Niall Blaney (Donegal North East, IND-FF)

I join my colleague, Deputy Keaveney, in speaking about the concern caused by the serious problems faced by Letterkenny General Hospital, which is unable to handle the current level of patient intake. It would be an understatement to say that the circumstances at the hospital, which I visited on Monday, are chronic. I have never witnessed anything like it. The day-services ward has six beds and can, therefore, accommodate six patients, but on Monday it dealt with 16 seriously ill people who were waiting for elective surgery and other surgical procedures. Those present were male and female and ranged from children to pensioners. No washing or showering facilities of any kind were available. I spoke to a consultant, Dr. Keating, who was tearing her hair out.

I support Deputy Keaveney's comments. I would like to analyse this matter from three perspectives. I will outline the causes and effects and then offer some solutions which, I hope, the Minister for the Environment, Heritage and Local Government, will pass on to the Minister for Health and Children.

It is important to state there are two major interrelated problems facing Letterkenny General Hospital. The emergency medicine department has six bays, as Deputy Keaveney said, and that is not sufficient to assess the 30,000 patients who attend each year. Six bays normally cater for only 10,000 patients. There are not enough beds to facilitate the annual number of admissions, which is just short of 10,000 per year.

As Deputy Keaveney outlined, the attendance level in the emergency department is rising. In 1992, approximately 15,000 people attended whereas now more than 30,000 attend each year. This is caused by changing demographics, urbanisation and growth. As Deputy Keaveney stated, the population of Letterkenny has grown by 42% in recent years.

There have been many consultant appointments in the hospital since 2000, including a haematologist, oncologist, cardiologist, respiratory consultant, nephrologist, geriatrician, breast care surgeon, two radiologists and two anaesthetists. There have been two appointments to the accident and emergency department. Although new consultants are being appointed, we feel we are not getting a fair crack of the whip. As the Ceann Comhairle will know, each consultant needs his or her own bed in turn. Only 17 beds have been added to Letterkenny General Hospital in the past 25 years.

The effects of all these problems include the cancellation of day service procedures, elective inpatient procedures and outpatient appointments. The morale of staff is at an all-time low despite that there are good staff at the hospital. Public confidence in the hospital is also at an all-time low. The effects are also such that patients admitted overnight are put in inappropriate accommodation. Some 340 patients were put in inappropriate accommodation so far this year. Already in 2005, 250 procedures have been postponed owing to the unavailability of beds. Twenty-two of the procedures were cancelled twice. This will increase the number of patients on the day case waiting list for next month by up to 10%. Waiting lists will get even longer if the problem persists.

On the cancellation of elective inpatient procedures, 52 procedures were cancelled during January 2005 owing to the lack of a recovery bed. Cancelled procedures included boil, bladder and breast cancer cases. Some patients' procedures were cancelled two, three or four times. The inpatient waiting list grew by 22% during 2004 and it is growing further as we speak. On the cancellation of outpatient appointments, 315 patients had their appointments cancelled between 5 January 2005 and 12 January 2005.

Deputy Keaveney outlined some solutions. In this regard, I refer to the ten-point plan announced by the Minister for Health and Children and the uniqueness of the problem faced by Letterkenny General Hospital. All the points in the plan that can be implemented in the hospital have already been. The others cannot be implemented until the two issues we have identified are addressed, namely, the need for approximately seventy extra beds and the need for an adequate extension to the emergency medicine department.

We already have a transit lounge to be employed in respect of the second consultant appointed to the emergency medicine department. A joint management consultant group has been in place since 1998 and there are additional nursing staff in the accident and emergency department. The triage service has been introduced and extended and there are additional non-consultant hospital doctors in the emergency department. There is an air tube system for the delivery of samples and a digital X-ray system has been introduced. A bed manager and discharge liaison nurse have been appointed to maximise bed turnover.

Among the medium-term to long-term solutions are additional accommodation to house 70 beds and an extension to the accident and emergency department. These are essential. The 11 oncology and haematology beds also comprise part of the solution and they will need to be fully funded if they are to be commissioned in 2005. I ask the Minister of State at the Department of Health and Children or the Minister, if she is available, to come to Donegal to see at first hand the severe circumstances that prevail at Letterkenny General Hospital and note how the hospital is different from those in Dublin to which the ten-point plan relates. Circumstances are different in Donegal.

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