John Carty (Mayo, Fianna Fail)

Nobody is happy with a situation in which people, whether old, young or middle aged, have to spend a few hours on hospital trolleys, let alone the 24 to 48 hours reported by hospitals. Constituents have contacted me regarding elderly parents who had to occupy trolleys for 24 hours. That is not acceptable. Complaints are also made that doctors do not attend to patients and that consultants are unavailable. That is hard to believe because accident and emergency units seem to have plenty of staff. It leads one to wonder whether a plan of action is in place for treating patients.

When the accident and emergency unit in my constituency in Mayo is under pressure and no beds are available, patients who are capable of being discharged cannot be sent to private nursing homes with plenty of beds which could be used as step-down facilities until the patients are ready to return home. People in County Mayo are not allowed to stay in private nursing homes unless their families pay for them. However, patients discharged from hospitals in neighbouring counties can stay in private nursing homes. If this was the case across the board, the pressure would be alleviated because much needed beds would be freed. It is wrong that such a situation obtains in one county but not in another.

I am glad that the HSE has undertaken to identify where problems lie and to focus on solutions which will have the maximum impact in the shortest possible time. I welcome the proposal in the ten-point accident and emergency action plan for the development and expansion of minor injury units and chest pain and respiratory clinics, but while these have been put in place in some hospitals, they should be universal. I also welcome the provision of a second MRI scanner in Beaumont Hospital as there is an urgent need for this service and the waiting period is always lengthy. I hope that an MRI scanner will also be provided for Mayo hospital in the future.

Additional home care packages are needed but, in addition to providing them in urban areas, these services should be available to people living in isolated rural areas. A proper service provided in a familiar environment would greatly benefit patients and would save the State a lot of money. Elderly people are entitled to such a service. However, the home care service in County Mayo is virtually non-existent. The HSE should consider investing money in this useful service.

Mayo General Hospital is a top class facility and millions of euro have been spent on a new building and services, which is great for the county. Staff in all sections do a tremendous job. Although shortcomings exist, the public could receive a better level of service if management, consultants, doctors and nurses co-operated to bring order to accident and emergency departments. Too much nursing time is taken up on administrative duties.

Westdoc provides a good out-of-hours service for patients in my area. Within the next few months it will improve dramatically once the new first class treatment centre is opened in Knock and a proper work environment is established for nurses and doctors. The service should end the practice in which patients must present to accident and emergency units in Mayo General Hospital. The centre will act as a base from which patients in the immediate vicinity will be treated and from where the doctor will be driven by the Westdoc driver to satellite centres and to patients' homes as required. The ambulance service, also to be based in Knock, will ensure a joined up emergency service for people in my constituency.

Westdoc has seen 180,000 patients in its three years of service. Some 30% of patients surveyed would have attended an accident and emergency department had that service not been there. It is a worthy service and more should be made of it throughout the country. In Westdoc the average time from making a call to seeing a doctor is 40 minutes, alleviating the need for patients to go to an accident and emergency department. I ask that community diagnostic facilities such as x-ray and ultrasound be provided as this would also reduce the need for people to go to hospital. A young person injured on a football field could have an x-ray at such a service, which could be sent, using new technology, to a hospital where doctors could decide if there was a broken bone. It would save the person having to spend hours at an accident and emergency department. All this should provide a better service for the people.

Some time ago I outlined, during Private Members' time, the situation at the Sacred Heart Home in Castlebar where 12 beds are closed in St. Patrick's unit due to subsidence of floors and walls. I also brought the Minister of State, Deputy Tim O'Malley, to see the situation. I regret that nothing has yet been done to repair the section. Seeing the difference 12 extra beds would make in Mayo, I call on the HSE to provide the funds to remedy this. In Mayo we also need extra bed care for the elderly. As I said, people are in hospitals who have nowhere else to go. A site has been purchased in Ballinrobe and we urgently want a community hospital to be built there to service that part of the county. It is past time this should be done especially since the site has been provided and the money made available. The Department has told me that it is up to the HSE to put the capital funding in place and I urge the Minister to appeal to the HSE, as I have done in the past, to put this in place and to provide this service for the people of Mayo.

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