Michelle Mulherin (Mayo, Fine Gael)

The acute services at Mayo General Hospital are under considerable pressure and that is why I am bringing the matter to the Minister's attention. I am asking him to intervene to change the situation. In the past year, there has been an increase of nearly 28% of people presenting to the accident and emergency department in that hospital. As a result, there has been an increase of almost 9% in admissions. The Minister might ask whether they are striving for efficiencies to do their business in the way he and the HSE have outlined for hospitals to conduct themselves. I fully support that but this hospital, its management and the HSE team in the area are very much tuned into the Minister's policy and philosophy. In fact, these statistics are no reflection on the hospital's management because last year it boasted health figures placing it as one of the best performing hospitals in the country. The performance included a 64% reduction in people waiting on trolleys, which compared to a national average of 20%. Therefore the hospital management has been listening and has been trying to implement the Minister's guidelines.

Mayo General Hospital has been assessed by the Minister's special delivery unit and was found to be running efficiently, which is a reflection on the sort of work being undertaken there. However, major pressure is being placed on the hospital as a result of the closure of the accident and emergency department at Roscommon Hospital. Following an examination of relevant data, it has been found that many people presenting to Mayo General Hospital have addresses in County Roscommon.

I have cited figures for presentations and admissions at the accident and emergency department in Mayo General Hospital, but figures for the same period in University College Hospital, Galway, showed a 10% reduction in presentations to the accident and emergency department and a reduction of 5% in admissions.

It is significant that another tranche of people presenting to the accident and emergency department in Mayo General Hospital have addresses in north Galway. Anecdotal evidence points to the fact that people from Roscommon are either going to Mayo General Hospital or Sligo Hospital, and are not going to UCHG. Having visited UCHG's accident and emergency department on a number of occasions, I understand there is a problem in accessing it and it is already under pressure. This situation concerns people in counties Galway, Roscommon and Mayo.

When the accident and emergency department was closed in Roscommon Hospital there was no transfer of resources to Mayo General Hospital, notwithstanding the fact that fewer people were presenting or being admitted in Roscommon. As far as I understand it, the same teams are still there, although dealing with fewer people. That matter needs to be addressed.

Funding from the Minister's special delivery unit should be given to two intermediate care teams, which would take people out of hospital. It would also provide nursing staff, physiotherapy, occupational therapy and health care assistants in order to provide emergency interventions in people's own homes so they would not occupy hospital beds. This in turn would avoid unnecessary admissions to Mayo General Hospital or long-stay residential care, as well as allowing for an earlier discharge of patients from the acute sector.

It would naturally be a better use of the hospital's resources in addition to providing 24-hour nursing care with therapy interventions in the home. Over a maximum 12-week rehabilitation period, that should see patients referring to normal community services afterwards. In the interim, it would keep them well away from Mayo General Hospital, which has an average length of stay of 6.2 days for patients. That compares favourably with other statistics.

The Minister has set aside €28 million to address this issue so that people will not be on trolleys and to target acute services where they are needed. It is an expensive process and costs approximately €1,000 per day to keep someone in Mayo General Hospital. The cost for a step-down facility comes to about €400 or €500 per week. It makes financial sense to keep people out of acute hospital services. Mayo General Hospital is carrying an extra burden and I hope the Minister recognises that. The facts and figures are there to back it up. I am asking the Minister to make an allocation from that fund to the acute services.

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