Joe Sherlock (Cork East, Labour)

I wish to share time with Deputy Burton.

I have listened to the other speakers during the past half an hour. It is pure sickening to listen to what is being said on this issue.

With regard to the care of the elderly, the issue of referring patients to private nursing homes arises on a daily basis. It is the practice in general hospitals to give families of patients application forms for nursing homes and they are advised they will receive a subvention. I refer to a case in Mallow General Hospital. An 86 year old lady, dependent on her pension, whose family could not afford to pay for a private nursing home, was told she had no choice but to accept the private nursing home and that the subvention would be paid immediately. A total of 500 people in the Cork-Kerry area are waiting for enhanced subvention. Is this the correct kind of treatment for our elderly people when in excess of 500 people are waiting for enhanced subvention?

In one case in the north Cork area, an application was made in November for a person who is severely disabled and the basic subvention has still not been paid. What authority has a HSE employee in a public hospital to direct a person to a private nursing home? They order people to go to private nursing homes. The payment of subvention is the big issue. No extra beds are provided in public hospitals and no provision has been made by way of contracting out arrangements between the HSE and private institutions. This matter needs to be fully investigated in the interests of our elderly. The services can be provided directly by the HSE in one of its hospitals, in another publicly funded hospital or by way of contracting out arrangements between the HSE and a private institution. The current legislation does not provide for this. If the Government wishes to provide for our elderly people, why does it not contract with the private nursing homes and pay the amount required?

The management of the general hospital system was referred to in a "Prime Time" programme last night. In 1989, Mr. Justice Gannon in the High Court granted that a proposal to discontinue acute services at Mallow General Hospital was void. It is a designated general hospital linked to the Cork University Hospital which takes all the share of the allocation. Mallow General Hospital should be treated like any other general hospital. The number of beds should be increased as they were reduced in the mid-1980s from 103 to 80.

I reject the decision of Comhairle na nOspidéal and adopted by the Government to reduce accident and emergency facilities at the hospital. This matter has been debated many times. Mallow General Hospital currently services more than 100,000 people and it is estimated this is set to increase substantially. The town is a designated hub town and a growth area under the national development plan. It has been established by the GPs in the region that the downgrading or removal of the 24-hour accident and emergency service at Mallow General Hospital would leave some patients two hours from acute care. Mallow General Hospital is a valued facility in its local community and catchment area. Patients benefit from visits from relatives and friends. Tertiary hospital care is very important in the health care system although it treats a very small proportion of the population compared with those treated in primary care services. The hospital staff in Mallow General Hospital are to be congratulated on the hospital winning the national hygiene awards in 2005, with an increased score from 88% to 91% in the section for national acute hospitals. The management team at Cork University Hospital is also responsible for the management of Mallow General Hospital and it is natural that priority is given to the university hospital rather than to Mallow. Ninety per cent of people requiring hospitalisation can be treated in the general hospital system. I do not wish to say anything against Cork University Hospital but the daily cost is twice that of Mallow General Hospital. There has been no progress in the matter of the day procedure unit at Mallow General Hospital. It is surprising that capital funding was referred back to the Department in 2005 by the HSE and not utilised to make provision for this unit.

It appears the response of the Government and the HSE is to encourage people as much as possible to pursue private health care. A new private hospital will be built in the Cork University Hospital area. I refer to the traffic situation in Cork and the amount of money being spent on the car park. It makes little financial sense to transfer patients by ambulance from Mallow to Cork to treat them in Cork University Hospital, when one considers that the estimated daily cost per patient in Cork in 2005 was €848 as against €574 in Mallow. The appointment of a consultant radiologist at Mallow General Hospital has been delayed since 2001. I ask the Minister of State to inform the House of the current position. The installation of a CT scanner is worthwhile.

There are significant issues to be addressed regarding the care of elderly people and the position of smaller general hospitals.

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