Thursday, 11 November 2010
Question 3: To ask the Minister for Health and Children when the two extra consultant radiologists for Tallaght Hospital will be put in place; the way the total number of whole time equivalent consultant radiologists at the hospital compares to international best practice; and if she will make a statement on the matter. [42372/10]
Since 2005 there has been a 34% increase in the numbers of consultant radiologists, from 183 to 245. Ireland now has a ratio of one consultant radiologist per 17,959 of population, which is similar to the UK at one per 18,040 of population.
There are currently 5.54 adult consultant radiologists and two paediatric consultant radiologists at Tallaght Hospital. An additional two locum consultant radiologists were appointed to the hospital in January 2010 to assist in dealing with the backlog of X-rays. The backlog has been cleared and currently there are 0.54 locums in post at the hospital. However, on 7 September 2010 the HSE issued formal approval to Tallaght Hospital to appoint two new consultant radiologists. This is in line with the recommendations of the Hayes report. Interviews are expected to take place next month and the two successful candidates will take up duty be as soon as possible in 2011.
The Hayes report recommended that consultant radiologist staffing levels be reviewed to ensure they are appropriate to the workload in each radiology department. The HSE is committed to carrying out a review of consultant radiologist staffing levels in hospitals and to strengthening workforce planning across all radiology departments. The review will be informed by the results of a survey of consultant radiologist staffing which is currently being undertaken by the faculty of radiology. The aim is to complete this study by the end of the year.
The HSE is committed to implementing the recommendations of the Hayes report as soon as possible. I am confident that adopting this approach will help ensure the provision of a timely and quality radiology service in Tallaght Hospital.
The reports states clearly:
There were severe systemic and other weaknesses at management level, and the structures at Board level were simply not robust enough to provide the level of governance, supervision and direction required in the management of a large and complex organisation.
Indeed, the same could be said of the HSE, but we are talking about Tallaght Hospital here. Warnings were ignored or met with an ineffectual response. There were 30 occasions between 2005 and 2009 when consultant radiologists expressed concerns about the radiology department and the litany of management responses in that period demonstrates a clear awareness of the problem but no resolve to address it.
Tallaght Hospital, as the Minister correctly points out, has 13 radiologists. St. Vincent's has 16 radiologists yet Tallaght Hospital does twice the amount of X-rays. Why is this so? When will the two additional consultants be appointed and commence work? The Minister will be aware of the problems that an over-reliance on locums has caused in the past. Permanent staff are what is required here. According to the Hayes report, it took 13 years and nine years, respectively, to appoint radiologists to Tallaght Hospital. Why does it take the Department and the HSE so long to appoint desperately needed staff?
As Deputy Reilly has acknowledged, the report draws a number of conclusions. First, on the formation and governance of the hospital, there are lessons we need to learn when we are bringing hospitals together. The Tallaght model is not the way to do it. While I understand it happened in the way it did for ethos and other reasons at the time, the hospital, from a board structure, remained an amalgamation of three different foundations coming from the Adelaide, the children's hospital and the Meath.
I have had discussions with the chairman of the board on many occasions. On Tuesday last he came to see me as a result of the Hayes report. The board of Tallaght Hospital has put a smaller board in place which, effectively, will be a management board. It is a sub-group of the current board and it is a smaller group. It has also appointed Mr. William McKee, who managed health services in Northern Ireland and has a terrific track record, and he is working with the current acting CEO of Tallaght Hospital on the management issues that have arisen in the context of the Hayes report and, indeed, the PricewaterhouseCoopers report. Mr. McKee is also a member of the board of the hospital.
Tallaght Hospital, in the almost 11 years of its existence, has virtually doubled in staffing size. As they expanded the number of consultants, they did not have a corresponding increase in the diagnostic staffing, including radiologists. Certainly, lessons must be learnt from that.
The two consultants are currently being recruited. I understand the hope is that they will be in place in the early part of next year.
I hope they will be in put in place. From the time of advertising to the time of appointment and of taking up duty, generally, it could be up to 18 months. They have suffered enough in Tallaght and I note that Deputy Brian Hayes has been highlighting this point.
When will the HSE national audit, which reveals if other hospitals experienced a backlog on X-ray or GP referral letters, be completed and published? Would the Minister care to inform the House how many CEOs Tallaght hospital has had since its inception ten years ago, as opposed to all of the other hospitals which have had far more consistency?
Tallaght hospital has had six CEOs since it was formed. I knew the first CEO, who came from Canada, well. The Leas-Cheann Comhairle was a Minister for Health during some of his tenure. He was a highly impressive individual but for some reason he did not stay very long. I think there is a lesson to be learned from the fact that there has been such a rapid turnover of CEOs; six in ten years is not very encouraging. That is why the board has brought in Mr. McKee, who has wide experience, to work for a number of months along with current management at Tallaght to put into effect not only the recommendations of Hayes, but also its own PricewaterhouseCoopers report and the many other reports commissioned on Tallaght hospital.
What was the other question?