Dáil debates

Tuesday, 21 June 2022

Our Lady's Hospital Navan Emergency Services: Motion [Private Members]

 

7:40 pm

Photo of Gerald NashGerald Nash (Louth, Labour) | Oireachtas source

I am pleased to speak for the Labour Party on this very important motion. I am more than familiar with Our Lady's Hospital, Navan. Outside of Our Lady of Lourdes Hospital, Drogheda, it is the medical facility with which I am probably most familiar . That will be the case for any resident of the Drogheda, south Louth and east Meath areas. It is a valued and very valuable piece of health infrastructure in our region in the counties of Meath and Louth. I say counties Meath and Louth deliberately because I represent Louth and a very significant part of the east of County Meath.

I also say this because no Louth-based Deputies were invited to the briefing with the HSE on 13 June. That was wrong; we needed to be. I will tell the Minister exactly why and I think he knows why. If the Minister proceeds with the plan to finally close the emergency department in Navan, and I acknowledge that he put on the record this evening his intention to pause that - for how long we do not know - then he knows he will be dealing with a whole host of new problems. The Minister articulated that in his response this evening. That problem is even more overcrowding in emergency departments and on the floors of Our Lady of Lourdes Hospital, Drogheda. This plan has been badly organised, badly planned, badly thought through and incredibly poorly executed. I say this because neither the Minister, the HSE nor the RCSI Hospitals Group over the past week could tell me precisely how many new beds and what additional capacity would go into Our Lady of Lourdes Hospital, in the event of this move going ahead, to deal with the additional demand that would inevitably arise were the emergency department in Navan to close.

We got some sense of this from a reply to a parliamentary question the Minister issued to me this evening in which references were made to ten additional beds. Anybody who is familiar with Meath and Louth will tell the Minister that ten additional beds, even in the context of the current demand, notwithstanding the Minister's ultimate plan for Navan, simply would not cut it. We know today that 521 patients were awaiting admission to a hospital bed across the country and 441 were in emergency departments. Those are the figures from across the country. I know too there are pressures today, as there are every day, in Our Lady of Lourdes Hospital, Drogheda.

I am very familiar with one case because it was raised with me today. Hardly a day and certainly a week does not go by, notwithstanding the very hard and dedicated work of the staff at Our Lady of Lourdes Hospital, without me being informed of a difficult situation in which an often elderly, frail and vulnerable person might find himself or herself. As I said, that is notwithstanding the commitment and dedication of staff to resolving all the problems that present themselves at emergency departments. I will give the Minister one case that illustrates the wider point. A family were in touch me today about their dad, who is a very elderly man with dementia and an acute respiratory problem. He was in the emergency department in Drogheda waiting for a room since 8 a.m. this morning. He is now in a multi-bed situation in one room. His family got in touch to tell me the circumstances he is in and the way he is being accommodated at the moment given the pressures on the hospital are not appropriate for him. I think the Minister would accept that himself. The man's daughter signed off her first email to me this morning by saying, "and they are talking about sending patients from Navan to this hospital". That is what she said I think she speaks for all of us - she speaks for me. She is right to be concerned and the clinicians and staff in the hospital are right to be concerned. The Minister expressed that himself in his remarks this evening. He confirmed that the clinicians in Our Lady of Lourdes Hospital, whom he has met, are concerned about the consequences of the closure of the Navan emergency department on an already stretched hospital.

This is not the first time that Our Lady of Lourdes Hospital has been in the firing line and has had to accommodate additional numbers of patients as a consequence of a closure of an emergency department in our community. I want to take the Minister back to the late 2000s and the initial reconfiguration programme, with which we will all be familiar, under a former Fianna Fáil-led Government. That Government made the decision to close the emergency department in Louth County Hospital, Dundalk. Let us look for a minute at how that went for Our Lady of Lourdes Hospital, Drogheda. As a resident of the area, then as a councillor for the area and later as a Deputy, I remember the chaos at a time when investment in our public services was stretched because of the collapse of the economy. In 2010, the year before the full impact of the closure of the accident and emergency department in the Louth County Hospital became apparent, the Irish Nurses and Midwives Organisation, INMO, annualised trolley watch figures from Drogheda suggested that 3,484 people were on trolleys in the emergency department at one point or another in that year. In 2011, after the closure of Dundalk, 7,449 citizens had been counted on trolleys at one point or other across that year; a more than doubling of the figures before the emergency department in Louth County Hospital was closed.

There is a direct and very severe causal relationship between the closure of emergency departments in the region and the impact on stretched resources at Our Lady of Lourdes Hospital. Now it appears, notwithstanding what the Minister said tonight about the pausing of his approach to the Navan ED, that he is still preparing the axe to fall. The sword of Damocles is still hanging over the emergency department in Our Lady of Lourdes Hospital because it appears that the HSE and the Department of Health are preparing to do the same thing again. They are incapable of adequately preparing and of learning the lessons of recent history in the north east.

Our Lady of Lourdes Hospital, as Deputy O'Rourke and others know, has historically been the poor relation in terms of centres of excellence in this country when it comes to investment. It is the de facto regional hospital but it never received the appropriate resources to bring it to the next level. It is the regional trauma centre. We are very proud of our hospital and of the great work that the dedicated and committed staff do there. We all rely on them and their expertise and dedication. One thing that the system never reflects in the hospital's budgets is the fact that it is also the hospital and ED of choice for many people in the Fingal area of north County Dublin, often because of pressures in Beaumont Hospital and other hospitals on the northside of Dublin. It is also a fact that many cases that one would ordinarily expect to be dealt with in the emergency department of Daisy Hill Hospital, Newry, for example, make their way to Our Lady of Lourdes Hospital, Drogheda. Even without the extra resources that would be needed as a consequence of the inevitable decision that the Minister will ultimately take regarding Navan ED, the case for significant investment in Our Lady of Lourdes Hospital should be clear.

The Minister should also be mindful of what I will say next. We now have a perfect storm of circumstances arising that could lead to a real potential catastrophe in the provision of healthcare in the area. It is a letter that all local Deputies received from North East Doctor on Call, NEDOC, the doctor on call service, last Thursday night. It is an absolutely explosive letter that acknowledged that because of GP burnout, the burdens on GPs in the area who are involved in the NEDOC co-operative and, importantly, because of underinvestment from the HSE, it plans to reconfigure its services and reduce the hours of operation from early August. We potentially have a situation where the ED in Navan closes, there is huge pressure on Drogheda and there is an imminent threat hanging over the NEDOC service as well.

This is being handled in a cack-handed way. I am glad the Minister is reflecting on how he will proceed on this, although I cannot help but think he is only reflecting because of the political fallout from a decision that seems to me to be inevitable and on which the Minister and the Government have made up their minds in any case. The Minister has to be clear on what the timeline is. Our Lady of Lourdes Hospital staff and the people of the region need reassurance that the service is not going to suffer when the Minister inevitably makes the decision to close the door of the emergency department in Navan, which will have huge implications for the provision of healthcare in our area.

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