Seán Barrett (Dún Laoghaire, Fine Gael)
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I thank the Ceann Comhairle for affording me the opportunity to raise this important matter. It was with deep regret that I learned of the content of a recent planning brief drawn up on behalf of the management and board of St. Michael's Hospital in Dún Laoghaire. This hospital has been part of the fabric of the greater Dún Laoghaire area for many years and has provided, and continues to provide, a wonderful service for thousands of people, including myself, over that period.

It appears that this report was carried out as a result of a recent inquest being told that there had been instances in St. Michael's of a virulent new strain of a hospital-acquired bug which is fatal in one in 12 cases. I will outline some of the disturbing facts stated in this report. The hospital building is at the end of its useful life. The operating theatres, their direct support and the day ward are functionally, spatially and technically obsolete. They offer patients and staff an inappropriate environment for the delivery of contemporary elective surgery and other investigations and treatments. The physical layout is inefficient. Existing space is grossly inadequate and environmental control systems are either absent, inadequately provided or obsolete.

A recent decontamination review observed that processing facilities incorporate no physical barrier between areas in which soiled instruments are received and washed and those in which clean and sterilised material are handled. There is no clear system to dispose of contaminated material. The scrub area attached to the main theatre can only be approached through the theatre or via a staff rest room. Room surfaces are finished in materials now considered inappropriate. The second floor day ward is not directly adjacent to either operating theatre which creates difficulties because of a lack of a bed lift. These are only some of the items specified in this recent report.

I am aware that the management and board have plans to upgrade this very important facility, which carries out just under 6,000 mainly routine surgical procedures annually. They plan to expand on the services currently offered, including an increase in the capacity of the day ward so that day cases can account for 70% of all surgery instead of the current 50%. This target is consistent with trends in Ireland and health systems in most advanced countries.

In light of the disturbing facts contained in this report, I am looking for a commitment that the Minister for Health and Children and the HSE will provide the financial support to allow the management of this hospital to proceed immediately with the upgrading and construction works. Unfortunately, the Minister is not here. It is not acceptable that these necessary works are put on the long finger and that we will have to wait a number of years before this hospital is restored to its rightful place as one of the leaders in the provision of first-class medical services.

The Acting Chairman and I have been Members of this House for a long time. Important issues are raised on the Adjournment. I wish to put a protest on record. I have nothing against the Minister for State, who is not responsible for the Department of Health and Children, but the preceding speaker also raised a very important matter in the health area when no Minister from the Department of Health and Children was present.

Máire Hoctor (Tipperary North, Fianna Fail)
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I am here.

Seán Barrett (Dún Laoghaire, Fine Gael)
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In terms of the items that are being raised, I do not blame the Minister of State for having to take this Adjournment debate but, as I said to my colleague, Deputy Ring, this is becoming a bit of a joke. One wishes to raise serious matters and, in my constituency, this is a very serious problem. As I said at the outset, this hospital is an essential part of the fabric of the greater Dún Laoghaire area and complements the very worthwhile services provided at St. Vincent's Hospital. As I also stated, over 6,000 operations are carried out in St. Michael's each year. The fact that it is increasingly moving towards day ward services is an essential part of the infrastructure in our health service.

If anything happens to this hospital, it will be a very serious matter in respect of the proper advancement of St. Vincent's as one of the key centres of excellence for the Dublin area so I appeal through the Minister of State. The funds are necessary. I understand that the board is in a position to go to tender in the very near future. There is talk about work commencing in October but given the current mess in the finances of this country, I am afraid that this matter will be put on the long finger. Having listed some of the matters contained in the report, everybody would agree that, in the interests of patient care and to prevent further illnesses arising from the lack of facilities, it is vitally important that this matter is dealt with urgently.

Máire Hoctor (Tipperary North, Fianna Fail)
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I will be taking the Adjournment on behalf of my colleague, the Minister for Health and Children. The Department has been advised by the HSE that the report to which the Deputy refers was prepared by management at St. Michael's Hospital. In order to address the issues outlined in the report, the HSE, as part of its ongoing capital programme, has recently approved in principle a capital project which will allow for the development of facilities at St. Michael's. It will involve new operating theatres and recovery facilities, a new theatre sterile supply unit and a new day procedures unit, including facilities for day surgery, endoscopy and minor surgical and medical procedures

The HSE has indicated that the selection of a design team for the project will commence shortly and it is expected that design and detailed planning will commence in early 2008. The decontamination review and hygiene audit referred to in the newspaper article are national initiatives to address quality and risk issues in service delivery.

A decontamination review and assessment took place in St. Michael's Hospital in November 2006. The HSE has advised that the hospital has taken steps to address the issues raised and this is reflected in the planning brief. Similarly, an assessment of hygiene services took place in the hospital during August 2007. Measures have now been put in place to address concerns that were identified. The HSE has assured the Department that patient care is not being adversely affected in the interim.