Dáil debates

Tuesday, 9 November 2021

Saincheisteanna Tráthúla - Topical Issue Debate

Hospital Trusts

9:40 pm

Photo of Brendan GriffinBrendan Griffin (Kerry, Fine Gael) | Oireachtas source

I thank the Minister of State, Deputy Rabbitte, for coming in tonight to take this important debate which I was keen to table here in the Dáil. I am disappointed that the Minister, Deputy Stephen Donnelly, is not here. I mean no disrespect to the Minister of State, who is doing an outstanding job in her area. I have been hugely impressed with her work and with her energy in her specific area within the Department of Health but this is a matter relating to an acute hospital and I would have expected that the senior Minister would have shown up for the debate. It is not good enough. It is happening far too often that senior Ministers are not coming in to take debates from Deputies under Topical Issues. It is not the Minister of State's fault. I appreciate the Minister of State, Deputy Rabbitte, being here. I know that she will take back what I am about to say here tonight.

From speaking to consultants, doctors, patients and everyone at University Hospital Kerry, UHK, the situation never seems to have been as bad at the hospital. As someone who cares deeply about that hospital, it pains me to say that. It is our hospital. It belongs to the people of Kerry. To sum up the challenges that are there at present, I will read into the Dáil record and convey to the Minister of State some of the highlights from a letter that was sent recently by consultants at UHK to the CEO of the South/South West Hospital Group. I will take snippets from it. It makes for grim reading:

We have lost confidence in the ability of the Health Service Executive locally, regionally and nationally to provide safe, timely and effective care for our patients in UHK.

We do not see evidence of strategic leadership to bring about the necessary changes to enable UHK to maintain and develop services for the population it serves.

We feel management processes have not progressed with each successive crisis. UHK, and the people we serve deserve better.

In relation to patient safety, it states that patient safety is at risk due to the current bed limitations in UHK.

UHK still cannot provide PCR testing for Covid after 8 p.m. and has been asking for this solution for more than a year. Reduced bed capacity and daily staff shortages continue to cause huge delays in patient flow. On bed capacity, UHK has a totally inadequate number of single rooms which increases infection control risk by leading to frequent outbreaks as well as causing a loss of further beds to deal with these outbreaks. The lack of single rooms has been highlighted repeatedly by infection control teams. UHK has never had a full-time permanent consultant microbiologist. This has been noted by HIQA which indicated that an urgent and permanent solution must be put in place. The consultants also highlight significant bed losses due to Covid and development works and ask why a contingency plan was not put in place in respect of these works. They also highlight the fact that an isolated modular unit has been urgently requested by the infection control teams to improve isolation facilities in UHK.

On surgical services, there has been no elective surgery in UHK since mid-September, with reduced activity for the last 18 months since the day ward capacity was reduced by more than half.

UHK is disadvantaged as its ability to record data accurately is seriously at fault. About 30% of physician activity in the emergency department is not recorded in iPIMS. UHK has no IT manager and no IT committee. It gets worse. Like other hospitals nationally, there is a shortage of nurses. Nurses in UHK are under additional pressure carrying out non-nursing duties. The director of nursing and her management team have repeatedly asked for extra support staff to perform these duties, but that support has not been forthcoming. The five fundamentals project to improve processes and pathways is now at risk because staff have been redeployed.

On the acute floor model the acute medical unit, AMU, opened for a few months during summer 2021 and demonstrated its effectiveness. Due to staffing issues the AMU is currently closed more often than it is open. On integration with community services, the consultants advocate that a formal integrated decision-making forum be created. On scheduled services, virtual clinics can only be done by telephone because the IT equipment and the WiFi will not allow video calling. On accommodation, consultants have a lack of office space as do secretaries and other grades of staff. There is no plan to address this. Finally, the consultants ask what is the plan in relation to the new oncology unit. They do not have a deputy manager in place since last summer.


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