Beverley Flynn (Mayo, Fianna Fail)

I also welcome the opportunity to speak on this debate. I thank the board of Crumlin Hospital, particularly the deputy chair and all those who attended for the presentation and tour of the hospital they gave to members of the Oireachtas health committee. As someone who has availed of the services of Crumlin Hospital for my daughter - many of my constituents have also availed of them - I am very conscious of the excellent work carried out there and I complement it on being a wonderful centre of excellence for paediatric care.

The concerns of the health committee, and my own concerns, and the reasons we were motivated to visit the hospital are that front line service for children be maintained, and all sides of the House agree with this. I recognise that because Crumlin is a national hospital providing many services exclusive to it, unlike an adult who may need a particular treatment or procedure and can avail of it in another hospital, often the only option for a child is Crumlin Hospital.

We recognise that the current economic climate is very difficult, and this has also been acknowledged by all sides in this House. In the past, when money was more plentiful, it was argued that value for money across all sectors in society was not achieved, and the medical sector is no exception to this.

I have examined the budget for Crumlin Hospital over the past five years and significant increases were provided. There has been a 38% increase in funding and the budget for this year stands at €139.6 million. It represents a 3% reduction on the money that was available in 2008, which was €143.63 million. I come from a town with a hospital and recognise that it is always very difficult for any hospital to operate within its budget, but it is also important that savings are made and greater efficiencies are achieved, where possible.

I was very impressed with the board of Crumlin when we met it yesterday with how it achieved efficiency between 2007 and 2008. They pointed out to us at the meeting yesterday that in 2007 the hospital had a budget deficit at the end of the year. Going into 2008, it requested an increase of €14 million from the HSE but was denied this and was given €7 million. In 2008, it still managed to break even without any reduction in service, ward closures or theatre closures. I am simply making the point that very successfully, through its own management efficiency, it managed to achieve excellent results and greater efficiencies in 2008, which is a credit to it.

The cost measure that causes me particular concern is the closure of St. Joseph's ward with 25 beds. This ward deals with orthopaedic and neurology patients, but the board pointed out yesterday that these patients are now being accommodated in other wards in the hospital. All of this information and the figures have been presented by the board and I am not dealing with any other information. My colleague mentioned Birmingham hospital and I point out that the board would disagree with some of the figures and the comparisons between those two hospitals. I acknowledge this and it is an issue we will have to take up with Professor Brendan Drumm when he comes before the committee next week.

I point out that there are 248 beds in Crumlin, 223 of which are open, which is 81,395 bed nights in a given year. In 2008, with all wards open in the hospital, 72,280 bed nights were used. The major growth in activity for Crumlin Hospital, again pointed out by the board, is in day cases involving those who do not stay overnight in hospital, in which there has been a significant increase of 30% in the past four years.

Another area of major concern for me is the closure of the theatre because theatre procedures increased by 34% in that four-year period, and I addressed that specific question to the board when I was at the hospital yesterday. However, I am heartened by the fact the hospital has clearly stated that no child has been denied access to emergency life-saving surgery due to the hospital's financial break-even programme for 2009 - it is important to recognise this point. I asked the board why it was necessary to close the ward and the theatre and they informed me that between 2008 and 2009 there were 25 fewer nurses in the hospital, which was necessitated by a €600,000 reduction in the amount spent on agency staff. Again, it is an issue I will take up with Professor Drumm next week.

On the positive side for the hospital, its management and administration is very competitive at 13.6% of staff, which compares very favourably with many other hospitals that have 16% to 20% of the staff taken up in this area. I would ask the Minister to address the issue which was brought forward, namely, that the staff complement at the hospital and the budget for the hospital has not been scientifically arrived at but has been inherited from the old health board days. I welcome the fact there will be a new national children's hospital. I believe this will be to everyone's benefit and we must ensure it is completed by 2014.

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