Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

I sought this Adjournment debate on learning of the revelations in a study that shows a significant increase in TB infection in parts of Dublin. This has been highlighted and has caused serious concern. The increase shows the inadequate hospital treatment provision for TB patients in the wake of the grossly irresponsible closure of the chest and respiratory unit, commonly known as the TB unit, at Peamount Hospital. The Government facilitated that closure. There is an urgent need for the Tánaiste and Minister for Health and Children to outline the measures she will introduce to address this threat to public health.

According to the study carried out by Dr. Margaret Hannan, consultant clinical microbiologist at the Mater Misericordiae Hospital, young working Irish men are increasingly at risk of contracting TB. The research looked at all of north Dublin and found evidence that people who had recently picked up the infection were young Irish-born males who were in employment and living in urban parts of Dublin. Margaret Hannan stated: "One of the things we found was that they were all living in certain areas and all drinking in certain pubs. That is indicative of poor TB control in the country and that could be the beginning of an epidemic outbreak."

There were 437 cases of TB provisionally notified in 2004. In 2003, 407 cases were notified and the figure for 2002 was 400. This is a very worrying trend and this is underlined by this latest study. Dr. Hannan has warned that there is a danger of an epidemic outbreak if urgent steps are not taken to control the disease. She says there is poor infrastructure in Ireland for the management, control and prevention of TB. She also said: "The closure of Peamount has taken away a service that was essential."

When the threat to close the TB unit at Peamount first arose, I wrote to the then Minister for Health and Children, Deputy Martin as follows:

I write to convey my concern at the decision of the Board of Peamount Hospital to discontinue Chest/Respiratory Services. I understand that it is intended that all chest hospital activity will cease from January 2004 and the services will be transferred to St. James Hospital.

You will already be aware that there is grave concern among staff and patients at the proposal to close the long-established and specialised TB ward at St. Ita's, Peamount. I have received very worrying representations from nurses' representatives and from a patient at Peamount. I believe they show clearly the excellent work done in this unit over many years and continuing to this day. There is particular concern that the special care provided to more vulnerable TB patients in Peamount could not be provided if the service is moved to St. James's.

I believe that this is not just a matter for the Eastern Regional Health Authority but, given the central role of Peamount in the treatment of TB in Ireland, is of national importance. Therefore I urge you to intervene directly to have the decision to cease Chest/Respiratory Services at Peamount reversed.

The Minister of State's colleague did not intervene and the unit at Peamount was allowed to close. The promised facilities at St. James's Hospital have not materialised and now we have a study showing an increased threat from tuberculosis. There is concern internationally at new and more virulent strains of tuberculosis. This is a very worrying situation and we are less well equipped today to deal with it than we were three years ago. I call on the Minister responsible to restore the unit at Peamount and to provide a national action plan to combat tuberculosis.

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