Jimmy Deenihan (Kerry North, Fine Gael)
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I thank the Ceann Comhairle for allowing me to raise this matter on the Adjournment this afternoon. This is not the first time I have raised on the Adjournment the issue of nursing shortages experienced at Kerry General Hospital. Almost eight months ago I warned the Minister that Kerry General Hospital was so under-resourced and understaffed that it could not conceivably continue to deliver the present level of service and that services would need to be curtailed if a commitment to provide additional nursing posts was not given.

At the end of May 2005, the industrial relations officer of the INO, Mr. Michael Dineen said:

Our members within Kerry General Hospital are under severe pressure to deliver an appropriate level of care to the patients in their charge due to staff shortages. If the present position continues, it will only exacerbate the difficulties being experienced as nurses will inevitably leave rather than continue to work in the current environment.

At that time I was informed by the Minister of State, Deputy Tim O'Malley, that representatives of the southern area of the HSE had offered to meet the INO representatives shortly afterwards to discuss the hospital staffing issues. Unfortunately, it took until today, when the INO was forced to threaten industrial action, for progress to be made between the Health Service Executive southern area and the INO. I welcome the outcome of today's meeting.

A staffing review will take place at a meeting between the Health Service Executive and the INO next Wednesday. At that meeting, in the event of staffing deficiencies being identified, I ask both the HSE and the Minister of State in his reply on behalf of the Tánaiste and Minister for Health and Children, Deputy Harney, that a clear commitment be given to have these deficiencies addressed. Otherwise, we may have a recurrence of this threat of work to rule.

I am not privy to what happened at the meeting but I understand a clear commitment was given by the representative of the HSE that vacancies would be filled as they arise and because of that industrial action at Tralee General Hospital was averted today. I understand that a bank of nurses within the hospital will be established for additional shift work if called upon, which will be done in a structured way. The services of agency nurses will also be retained in a structured fashion. They will fill any temporary vacancies that may occur as a result of absenteeism or so on.

The level of under-staffing at Tralee General Hospital stems from the failure to take the need for the relief component into account when staffing arrangements were being made. I understand that a hospital's nursing staff relief component is usually 25% of the total nursing staff level, which is approximately 410 in Tralee. When one considers the need for a relief component, the hospital should, therefore, have between 490 and 500 nursing staff. Provision is made for a relief component at all other hospitals in the country.

Tralee General Hospital should be upgraded to a band one hospital. It has a turnover of 22,000 patients per annum between inpatients and day patients. Hospitals with a throughput of more than 16,000 patients per annum generally fall into the band one category. It is clear that Tralee General Hospital thoroughly deserves band one status and funding should be increased commensurate with the activity level in the hospital.

When the hospital first opened in 1984, 15,000 patients used the accident and emergency department annually. This figure has jumped to more than 30,000. A nurse was absent from the unit today but a replacement nurse was not provided for the day. This is a regular occurrence. I call on the Minister of State to visit or ask that his senior Minister visit Tralee General Hospital during her forthcoming visit to County Kerry to meet the management, staff and consultants to discuss service levels.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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I am taking this Adjournment on behalf of my colleague, the Tánaiste and Minister for Health and Children, Deputy Harney. As Deputy Deenihan is aware, operational responsibility for the management and delivery of health and personal social services lies with the HSE, including responsibility for the provision of services at Tralee General Hospital. It would not be appropriate for the Tánaiste to intervene in industrial relations matters in Tralee General Hospital. Existing industrial relations mechanisms and procedures are in place to discuss and resolve issues of dispute.

The Department of Health and Children has been informed by the HSE that the threat of industrial action by the INO to which the Deputy referred has been withdrawn. The HSE has reported that a review of nurse staffing levels at Tralee General Hospital to commence on 1 February 2006 has been agreed. The review will be undertaken by an external consultant.

It has been acknowledged by all sides in this dispute that every effort will continue to be made to maintain current nurse staffing levels using all available resources. Hospital management has stated that the same high quality of patient care will continue to be delivered by Tralee General Hospital.