Cecilia Keaveney (Donegal North East, Fianna Fail)

It is with great disappointment that I rise to speak about the need to provide extra beds at Letterkenny General Hospital. Although the matter was discussed when I was a member of the former North Eastern Health Board, neither side ever made progress for a number of reasons.

I would like to outline why it is sad that I have to raise this issue tonight. Letterkenny General Hospital is one of the best staffed and managed hospitals in the country. There is a great feeling among its staff and its patients receive great care and attention. The hospital's problems are not caused by the type of bed blocking we hear about in other parts of the country. The population of County Donegal is increasing significantly — Letterkenny's population has increased by 42%, for example — and the population of the region is aging.

I would like to discuss two issues which are causing great difficulty, the first of which is the state of Letterkenny General Hospital's accident and emergency department, where a new 12-bay medical assessment unit is needed. The Tánaiste said in January, in response to a question from me, that the unit has been identified as a priority for attention. Since then, she has announced a ten-point action plan, the progress of which will be implemented by the Health Service Executive. The executive told me in February that an application has been made and that it is awaiting approval to proceed to the design stage.

It is important for progress to be made. Accident and emergency patients are being moved into areas where day services should be carried out, as a consequence of the lack of space in the accident and emergency unit. Day services are under pressure — they cannot absorb the number of people currently availing of such services.

It is not right that just six bays are available in an accident and emergency department that is accessed by 30,000 patients each year. There is a need to develop the hospital's accident and emergency service because 8,000 of the 30,000 people who avail of it every year are deemed to be GP referrals. Therefore, 90% of them will be looking for an inpatient bed. The 8,000 patients who are sent to accident and emergency units by their GPs are causing problems for inpatient elective surgery and day services, through no fault of their own.

In recent months, hundreds of people have been prevented from accessing such services as a consequence of the problems I have mentioned, some for the third or fourth time. There were over 100 such cases in a single week recently. In some cases, a patient who has been prepared for his or her operation has been informed that it will not take place. It is an unacceptable set of circumstances for patients, staff and onlookers. The vast majority of people in County Donegal have either used the hospital directly or are related to somebody who has done so. Of the 100 day cases which were deferred over a single week recently, 20 were serious inpatient cases which were scheduled for elective surgery. As a doctor, the Ceann Comhairle knows the difficulties such postponements cause for everybody.

A proposal has been submitted to the Department of Health and Children for the construction of an additional two storeys, providing 70 additional beds, over the new accident and emergency department. That development is as important as the extension of the accident and emergency unit, but it falls under a separate application. It is important that both plans are considered.

There have been difficulties in deciding which of the two options to pursue. Some people who were on one side are now on the other side. It is important, however, that the entire project is advanced. I asked for some information about the first option, which is to transfer the acute psychiatric unit to St. Conal's Hospital and to convert the vacated psychiatric unit to provide a maximum of 30 beds for medical patients. That would cost approximately €10.5 million. The preferred option is to refurbish the acute psychiatric unit, while providing temporary accommodation, and to build the two additional floors over the proposed new accident and emergency unit. That option would cost approximately €16 million.

There is a timeframe of 18 months for the acute psychiatry service and a 36-month lead-in for the medical beds. It seems that no plans have been submitted yet. Therefore, I understand that the Tánaiste might be in a position to say that there are no plans. I would like the problems in Letterkenny General Hospital's accident and emergency department to be relieved immediately.

I am sorry that the Tánaiste is not here tonight to respond to the important issue being raised by Deputy Blaney and me. It affects every family in our constituency. I ask her to meet the Deputies who represent the area and those who are capable of moving this process forward. The HSE, the Department, the hospital and the different partners can blame each other, in one sense. I would like all those involved in progressing the two related but separate applications to come to a single table to thrash out the issues, take a decision and make progress on the basis of that decision. It is simply unacceptable that people who are ready for surgery have been denied it on three of four occasions.

The population of County Donegal is increasing and aging. A high-dependency unit needs to be opened. I appreciate that we are doing the best we can with the resources available to us. I hope a renal dialysis unit will open in October. We need the support and help of the Department of Health and Children and the Health Service Executive. They cannot be separated — they must work together, for example by talking to those involved at the coalface. They must decide that Letterkenny General Hospital is a priority. The hospital has not yet benefited from many services, such as BreastCheck. We are working in co-operation with those on the other side of the Border, such as the authorities at Altnagelvin Hospital. We need more beds and we need them now.

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