James Bannon (Longford-Westmeath, Fine Gael)
Link to this: Individually | In context

I thank the Office of the Ceann Comhairle for allowing me time to raise this urgent matter, namely, the need for the Minister for Health and Children to clarify her position on the Midlands Regional Hospital, Mullingar. I would like her to assure me this evening that the withdrawal of services from the hospital and the refusal of scan and X-ray services to public patients are not indicative of the closure of the hospital by stealth. The hospital is a valuable and much-needed health facility for the midlands.

What exactly are the Minister's plans for the hospital? The completion of phase 2B at the hospital must be one of the longest sagas of inefficiency on the part of her Department, despite the ring-fencing of €57 million for the hospital 12 years ago. This sum has ended up being drip fed over the past 12 years and work has not been completed to date. Longford-Westmeath was assured services in the area would be fully supplied and remain at the hospital. However, among other cutbacks, the breast cancer unit was withdrawn in November 2007, 25 beds have been closed at the hospital, front-line staff numbers have been reduced, budgets have been cut, transport vouchers have been withdrawn and now post mortem services are to be redirected to Tullamore hospital. Scans and X-rays are apparently unavailable for public patients and lives are being put at risk.

Last September, the HSE supported the issuing of bogus appointments for a consultant dermatologist in a department that did not exist at the hospital. This meant seriously ill patients were being given appointments for a consultant who had left the hospital six months previously. A new consultant had not been appointed and the department was effectively closed. Appointments were cancelled at the last moment and patients were strung along in a blatant cover-up.

I draw the attention of the Minister of State, Deputy Connick, to the latest health-threatening cutback at Mullingar hospital. I ask that a full investigation be carried out by the Minister for Health and Children in regard to it. Public patients are being refused scans and X-rays at the hospital and it is alleged that general practitioners are being forced to refer patients to Dublin hospitals on a private basis. This is putting the gun to the heads of vulnerable patients, who are, once again, being forced to put their hands into their own pockets to avail of necessary procedures.

It is scandalous that the Department of Health and Children is putting in place measures to ensure patients must either go without investigative procedures or pay privately for scans or X-rays. If this is a deliberately orchestrated response to general practitioners' referrals, the Minister should consider her position. If it is the case, I will accept nothing less than a resignation from her because she is totally incompetent and inefficient in her administration of the health service.

Irrespective of whether this scandal is geared to close the hospital by stealth or not, it should be thoroughly investigated. If this is happening in Mullingar Regional Hospital, then the chances are that this directive is in place around the country. Longford lost its hospital, which was closed in 1986. Guarantees were given that a full service would be available to all in Mullingar. This is not proving to be the case. Longford-Westmeath relies on this valuable hospital, which is one of the top performing hospitals in the country. It must be supported by the HSE in an open and fully transparent manner, with all the necessary services being provided.

I stress that a deliberate and cold-hearted campaign of axing services in Mullingar Regional Hospital, to the detriment of the health of the people of Longford-Westmeath will not be tolerated and questions must be answered by the Minister.

Why are patients being denied life-saving procedures? Why is it that under this Minister's watch patients' lives are continually being put at risk in this hospital? I demand answers here this evening.

Seán Connick (Wexford, Fianna Fail)
Link to this: Individually | In context

I thank the Deputy for raising the question which I am taking on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

The Midland Regional Hospital at Mullingar, MRHM, is part of the Dublin Midlands Hospital Group. The aim of the hospital is to deliver a quality-driven, people-centred service to the population of Dublin-Midlands and in particular the Longford-Westmeath area.

The Deputy's question assumes there has been a withdrawal of services at Mullingar Hospital and also a refusal to provide scan and X-ray facilities to public patients. The HSE has confirmed that there has been no withdrawal of such services at Mullingar. On the provision of scan and X-ray facilities, a recent nationwide survey conducted by HSE HealthStat revealed that access to radiology for urgent cases in the MRHM catchment area is the best in the country. This is achieved through the diligence of the radiologists in the Department reviewing individually every request for CT, MRI and ultrasound, and prioritising them. While this can be a very time-consuming process, it is considered to be an efficient and effective process by the consultant radiologists at Mullingar hospital.

The trend in modern medicine practice is to use more and more investigation. From a clinical perspective, not all of this is considered to be helpful. However, a consultant radiologist at Mullingar has indicated that in many cases GPs' requests can be unnecessary, resulting in the waiting times for more appropriate examinations taking longer than necessary. Consultant radiologists at Mullingar hospital return a number of requests to the referring doctor for various reasons, usually because the test requested is inappropriate for the clinical problem. This practice applies to requests from both general practitioners and internal requests from doctors in the hospital.

I am informed that, for example, international evidence shows that in the case of back and neck injury presentations, unless there is evidence of neurological damage, the use of imaging is not indicated. Inappropriate requests are not accepted for scans on any patient, whether public or private, at the hospital. The HSE has categorically confirmed to the Department that all patients, both public and private, are treated equally for the purposes of radiology requirements at Mullingar Hospital.

Where scans are available from private providers, the criteria used to decide whether they are required may be different. This could give the mistaken impression that these private patients are getting a better service.

The activity and volume through the Radiology Department at Mullingar hospital is constantly increasing year on year. The position on radiological tests at the hospital during 2008 and 2009 is an increase of 2.5%. I am confident that services at the Midland Regional Hospital Mullingar are designed to deliver the best and most appropriate services to all of its patients and will continue to do so into the future.

Seán Sherlock (Cork East, Labour)
Link to this: Individually | In context

I should say at the outset that Cobh community hospital is a facility that is very well-regarded by the people of Cobh. I have been asked by my Labour Party colleagues on Cobh Town Council to raise this issue as a matter of urgency because there is a situation whereby the National Treatment Purchase Fund has taken over the fair deal scheme as it relates to Cobh hospital. That will have serious permutations for the cost per patient per week in that it is stated that the possible drop in fees from €1,200 to €800 per bed per week could result in a serious deficit. Obviously a deficit in funding would have an impact on the ability of the patients to remain within the hospital in the first instance, but also severely impact on the hospital's ability to take in new patients.

It is a 38-bed hospital and there are approximately 40 staff. What goes to the heart of this is the issue whereby care for our older people who are in community-based facilities is being eroded by this Government through a process of stealth. The Government's model of health care is about rolling back the State and these wonderful community-based facilities so that they may be completely and utterly subsumed into a private nursing home model, thereby rolling back the stakesholdings that communities have within these hospitals which make them the excellent facilities they are. It is all being done under the wonderful guise of HIQA rules and the fact that these institutions are older. Anything that is deemed to be older in this new paradigm we have with this Government is deemed not to be of sufficient standard.

I want to speak for hospitals such as Cobh, the welfare home in Youghal and Nazareth House in Mallow, all of which provide an excellent standard of care, but are now under threat because of the new rules that have come into play through the fair deal scheme and the new punishing HIQA standards. All I want to do here is make the case for Cobh community hospital, in that it is an excellent facility. There is a significant buy-in from the people of Cobh into this hospital. The staff coterie is very loyal to the hospital. The patients there are happy, and I would hope the Government ensures the continuation of this hospital in perpetuity, especially for the older people of Cobh who will use it, hopefully, into the future.

Seán Connick (Wexford, Fianna Fail)
Link to this: Individually | In context

I thank Deputy Sherlock for raising this issue which relates to the nursing home support scheme, "a fair deal". The scheme commenced on 27 October 2009 and the HSE is now processing applications.

The scheme was introduced in order to address the fundamental inequity in the treatment of public and private long-term nursing home residents and in order to alleviate the financial hardship being experienced by long-term residents in private nursing homes. Prior to the introduction of the scheme, many people in long-term nursing home care experienced unaffordable care costs over periods of many years. The result was that many people had to sell or remortgage their houses or had to turn to family and friends in order to find the money to meet their care costs.

A fundamental purpose of the new scheme, therefore, was to offer assurance to one of the most vulnerable groups in society - those in need of long-term nursing home care - that such care will be affordable and will remain affordable for as long as they need it. In order to achieve these objectives of equity and affordability, the new scheme involves a fundamental change in the way in which long-term nursing home care is funded and, consequently, the way in which nursing homes and community hospitals are funded. In the past, many of these facilities were allocated a lump sum annually. In contrast, the new scheme supports the individuals in need of long-term residential care, not the facilities providing the care. This means that funding follows the patients, regardless of whether they choose a public, private or voluntary nursing home, and ensures that these facilities are not being funded for empty beds.

In order to qualify for the scheme, all private nursing homes, including Cobh community hospital, must negotiate and agree a price for the cost of care with the National Treatment Purchase Fund. This is a necessary feature of the scheme due to the commitment by the State to meet the full balance of the cost of care over and above a person's contribution. As stated above, the nursing homes support scheme only applies to long-term nursing home care. Nursing homes and community hospitals can continue to have separate agreements with the HSE for the provision of other services, for example, day care, respite and convalescence.

Finally, the Government is committed to developing a financially sustainable funding model to support all long-term care services, both community and residential care services. It is envisaged that this work would also encompass short-term residential care such as respite and convalescence care. This commitment by Government was made in the social partnership agreement, Towards 2016, and preliminary work has commenced within the Department of Health and Children on the analysis of funding models.