Wednesday, 21 November 2007
Hospitals Building Programme.
Question 47: To ask the Minister for Health and Children if she will implement the recommendation contained in the report from RKW consultants that an urgent care centre be built in Tallaght Hospital to cater for accident and emergency attendances by children; the steps being taken to implement this recommendation; its implications for Harcourt Street Children's Hospital as part of the Tallaght Hospital complex; and if the recommendation is being implemented to date when the new care centre will open. [30032/07]
On 31 October last, the HSE announced the details of the high level framework brief for the new national paediatric hospital. The brief was prepared by Rawlinson Kelly & Whittlestone Limited, RKW, an established UK-based health care planning company. The content of the report was informed by the views of a range of international experts, including architectural and clinical experts.
The brief sets out the range of services to be delivered at the new hospital and the additional services to be provided outside of the main hospital through an ambulatory-urgent care service. The brief will help to inform the work of the national paediatric hospital development board in planning, designing, building, furnishing and equipping the new hospital.
The new hospital will be at the centre of a national paediatric network, linked to regional and local hospitals and to primary and community care services through outreach, telemedicine, joint appointments and staff rotation. The new hospital will be supported by an ambulatory and urgent care service. The first such centre will be developed at Tallaght.
The vast majority of children attending the National Children's Hospital emergency department do not require admission and will continue to access their care locally at the new ambulatory and urgent care centre. RKW estimated in the report that the first centre at Tallaght will have the capacity to cater for up to 48,000 emergency attendances and up to 58,000 outpatient appointments, based on demographic and activity projections up to 2021. A significant level of day case surgery will also be carried out at the new centre. There will be 20 day case beds and three theatres with capacity for up to 9,000 day case procedures. Clearly, this projected level of activity would be subject to change depending on the number and location of any additional ambulatory emergency units. The high level framework brief has been provided to the national paediatric hospital development board. The HSE will be meeting with the board to agree on the operational arrangements for bringing the project forward to the next stage.
What is the timeframe for providing this new facility in Tallaght? When will it open? Can the Minister confirm the report stated quite clearly that it is essential that it opens prior to, or simultaneously with, the new hospital to be built at the Mater site?
I agree it is essential they open together because the two are part of the same facility. The ambulatory care centre at Tallaght will be under the auspices of the national hospital. The timeframe we are working to is 2012. I had a meeting recently with the development board, which is working to the same timeframe. There are many projects seeking capital funding in health but this is a priority and capital funding will be made available.
It is envisaged that the hospital will be open 18 hours per day, from 8 a.m. to 12 midnight. It will be closed between 12 midnight and 8 a.m. because the level of attendances during that period would be low. Other issues to be considered include the availability of ambulances at Tallaght so that those patients can be taken to the hospital at the Mater site.
Considering the burgeoning population of south Dublin and the outer regions, for which Tallaght Hospital currently caters, and the investment in the construction of the facility, it is a false economy to close the hospital from 12 midnight to 8 a.m. daily. There may be serious night-time emergencies for children and the proximity of the hospital can be crucial in saving the life of a child. If consultants indicate it is crucial that this facility be provided in Tallaght, it is just as relevant, in the context of access, travel and the major young population in the vicinity, that the facility be open 24/7. It is a waste of that resource to close it at midnight and it places lives at risk.
I do not accept that. This accident and emergency unit will deal with 48,000 attendances as opposed to 31,000 in Tallaght at present, 9,000 day cases as opposed to 3,500 at present and 58,000 outpatients as opposed to 30,000. The advice is that it is not necessary to have the facility open between midnight and 8 a.m. because a small number of cases would arise during that period. This is the advice of clinicians, not something I have made up off the top of my head. The staff at the centre will be rotated. The paediatric staff from the centre at the Mater Hospital will be rotated and arrangements will be made between the two hospitals, such as ambulances on standby to transfer those who arrive at Tallaght to the Mater site. These logistical issues must be addressed by the development board in conjunction with the hospitals.
That concludes Priority Questions. We are five minutes over time and I wish to proceed with Ordinary Questions. I remind Members that the questioner and the Minister have one minute each for supplementary questions during Ordinary Questions.