Dáil debates

Wednesday, 6 February 2008

Health Services: Motion (Resumed)

 

8:00 pm

Photo of James ReillyJames Reilly (Dublin North, Fine Gael)

I thank everybody in the House who contributed to this debate, as these are very important issues. I welcome the members of the Cystic Fibrosis Association of Ireland in the Gallery who have come from Rush. I know it took much effort on their part to be here. Every time these people go out they are exposed to more infection, so I appreciate their being here.

We discussed cystic fibrosis last night in the Chamber. It is clear we have the highest incidence of this life-threatening illness in the world, with more than 1,100 cases in the country. We have the worst prognosis in western Europe, with people suffering from cystic fibrosis in this country dying ten years younger than their counterparts in the UK or even up the road in Northern Ireland.

There are many reasons for this, which we discussed last night, such as lack of neonatal screening, proper homecare support, isolation beds for treatment in hospital and isolation facilities when those suffering from the disease attend accident and emergency departments. There is also a lack of a specialist centre in St. Vincent's.

The main reason for the problem is a lack of isolation rooms and the danger of cross-infection. We have no reference laboratory in this country funded by the State, although there is one working on a voluntary basis in Tallaght. That is run by Dr. Philip Murphy and financed by the Cystic Fibrosis Association of Ireland. It is the only lab capable of checking and growing different species of a bug called cepacia, which is very often fatal for people with cystic fibrosis. Once people have contracted this bug, they are no longer considered eligible for a lung transplant because the outcome is not as good. The lab should be funded by the HSE so the burden of funding can be taken away from the Cystic Fibrosis Association of Ireland. This will protect patients from the bug but if they are unfortunate enough to contract it, we can check for the multiplicity of antibiotics that must be used in combination to treat it successfully. Most labs in the country do not check for that bug.

We need neonatal screening and high-frequency oscillating vests, which are applicable to certain people with cystic fibrosis. For them, it could save significant amounts of money for physiotherapy. We require proper home support. These are brave young outspoken people, and all they are asking of the Minister and this State is to be given a fighting chance against this life-threatening illness. I ask the Minister to commit tonight to delivering the service to these people within a real deadline, unlike other commitments in the past. It is particularly disappointing that 82% of sufferers have not seen any significant improvement since the Pollock report was published three years ago, that they are still exposed to cross-infection and that the too little, too late approach continues with talk of 14 rooms in St. Mark's ward by the end of the summer, while we wait almost three more years for a dedicated unit at St. Vincent's. It is not satisfactory, particularly when there are 18 patients with cystic fibrosis in St. Vincent's and ten more on the waiting list, making a total of 28. Plans are no substitute for action and promises do not save lives, only service does.

I told the Minister of State last night that there is a company in Tyrone which can build modular units in four months and has already done so at various sites around the city for the Department of Health and Children. Will he use the unspent money to engage these contractors to build these modular units, particularly at St. Vincent's and at the other sites, as promised by the Minister, in Galway, Limerick, Cork, Waterford and north Dublin? That is the solution. There should be no more reports or experts. The Minister should just do this and give these young people a fighting chance.

Mental health patients are treated in atrocious conditions, particularly in St. Ita's where 23 people on the male admission ward and the female admission ward are cared for in an open dormitory in conditions similar to those that existed in Romania under Ceausescu. These patients are in an open ward. This is 2008, not 1908. The building was built over 30 years ago as a temporary measure and I have nothing but admiration for the doctors, nurses and care staff who work there. It is a credit to them that there has not been a serious injury or fatal incident in the hospital. It is unbelievable that 23 patients are treated in an open ward with 3 ft between the beds. A lady there was nearly smothered by another patient who came back from day leave.

People are infuriated that the delay is connected with the psychiatric unit at Beaumont. This was promised over 20 years ago and was built but then used for the overflow from the medical wards. The attitude was that the psychiatry patients could wait. Planning permission was granted in 2004 for a new building and it went out to tender in 2005. How many millions of euro were spent on that planning application? A co-located hospital is to be built on part of that site rendering that planning permission null and void. People who are mentally ill go to the back of the queue because they are the least important to the Government. That is how it treats the most vulnerable people in our society.

It is galling that people who live in Artane and Killester have to drive by Beaumont Hospital to the far end of the peninsula at Portrane to seek treatment in a Dickensian building. We want the money that will be realised from the assets of the psychiatric institutions ring-fenced for psychiatry and mental health, and the money promised for the implementation of A Vision for Change used for that purpose, not to meet daily costs. Above all, I want to see a deadline for a completion date for a psychiatric unit in Beaumont Hospital. That is the least my constituents and those of Dublin North-East expect.

Last night I alluded to the terrible cutbacks taking place all over the country and the failed and broken promises of the Government, particularly the Minister for Health and Children. First, they said there would be no cutbacks, then that cutbacks would not hurt patients, then they introduced a raft of cutbacks and delayed operations, which continues. According to an article in last night's Evening Echo, nurses will be asked to take six weeks' unpaid leave. The HSE is €370 million short. Every time it plans to save money it does so at the patients' expense. There is never a question of increasing efficiencies within its bungling burgeoning bureaucracy.

We do not have the capacity to meet the demand but we can resolve this in two ways, one, reduce demand by instituting preventative care in the community through general practices. A national body test would prevent illness or pick it up early and make major savings. Every euro spent on prevention would save €20 on treatment. This could be achieved through one-stop shops in the community where there are groups of general practitioners with nursing staff, physiotherapists, X-ray and ultra sound facilities, rooms for visiting consultants to see patients, and endoscopy, the camera that examines the upper and lower bowel. That can be done in the community, keeping people away from hospital. The Minister should bring the service to the people where they want it in comfortable, familiar surroundings.

There are more people like Susie Long and the waiting list for a colonoscopy remains several months in many parts of the country. More people will die through Government inaction. Real action can keep people out of hospital and would not cost a great deal. It would be much cheaper to do this in the community.

The second part of this action is to increase the capacity of the hospitals by two mechanisms. We need more beds. Even PA Consulting, commissioned by the Government, reported a few weeks ago that we need 1,200 beds and we will need many more if we do not change the way we do business. That is the purpose of the preventative early intervention course in the community. The 57,000 bed-days lost in the Mater and Beaumont hospitals last year alone are equivalent to a 150-bed hospital. Moving those patients into the community would free up the equivalent of a new hospital. That could be done within six months.

There are people in private enterprise who are planning to build nursing homes. They only want to know whether the patients will come and they will deliver. Patients should not be stacked in nursing homes. There should be physiotherapy, occupational therapy and speech and language therapy so that the patients can continue their rehabilitation close to their families and loved ones and eventually go home.

Last night, the Minister of State, Deputy Devins, who was here earlier tonight but has left, said he was disgusted that Fine Gael would raise the issue of the absence of the Minister for Health and Children, Deputy Harney, from the country during this debate. He said that her trip was organised several months ago, as the Minister for State, Deputy Gallagher, also said. If that is so, why does it not appear in Iris Oifigiúil, which informs us of where Ministers will be when the rotas are being drawn up? It is not there. No major event is taking place. This is a fact-finding mission. We are up to our gills in reports and we have experts coming out our ears. The Minister has gone to study cancer services, having brought a new cancer expert into the country. We do not need more experts or reports, we need action and leadership.

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