Michelle Mulherin (Mayo, Fine Gael) | Oireachtas source

I raise this matter on account of the serious ongoing trolley problem at Mayo General Hospital, which is in the red zone as it has between ten and 12 patients, on average, on hospital trolleys day after day. The problem has been intensifying over the past year and is getting worse. It affects elderly people, who are not fit to be left lying on trolleys.

This is of grave concern to the Minister for Health. I compliment him on his nationwide campaign to eliminate the problem and his initiative in setting up and funding the special delivery unit to tackle the problem of people on trolleys. The state of affairs at Mayo General Hospital is even more disturbing given that the hospital got on top of the trolley problem in 2011 with a 64% reduction in the number of people on trolleys. This is a considerably greater achievement than the national average, a reduction of 20%. There is evidence that the management knows its stuff and has a track record of thinking outside the box to tackle the issue. This is exactly the challenge the Minister has laid down.

However the problems and blockages at Mayo General Hospital are caused by external factors and the problems are twofold. There was a significant increase of 8% in people presenting at the accident and emergency unit in 2012, together with an 8% increase in the number of medical patients being treated in the hospital. One of the reasons for this is that 5% of patients are from Roscommon. This is a knock-on effect of the closure of the accident and emergency unit at Roscommon hospital, which leads to an increase in the number of people presenting from Roscommon. Anecdotally, it seems that changes to the way GPs are paid means they are doing fewer house calls. Consequently, more people are being referred to accident and emergency units. There is an increased dependence on the public health system, with fewer people able to afford private health care.

The greatest problem causing overcrowding at Mayo General Hospital is delayed discharge, which is a major problem in the hospital. This week, the average delayed discharge daily figure is 16 patients. Last week it was 12. Over the previous weeks a similar pattern has emerged. These patients are passing their time in an acute hospital bed and should be transferred into stepdown facilities. The problem is a lack of stepdown facilities available in the county.

A startling statistic is that following the closure of 12 stepdown beds in Ballina District Hospital since the end of 2011, the number of delayed discharges at Mayo General Hospital has increased by 400%. The blockage at Mayo General Hospital is chronic and needs urgent intervention, which is what I seek. I acknowledge the €105,000 allocated from the special delivery unit this year and the €300,000 last year to support the acute medical assessment unit. These moneys were spent to good effect.

The money allocated for this year is insufficient to address the problem. We need more stepdown facilities. I request that the HSE is directed and funded to open 12 beds in Ballina District Hospital. It makes economic sense. A patient in a medical bed in Mayo General Hospital costs the State €900 per day, compared to €1,000 per week at Ballina District Hospital. Stepdown beds at Swinford and Belmullet district hospitals could also be part of the solution. It is imperative funding is made available for two intermediate care teams in County Mayo. This will allow patients, where appropriate, to receive hospital-style treatment in their homes. In many cases, it would prevent these people being admitted to hospital in the first place and allow for early discharge. I seek funding and urgent intervention. Management has a proven ability to tackle the trolley issue but external factors are having an impact and the hospital needs the support of the Minister and the Department.

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