Cathal Crowe (Clare, Fianna Fail) | Oireachtas source

The patient advocacy and liaison service needs improvement and we need more of that service.

I compliment all the staff, as have others. We want to hammer home the message that we appreciate the great work done by staff. I know that morale can often be low in the hospitals group when staff hear incessantly on the airwaves about failures or services that do not work. The staff are incredible. Certainly, the staff who cared for my family member recently were incredible.

Where are the staff shortages and what areas need to be built up? The Neurological Alliance of Ireland told the committee that more neurological nurses are needed. We heard about different areas. One of the issues I want to home in on is discharge co-ordinators and the inability to send people home at weekends when they are ready to go home. This happens too often. Two years ago, when a different member of my family was in hospital and ready to go home at 5 o'clock one Friday evening, as the nurses and everyone else on the ward could see, a discharge co-ordinator or consultant could not be found to sign off the discharge until the following Monday or Tuesday. My family member was, therefore, a bed blocker who prevented somebody else on a corridor in the accident and emergency department in need of a bed from being moved to the ward. This is an ongoing problem. How is the out-of-hours discharge of patients dealt with?

The witnesses should not take my critique personally but how can the management group have oversight of what happens in the hospital environment when it is based in an office block located 1.5 km from the hospital? I was a schoolteacher before I became a Deputy and my principal had an office down the corridor. In Garda stations, the superintendent has an office down the corridor. There is no way a management team can manage and oversee an acute hospital environment when based a distance away in an industrial estate. The office must be in the acute environment. I know the UL Hospitals Group has several hospitals. Management cannot be based in an office block located a distance away from where everything is happening. I do not expect management to walk every single ward and check every bed every day but surely managers must be on site, as the HIQA report identified. I am not being personal but management staff must be located in the hospital.