Seán Sherlock (Cork East, Labour) | Oireachtas source

I support the motion. I will talk specifically about Mallow General Hospital, which is categorised as a level 2 hospital, but in our minds in north Cork, we think it is somewhere between level 2 and level 3 in terms of what it delivers for the people of the region that I represent.

In 2007, we in Mallow underwent quite a difficult process, prior to people like myself ever being in government, where the sword of Damocles was hanging over the accident and emergency unit there. We sat down and we figured out what it was that would make a hospital like Mallow thrive. When the accident and emergency services were reduced or diminished significantly, we made our pitch for endoscopy services, medical assessment units and a local injuries unit and, thankfully, all of those are in place today. That is thanks in no small part to the gargantuan efforts of voluntary organisations, local political effort and a recognition of the fact of a changing medical environment, where we recognised that the nature of medicine was changing such that more and more procedures would be done on a short-stay, elective basis. What we have today is a hospital that we are extremely proud of, and not only do we have those services, but we are also now expanding the hospital further again and we have the construction of a 48-bed unit under way.

The questions I have for the Minister of State today are these: when will that unit be complete, when will it be fitted out and what exactly is it that will go in there? We believe locally that we can take capacity from CUH, which is under massive strain at the moment. I have had reason over recent months to visit CUH on a number of occasions, including visiting the accident and emergency unit where, clearly, there are massive pressures and there does not appear to be any alleviation of those pressures. One thinks that hospitals like Mallow General Hospital, if the capacity was built out and staffed appropriately, could take a lot of pressure off a hospital like CUH, which is a tertiary facility, and more and more services could be circulated or brought to hospitals like Mallow. That is the ambition we have for Mallow General Hospital because we believe there is an excellent professional staff there who will deliver, and if additional staff are allocated for that purpose, we believe more services could come to Mallow. That would benefit everybody. It would benefit the Government and, most importantly, it would benefit the people because if they can be treated locally in their own local hospital, their outcomes are far better.

My ask today in supporting this motion is that, in regard to hospitals like Mallow where there is capital expenditure by the HSE at present, some vision is created for a service that would ensure we can take more capacity out of CUH and treat people locally within their own community, as I have said.

There is an issue for us when one considers Cork. There was a Government announcement around an elective hospital for Cork that is to be located in Glanmire. This was announced with great fanfare by the Government some time ago but what we have not seen since is any articulation of what exactly that would look like, what kind of services would be offered there and how that would operate in practical terms. We have no sense of what the capital expenditure for that will be and, as I said, while we know where it will be located, to date, we have not had sight of any planning application or information on when the sod will be turned on that. We need clarity around Government announcements, in particular in respect of elective hospitals. If we acknowledge that medicine is increasingly moving towards acute elective procedures on a short-stay basis, the capacity to deliver that in the county of Cork is still far short of where it needs to be. There is a long way to go.

To come back again to Mallow General Hospital, what I want to see within those 48 beds is some capacity for rehabilitation services. For example, Mallow is located in the heart of Munster but a lot of people have to go to Dún Laoghaire for services. If a certain number of beds were allocated and if the vision is right, a hospital like Mallow could provide such rehabilitation services.

In essence, we support the motion. We are making a call for greater capacity in hospitals like Mallow General Hospital. If we increase the capacity, more and better care can be delivered. We must ensure that there is a greater referral pattern directly into level 2 hospitals like Mallow. We could triage a lot of people away from CUH if the referral protocols were robust and fit for purpose. More and more people could be treated in hospitals like Mallow if the referral pathways were fit for purpose and that needs to be looked at as a matter of urgency.

We were told that the South/South West Hospital Group and the National Ambulance Service were implementing a referral pathway for clinically appropriate patients to the medical assessment unit in Mallow on a pilot basis. I asked a parliamentary question on this in February 2023 and was told that the outcome of the initial pilot which was conducted over a three-month period demonstrated the safety of this pathway model for patients and hence, this model is expected to continue into the future. What we have not been able to get are the metrics, or the numbers of people who have benefited from that referral pathway. We strongly believe that if somebody has presented to a hospital like Mallow General Hospital and has to come back in, via ambulance, again, the referral pathway should not be to CUH but directly back to the hospital where the person was treated. We need to see more of that. At present, the ambulance protocols for hospitals like Mallow are such that it is bypassed and patients go straight to CUH. Often that is clinically appropriate and that is acknowledged by those of us who are reasonable. However, we could treat a lot more people and prevent a lot more people from going to hospitals like CUH by creating greater pathways of care in level 2 hospitals.

Given that I have a few seconds left, I want to acknowledge the retirement of Mr. Gerry O'Dwyer, the CEO of the South/South West Hospital Group. I want to acknowledge the fact that he was always available to people like me. I have had many a heated debate and argument with Gerry O'Dwyer down through the years-----

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