Brendan Smith (Cavan-Monaghan, Fianna Fail) | Oireachtas source

In May 2014 I instigated a Topical Issue debate on the need to provide a new emergency department at Cavan General Hospital. The hospital opened in June 1989 and since then the number of patients presenting at the emergency department has grown substantially. That particular debate, to which the then Minister for Health, Senator Reilly, replied at the time, highlighted the need to provide appropriate resuscitation and isolation facilities at the emergency department and in particular the need to provide more examination cubicles. I also highlighted the benefits that would accrue from having a minor operating theatre within the emergency department.

The layout of the department is not suitable due to the numbers presenting nowadays. That has been accepted by the HSE and by all medical and nursing clinicians as well. There has been an increase in the population of the Cavan-Monaghan area, which I very much welcome. When I raised this issue in 2014, the population of both counties at that time was 133,500 people. Today, thankfully, it has reached 137,562 people. I raise the point about population because there is a high proportion of older people in the Cavan-Monaghan area. It is well above the national average. As the hospital also provides services for our friends and neighbours from counties Meath, Leitrim and Longford, it has a major catchment area. Over the years, thankfully, there have been major developments at the hospital and I welcome the provision in 2009 of a medical assessment unit. A paediatric assessment unit was also provided. In 2014 an outpatient facility for paediatric cystic fibrosis patients opened and that occurred with huge input from the local community as well. From 2000 to 2011, a major capital programme was in place in which more than 20 additional beds were provided for the hospital, as well as a magnetic resonance imaging, MRI, unit, a computed tomography, CT, scanner, oncology services and a major expansion in renal dialysis services. Thankfully, today services are provided at Cavan General Hospital that once one could only access in the tertiary hospitals in Dublin.

We welcome the provision of additional services but they pose additional demands on the emergency department. When capacity is expanded - which I was very glad to support and to work towards achieving - that creates an extra demand on the emergency department. In the meantime the investment has not taken place in upgrading existing facilities or providing additional facilities. A number of years ago, the HSE brought the design plans to a very advanced stage on three or four occasions. There was going to be a major capital investment but each time, it did not happen. It would have been a very substantial project with additional facilities that everyone would have welcomed. In the meantime, plans were put in place to have a more minor investment that nonetheless would be very important. It was a programme that had advanced through planning. We were told the money was in place but unfortunately it still has not happened. The smaller project, which would be very welcome, would provide eight more cubicles. That would be extremely important. People with family members who have attended and people who have worked in the hospital over the years have told me the extra accommodation - comprising of examination cubicles - would be key in providing a better service to the patients presenting. I have been told, via replies to parliamentary questions, correspondence with the HSE and meetings with successive Ministers and senior representatives of the HSE, that a resuscitation area is being developed. Nothing has happened on that, to my knowledge. I would appreciate if the Minister could give me an outline of what is proposed at present, because nothing has happened so far. The numbers presenting are increasing on an annual basis. That is a clear fact.

The HSE is fully aware that in 2016 approximately 35,000 people presented at an emergency department which lacked adequate facilities to deal with such patient numbers.

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