Mary Upton (Dublin South Central, Labour)

I thank the Ceann Comhairle for giving me the opportunity to raise this matter on the Adjournment. Ireland has the highest incidence of cystic fibrosis in the world. Survival of cystic fibrosis patients in Ireland is much worse than in England, Wales and, most significantly, Northern Ireland. As St. Vincent's Hospital in Dublin had 304 adult patients on its books at the time of publication of the Pollock report, the situation was reported as being stark. According to Pollock, cystic fibrosis patients and elderly respiratory patients are located "cheek by jowl in a tightly constrained space". Segregation from an infection control point of view is difficult and the social mix of young cystic fibrosis patients and elderly patients, some of whom are incontinent, is very unsatisfactory.

A recent letter to me from one of the young adult patients, Simon, identified the following problems:

The ward which has been allocated to us is now being used for older men and women who are awaiting beds in Old Folks Homes or hospices. Because of this CF patients are suffering and we cannot get beds. At the moment, [31 January this year] there are three six-bedded rooms for women and one six-bedded and one three-bedded room for men. Out of these twenty-seven beds, older men and women who do not suffer with Cystic Fibrosis are taking up the majority. Some of these patients are on this ward up to one year... There are patients on the transplant list awaiting beds from casualty for a number of days. These patients are prone to the MRSA bug, which is in the hospital. No one is screened for this when they arrive in casualty . . . I am now in to the third week of a severe chest infection and I am reluctant to go back in to hospital, as God only knows what problems will arise. I am regularly admitted to hospital and it is difficult enough having CF without the added grief that I and others are given.

I have been told of other incidents where, for example, an elderly patient climbed in to the bed of a cystic fibrosis patient when he went out for a few minutes. The result of this was that much valuable nursing time was taken up sorting out the problem, with beds having to be remade and disinfected and efforts made to prevent the elderly patient causing any other havoc. Many other such incidents have been reported to me by the young adults in the cystic fibrosis wards.

The Pollock report, published in February this year, made a number of observations that represented a serious indictment of the services and facilities available to cystic fibrosis patients in Ireland. Specifically, Pollock described the current staffing for cystic fibrosis patients as dangerously inadequate. He identified that approximately 40 staff serve the total cystic fibrosis population of 1,143. Based on recognised standards of care this should be 175 staff, which would require an increase of 338%. He also stated that the physical resources fall well below accepted standards, noting that those in St. Vincent's Hospital are particularly poor. This is the largest cystic fibrosis centre in Ireland. The patient profile is one of young adults. That the primary centre for the treatment of young adults with a life-threatening disease can be described in a professional report as "seriously inadequate" is a disgrace. Furthermore, it is ironic that within 20 yards of the cystic fibrosis ward in St. Vincent's Hospital there is a state-of-the-art extension, completed for more than 18 months and not yet occupied. Will the Minister investigate this and ensure the building is used for the purpose intended so other beds in the hospital may be freed up? Taxpayers' money should not be squandered in this way while patients are left in a totally inappropriate environment.

Beds for cystic fibrosis patients should be in single rooms to avoid cross-infection. Patients should not expect to be left in a six-bed ward with patients suffering from respiratory or other infectious medical conditions. It is the risk of cross-infection which causes greatest concern to these young adults. Identification of the bacteria responsible for infection in cystic fibrosis patients is often complex and cannot be carried out in a routine laboratory. Why is there is no consultant microbiology service, backed up by a reference laboratory attached to the biggest cystic fibrosis centre in the country? As it stands, some samples have to be sent to the UK for identification. This delays treatment, thus further compromising the patient and hindering his or her opportunity for rapid improvement.

I ask the Minister to take account of the recommendations in the Pollock report and to visit the hospital for herself to see the conditions patients and staff must endure. The commitment of the medical, nursing and ancillary staff in the specialist ward is above reproach. They struggle on a daily basis to deliver quality health care to a cross-section of patients with very different medical and nursing needs. However, it is not good enough that young cystic fibrosis patients are compromised because of a failure in our health system.

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