Ruairí Ó Murchú (Louth, Sinn Fein)

I thank everyone who facilitated me to do this. I have just made my way up from the civic reception in Dundalk to celebrate the Louth Ladies Gaelic Football Association, the Louth senior team and the under-20 team after a spectacular year. Hopefully, there will be more of that to come. I had to leave Jarlath Burns and Marty Morrissey, but this is obviously an incredibly important issue.

This Topical Issue arises from the retirement of the clinical specialist sonographer in ultrasound at Louth County Hospital in Dundalk. The position was advertised in the summer and there were a number of applications, but there has been no progress in filling the position. There is now serious concern among the staff and public that the position will not be filled at the hospital and that the service, which has been incredibly well used over the years and is growing in demand year on year, will be run without on-site management. This situation is not recommended by the Irish Institute of Radiography and Radiation Therapy, IIRRT, which recommends that there be a clinical specialist sonographer working on site, especially in a hospital the size of Louth County Hospital. This is because such staff play a vital role in managing and supervising the unit.

The previous clinical specialist sonographer in ultrasound at the Louth hospital was the only full-time radiographer who worked in ultrasound at the hospital. Her retirement leaves vacant three-and-a-half posts, two of which also look after all other scanning such as general X-ray, CT and DXA. A fourth person is due to start at the Louth hospital in January but it will still mean that two of the four at the Louth hospital will be basic-grade radiographers.

To put it in perspective, the HSE's own numbers are stark. The recently retired clinical specialist sonographer completed 2,000 ultrasounds herself at the Louth hospital in 2024. In the first ten months of this year until her retirement, she had completed 1,465. At the same time, the waiting list for ultrasounds in the hospital's group is the largest it has ever been, with 5,000 outpatient appointments needed at the moment and 35 referrals a day coming into the Louth hospital. The total number of ultrasounds done in Louth County Hospital in 2024 was 7,825, up from 7,608 in 2023.

The real scandal is that there has been considerable outsourcing of ultrasound scans happening in the north east of the State for many years, with 5,348 ultrasounds done in one private clinic in 2024 alone. Many of these scans are being recorded by HSE radiologists, which they are allowed to do under their HSE contracts. The public waiting list continues to grow and the outsourcing of ultrasounds to private clinics where the HSE is paying a huge amount of money grows also. Instead of putting in jeopardy the ultrasound service at Louth County Hospital, the HSE should be developing it. The best equipment is there but there are two rooms that are not being used to their full capacity due to lack of staff at the hospital.

Four years ago, a radiologist was on site at Louth County Hospital. Now, there is none. Instead, they are on the phone. It cannot be the case that a clinical specialist position at Louth County Hospital remains unfilled. The clinical specialist sonographer not only does the bulk of the ultrasound scanning but also does the organisation of the list, the management of the service to the public and the oversight and training of other scanning staff. As per guidance from the IIRRT, it is not best practice to run an ultrasound scanning service for Louth County Hospital without a clinical specialist sonographer being on site.

There are real fears that the whole ultrasound service will be downgraded and frittered away until there is no service. Everything that is needed in order to continue the great service that was being done before the retirement of the clinical specialist sonographer is there, except for the replacement sonographer. Ironically, Louth County Hospital was the first hospital in the State to get a clinical specialist in ultrasound when the service was established all those years ago. It cannot be the case that it does not get one now when it needs it more than ever.

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