Dáil debates

Tuesday, 19 October 2004

Adjournment Debate.

Hospital Services.

8:00 pm

Jerry Cowley (Mayo, Independent)
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Thank you for the opportunity to raise this matter on the Adjournment.

Six Mayo patients requiring dialysis are currently obliged to pass by a state-of-the-art dialysis unit at Mayo General Hospital in Castlebar, County Mayo — the third largest county in Ireland — and travel to a unit a considerable distance away in Galway. This involves a round trip of 1,000 miles per week in some cases for people who are very ill or elderly.

Only 30% of the people in question would be suitable for a renal transplant. One man awaiting dialysis is vomiting day and night from a build-up of urine in his blood because his kidneys no longer function. Despite living in Castlebar where the renal unit is located, he must travel to Galway to receive the treatment he needs. He is not fit to endure the ordeal of making a 330 mile round trip at least once a week. He has suffered a stroke, has double vision and requires an ambulance to transport him to Galway. Although he has a medical card and despite representations made by his family, it is still not certain an ambulance will be guaranteed three times a week. He has no choice other than to travel to Galway because he will die without dialysis. He is nauseous and experiences vomiting and must use the machine in Galway as it will perform the function his kidneys cannot. It is a scandal that this man cannot have this treatment in the unit in Mayo General Hospital in Castlebar which has capacity for 26 patients and is currently treating 28 patients.

Many years ago, I and others campaigned for a renal unit at Mayo General Hospital. My contribution to the campaign was to provide information to the media and supply car stickers with the message "Mayo dialysis unit now". It is a scandal that disabled people and five other individuals, including a man from the fringe of County Mayo, cannot use the unit. Some parts of the county are almost as far from Galway as this House. I ask the Acting Chairman to imagine if he or a relative had to make a round trip to Galway three times per week to spend four hours attached to a machine. This is almost the distance from Galway to the furthest point in County Mayo. One would not expect anybody to make such a journey, yet ill people who should be resting at home are expected to do so. When such a unit is available in one's own town, one should expect to get access to it.

This problem could be solved overnight if the health board were not prohibited from hiring the four staff necessary to provide an extra shift. The renal dialysis unit in Castlebar General Hospital operates two shifts as opposed to the three shifts operated in Galway. A third shift cannot be provided because four nurses are needed and cannot be recruited because of a recruitment embargo. The people affected are going through hell on earth when the problem could be solved overnight with the recruitment of four nurses. If the Tánaiste were to allow them to be recruited, it would be a superb gesture. It would mean a great deal to those concerned and provide encouragement to the consultants, nurses and other staff in the unit.

A sum of €150,000 available for a water treatment unit would increase the capacity of the renal unit. However, because it is needed for capital development, it cannot be used for this purpose. Even if it was possible to use it for the renal unit, it should not be used for this purpose because the development of a water treatment unit is also necessary. Expansion of the renal unit at Mayo General Hospital will be necessary in future. Ideally, nine staff — five nurses and four health care assistants — would be available.

The ratio of people who receive dialysis here is 600 to 800 per 1 million inhabitants. In the United States and Japan the figure is 1,000 per million inhabitants, while in County Mayo 256 persons per million inhabitants receive dialysis. When compared with the United States, Japan and the national figure, County Mayo is suffering badly. I ask the Tánaiste to help us by expanding the service.

We should consider the cost of taxis and ambulances. I am sorry for those working in the ambulance service in County Mayo. How can they supply a proper emergency service when they are expected to provide an ambulance three times per week to transport dialysis patients? Why should they have to provide this service because the local unit has insufficient capacity? It would be easy to provide additional capacity.

I have received also representations on this issue from emigrants who cannot return home because no dialysis service is available. The number of patients in Mayo General Hospital has doubled while the number of staff has remained the same. I ask the Tánaiste to examine the matter.

Photo of Mary HarneyMary Harney (Tánaiste; Minister, Department of Health and Children; Dublin Mid West, Progressive Democrats)
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I thank the Deputy for raising this issue. Renal services are one of the main priority areas for development. Additional revenue funding of more than €20 million has been provided since 2000 to develop renal services in response to increased demand at national level. This includes an additional €5 million provided in the current year, of which €400,000 was allocated to the Western Health Board. This investment has supported the development of renal services on a regional basis. More patients than ever before are now accessing renal dialysis units.

As regards renal dialysis at Mayo General Hospital, I understand from the Western Health Board that in 1997 the unit was treating 12 patients and is currently treating 26 patients. Staffing levels in the unit have increased and arrangements are being made to increase capacity of the dialysis stations in the unit from nine to 13. Since 2000 in excess of €1.2 million has been provided to the Western Health Board as part of the structured programme of investment in the development of renal services for the region. Two consultant nephrologists currently provide services in the region.

While the hospital has attempted to meet the increasing demand for dialysis and is currently treating 26 patients, a number of patients from County Mayo receive dialysis treatment in Galway. The hospital has informed me that it is exploring all possibilities of meeting the existing demand within current financial and human resources constraints. I assure the Deputy that in my time as Minister for Health and Children I will continue to develop services at hospitals such as Mayo General Hospital.

Jerry Cowley (Mayo, Independent)
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Why can four nurses not be hired? With the recruitment embargo in place, the hospital can do nothing.

Photo of Pat CareyPat Carey (Dublin North West, Fianna Fail)
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There is no provision in Standing Orders for Deputies to respond to a Minister's reply.