Finian McGrath (Dublin Bay North, Independent) | Oireachtas source

I apologise on behalf of the Minister, Deputy Harris, who cannot be here. I thank Deputy Funchion for raising this matter and giving me the opportunity to update the House on the position in relation to maternity beds at St Luke’s Hospital Kilkenny. First, I assure the Deputy that over the past two years there have been significant improvements to the maternity services at St. Luke’s General Hospital. These include the appointment of additional midwives, a bereavement support midwife counsellor, a clinical practice facilitator, 24-7 shift leaders for the delivery suites, a lactation nurse specialist, an advanced midwife practitioner and a fourth consultant obstetrician. In line with the national trend, the number of births at the maternity unit at St Luke’s has decreased by 9% over the past four years.

We are all aware of the challenges for hospitals, including St Luke’s Hospital, in managing emergency demand and high trolley numbers during the first few weeks of January. These can be attributed to high demand for emergency care, bed capacity restraints and increased incidences of flu in the country. St. Luke’s Hospital in Kilkenny had a 6% increase in overall admissions for medicine and surgery to the hospital during 2016. It is a site of concern today with 29 patients waiting on trolleys this morning at 8 a.m. and 24 patients at 2 p.m. and I agree with the Deputy that this is totally unacceptable and we have to act on the matter.

The HSE escalation framework sets out the process and procedures which define how hospitals should react and deal with emergency department overcrowding. This can include the appropriate use of all other empty inpatient beds for a surge in emergency department capacity in order to ensure patients do not have to spend a night on a trolley when other hospital beds are available. I understand from the HSE that St. Luke’s Hospital is actively managing emergency department demand. This includes consideration of the use of part of the maternity service bed capacity as surge capacity when not being utilised for maternity patients. The layout of the hospital's maternity facilities ensures that any space used for emergency department referrals would be in an enclosed four-bed bay and not part of a larger maternity ward, thus ensuring the privacy, dignity and clinical well-being of all maternity and emergency department patients. The hospital is also focusing on discharging patients and maximising community supports to support discharges.

On 5 January 2017, the HSE announced a series of enhanced measures as part of the existing winter initiative plan. These measures focus particularly on augmenting the supports for primary and community care and targeting of acute capacity, and are designed to alleviate the current significant demands on emergency departments. The enhanced measures under the winter initiative include the opening of 63 new acute hospital beds nationally, in addition to the 35 beds already opened this winter. Approximately 40 of these beds have already opened and, under this funding, work is under way to open eight new emergency department beds in St. Luke’s as soon as possible. The money is there to open these new beds.

Under the winter initiative, St. Luke’s in Kilkenny was selected as a pilot site to develop an integrated case management approach, between acute hospitals and the community organisations, to the provision of health care services to our frail and elderly population. The Ireland East Hospital Group has advised that it is continuing to work closely with St. Luke’s Hospital Kilkenny to support it in managing the situation and to improve the experience for patients and staff attending the hospital.

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