeach Laighean. Ba mhaith liom fíorfháilte a chur rompu go léir.
I now call on Senators Hoey and Gavan, who are sharing time. As Senator Black is not present, the Senators will have equal time. Is that agreed? Agreed.