Jimmy Deenihan (Kerry North, Fine Gael)
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I understand Deputy Ring's frustration and feel it is a disgrace that, with one Minister and four Ministers of State, no representative of the Department of Health and Children could attend this evening to listen to the matters raised on the adjournment by Deputy Ring and me. It makes a farce of the Adjournment debate, though I mean no disrespect to the Minister of State, Deputy Haughey.

Yesterday evening three consultant surgeons in Kerry General Hospital took the unprecedented measure of inviting all Oireachtas representatives of Kerry to a meeting at the hospital to discuss its future. They are concerned at the future of the provision of cancer treatment at the hospital and wonder what will happen as a result of the creation of a centre of excellence in Cork. They referred to the need for an endoscopy unit, a high dependency unit, staff for the day care ward, a maternity ward and orthopaedic services at the hospital. I am glad to have the opportunity this evening to outline the lack of orthopaedic services in Kerry General Hospital.

The outpatient waiting list at the moment for orthopaedic procedures at Kerry General Hospital consists of around 600 adults. Some 200 have been waiting more than two years and 300 more than 12 months. I do not believe there is another part of the country with such a long waiting list. The inpatient waiting list is shorter and around 46 people have been waiting more than three months. A reason is that consultants use the treatment purchase fund to send patients to other hospitals for procedures.

Many people have problems with their knees, especially the elderly, but knee replacement procedures are not done at the hospital. Operations on patients on the trauma list, that is, patients with broken bones, can only be carried out on Fridays. If one breaks a bone in one's leg or finger one must, generally, wait until Friday to be operated on. The trauma list should be dealt with every day, as in most hospitals, and a person who breaks a leg or hand should be operated on immediately.

Patients with broken bones require rapid assessment and treatment by an orthopaedic surgeon and anaesthetist. Early discharge to a comfortable environment with adequate rehabilitation facilities is also vital. Unfortunately, this level of back-up is not available and patients are generally discharged into mixed wards.

There is an urgent requirement for a daily trauma operating theatre list with adequate radiographic back-up. Only one radiographer is on call out of hours, including the weekend. There should be at least two. There is also an immediate requirement for a dedicated ward space, including a day ward facility, so that minor injuries such as finger and wrist fractures can be treated on a one-day basis.

The population of Kerry almost doubles during the summer because of the influx of tourists. Many of these tourists engage in activities such as horse riding, hill walking and rock climbing, which can result in accidents. Thus, Kerry General Hospital is under significant pressure to provide services not only for the local population but also for visitors. The resources are simply not available. I understand members of the HSE review issues that are raised in the House. I call on them to do what is necessary to make Kerry General Hospital a centre of excellence in orthopaedic services.

Seán Haughey (Dublin North Central, Fianna Fail)
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I am taking this matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney. In recent years, the demand for orthopaedic services in Kerry has consistently increased due to the growing population as well as significant elderly and visiting tourist populations. In response to this, the HSE has endeavoured to ensure that a comprehensive orthopaedic service is provided.

Since July 2007, the medical staffing of the orthopaedic department at Kerry General Hospital has increased by an additional registrar and now consists of three orthopaedic consultants, four senior house officers and three registrars. The department currently provides the following services: elective, or planned, and trauma, or emergency, surgery; six consultant-led outpatient clinics; on-call ward rounds; and trauma admissions. Activity in the orthopaedic department is intensive. Twelve elective orthopaedic surgery sessions are carried out each week, while trauma orthopaedic surgery has three dedicated sessions. However, some trauma cases are included in the elective sessions. Orthopaedic emergencies are managed within the general emergency theatre lists on a Saturday, Sunday and out of hours.

Within the hospital structure, there are 30 beds dedicated to orthopaedics. The complete upgrading of this ward has been flagged as a priority by management and funding in excess of €3 million has been approved for this purpose in 2008. This project will involve structural changes including the making available of high-quality facilities, including an isolation room, and will separate elective and trauma patients to reduce risk of cross-infection.

Management at Kerry General Hospital is working closely with the national treatment purchase fund towards reducing waiting times for orthopaedic patients. So far this year, 60 inpatients have been referred for surgery and a further 41 persons have been referred for outpatient consultation to the Bon Secours Hospital.

The HSE is committed to providing the best possible quality of care to all orthopaedic patients attending the hospital. The executive is undertaking a review of acute hospital services in Kerry and Cork with a view to developing acute health care that minimises risk to patients and is in line with best international practice and national policy. The review will identify the appropriate model for acute service provision in the HSE southern region and will recommend how best to configure acute hospital services in Cork and Kerry to deliver on this model.