Jimmy Deenihan (Kerry North, Fine Gael)
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At a time when the Government is planning a pre-local election spending spree on health, which would see the opening of hundreds of new beds, the appointment of up to 1,500 additional staff and the commissioning of new hospital facilities worth approximately €400 million, the authorities in Tralee General Hospital, County Kerry, are being forced to close a ward for three months over the summer because they do not have enough money to allow for staff locums when they are on holidays. This means the waiting list for elective procedures, such as very simple ones for gall stones and varicose veins, will increase. No non-urgent patients will be seen in the out-patients section during the period. At present, there are up to 2,000 patients waiting to be seen in this category, many of whom have undiagnosed cancers. This unacceptable wait has led to a legal case because a cancer was not diagnosed in time.

In addition, the population of County Kerry swells during the months of July, August and September. The influx of thousands of tourists puts further pressure on the services at Tralee General Hospital. Surely, it is not fair, just or responsible to reduce services in what is Ireland's and one of Europe's best-known destinations at this time of the year.

The proposed ward closure is bad for patient care and divisive for the staff. With proper funding for the hospital, this closure would not be necessary. The hospital was under-funded by €2.5 million in 2003 and it is under-funded by at least €1.5 million in 2004. A day surgery ward was provided and equipped but lies empty and unused because there is no money to staff it.

Elderly patients with broken hips and patients who require major surgery for cancer have had their surgery delayed because of the lack of intensive care beds. These delays increase the mortality and the morbidity of the surgery. A high dependency unit has been equipped and would solve the intensive care problem, but there is no budget to staff it.

The hospital only recently received money for a third obstetrician, a general surgeon and an orthopaedic surgeon, years after similar appointments have been made in equivalent hospitals elsewhere. Indeed, those hospitals are now on the way to appointing a fourth consultant. The hospital is still without the services of a cardiologist despite that the death rate from cardiac diseases in County Kerry is the highest in the country. There are many other problems. When clerical staff go on holidays, for example, there is nobody to provide a locum so the correspondence and work piles up and awaits them on their return.

Patients in County Kerry do not receive fair treatment. This is a direct result of Government underfunding of Tralee General Hospital. There are no corresponding cuts in Cork and we do not see the same hardships there. Unfortunately, however, Tralee General Hospital, which serves County Kerry and a much larger population during the summer months, is subject to blatant discrimination. I hope the Minister of State will have good news for the staff, patients and consultants at the hospital and for the people of Kerry.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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The Deputy will be aware that responsibility for the provision of services at Tralee General Hospital rests with the Southern Health Board in the first instance.

It is a feature of all acute hospital systems that some beds are out of use for short periods. Bed closures fluctuate over time and may arise for a variety of reasons such as staff leave and seasonal closures. Tralee General Hospital will close a 30 bed general ward from July to the end of September 2004. The Department of Health and Children understands that the seasonal closure of the ward in Tralee General Hospital will be similar to the seasonal closure of some beds that occurred in 2003. This seasonal closure will enable hospital management to co-ordinate annual leave for staff and thus reduce the level of locum cover needed while staff are on holiday.

The hospital prides itself on prioritising patient care and providing a high quality service. It has reported to the Department, for example, that when this ward closed last year, there were no delays in urgent or essential treatments. Staff rostered on this ward are assigned to other areas of the hospital during the temporary closure of beds.

The Department of Health and Children allocates funding on an annual basis to the Southern Health Board for the provision of health services. Distribution of this funding to individual hospitals in the region is a matter for the board. The haemodialysis unit in Tralee General Hospital has recently been extended. The unit now has ten dialysis stations and can cater for up to 40 patients. This greatly enhances the service available to renal patients at the hospital.

Increasing the bed capacity of the acute hospital system nationally is a key priority in improving access to acute services. More than 580 new beds have now been provided in hospitals throughout the country under the acute hospital bed capacity initiative. An additional investment of €1.7 million was provided to Tralee General Hospital to fund an additional 16 beds under this initiative. Approval has been given to the Southern Health Board for the appointment of a design team for the development of a new community nursing unit on the campus of Tralee General Hospital. This will represent an investment of €8.5 million when completed.

Base funding of €1.8 million has been provided in 2004 to Tralee General Hospital to progress the appointment of a number of permanent consultants who have been in place on a temporary basis for a number of years. These posts are in the specialities of obstetrics, general surgery, orthopaedics and anaesthetics. I am confident that the measures I have outlined and the additional investment in Tralee General Hospital is clear evidence of this Government's commitment to the further development of acute hospital facilities for the people of Kerry and throughout the country.