Séamus Healy (Tipperary South, Workers and Unemployed Action Group) | Oireachtas source

I welcome our visitors and thank Mr. Woods for his presentation.

I will deal almost exclusively with the report on South Tipperary General Hospital. Obviously, I have a particular interest in it as I am elected in Tipperary South, but I am also a former employee of the South Eastern Health Board and I was manager of the hospital for quite a number of years.

First, I welcome the report. I believe it is a positive report. It gives the unit a clean bill of health. It paints a picture of good staff working well together, good facilities and good outcomes. There is a paragraph in the report which is worth repeating because it gives a sense of the unit at the hospital, and probably gives a sense of the strength of units such as this throughout the country. It states:

The sense of strong team working is palpable in the unit. The broader Midwifery leadership team is energetic and positive and just gets on with things. This too adds to the resilience. A large proportion of the staff are local people who have a huge personal commitment to the hospital which means that they frequently turn up to work outside their contracted hours when things are busy. This is such a strength and should not be underestimated or taken for granted.

That final sentence is important, "This is such a strength and should not be underestimated or taken for granted." That has always been a feature of South Tipperary General Hospital, and, indeed, its maternity unit, and, to a large extent, general hospitals right throughout the country. I compliment and thank the staff, generally in the hospital, and particularly in the maternity unit, for the work, service and commitment to the unit that they have shown down the years.

I welcome also that Mr. Flory identified issues that need to be dealt with within the unit in the future. To some extent, Mr. Flory is confirming the policy of grouping the hospitals, which has been accepted and which, as we speak, is being implemented in the south-west grouping. The report simply confirms that position.

There are issues that Mr. Flory raises in the report, and it is important that we get some clarification from the HSE, because there is a fear out there among all smaller units and general hospitals that the view behind all such reports is that downgrading or closure is only a step away. Of course, that fear has been strengthened by the conduct of the HSE over the past number of years. I refer, in our case, to a strong and determined approach by the HSE to transferring services from the hospitals to other areas in the south east a few years ago. Indeed, it took 15,000 people on the streets of Clonmel to stop that development. The HSE has a particular responsibility to make it very clear that it supports units such as the South Tipperary General Hospital unit and wants to see such units continue in existence in the future, providing a good-quality service for the people of south Tipperary.

Specifically, in the report, Mr. Flory speaks about staffing deficiencies. With regard to consultant staff, he makes it clear that at least a fourth consultant is required for the unit. I want to know what the situation is in that regard. Mr. Flory also highlights the issues of governance and management, and the lack of a significant number of management staff within the hospital and the unit. I also want to know what proposal the HSE has for dealing with that situation. I accept that to some extent the whole governance area is in transition because of the hospital group situation. We have a situation in which the structures may not be fully in place, but there are strong professionals with leadership qualities who to some extent at this stage would be compensating for the lack of formed structures.

Will the HSE representatives outline their proposals for strengthening the management system within South Tipperary General Hospital? While Mr. Flory indicates that midwifery numbers are at a ratio of 1:32 deliveries, he goes on to say that this level does not provide enough staff to provide leadership on a 24-hour basis. He states:

The midwife to births ratio is a healthy 1:32 following the addition of five new posts in the last few months. Whilst this is positive the unit still cannot operate 24/7 shift leaders.

What proposals does the HSE have for dealing with that situation?

Another issue is the question of the development of the group. It seems to be developing very slowly. Mr. Flory refers to that in the report. My understanding is that the boards of the groups have not been appointed as yet. Again there are gaps in the filling of posts within the groups. That whole area needs to be developed.

In the case of South Tipperary General Hospital, Mr. Flory refers to a number of specific areas which he feels must be upgraded. We have been asking for that for quite some time. The Minister visited the hospital in July of this year and I, as chairperson of the hospital action committee, put this point to him. The phase 2 development plan, which has been in existence for quite some time, effectively means the upgrading of the old hospital building. This is the former workhouse dating from 1846 and that part needs to be urgently upgraded. Has funding for this development been put in place and when will see work on this second phase?