Thursday, 13 January 2011
Accident and Emergency Services
Roscommon County Hospital provides an important range of elective and emergency services and treats cases on both an inpatient and a day case basis. Like a number of other hospitals, Roscommon County Hospital has experienced difficulties in recruiting non-consultant hospital doctors during the normal six monthly rotation in January 2011. This is not a staff moratorium or financial issue; smaller non-training hospitals like Roscommon County Hospital are finding it increasingly difficult to attract the number of non-consultant doctors required to maintain all services as structured at present.
The HSE has assured me that, in the light of these difficulties, it will employ all possible measures to address the staffing issues, including continued recruitment efforts and the use of nursing and other supports from Merlin Park University Hospital and Portiuncula Hospital, to maintain the 24-hour emergency service provided at Roscommon County Hospital.
The HSE is in the process of devising a reorganisation programme for hospital services in Galway and Roscommon. This will be informed by the HSE report on the national acute medicine programme, which was published in December. As a first step, in 2010 a clinical director was appointed to manage Galway University Hospital, Merlin Park University Hospital, Portiuncula Hospital and Roscommon County Hospital as one integrated service, to provide additional support to the hospitals concerned and to ensure that care is delivered on a safe and sustainable basis.
A reorganisation project group has been established to develop a plan for services in Roscommon and Galway. Following consultations with key stakeholders including clinicians, senior managers and directors of nursing across the three hospitals, a reorganisation plan will be developed by the group. A clinical lead will be identified in the coming weeks and a project manager will be appointed to co-ordinate and drive planning and implementation. It is expected that an agreed detailed plan will be available in the course of 2011.
I thank the Minister for her response. I ask the Minister to clarify why every other appointment to Roscommon is done on a joint basis of a hospital group of Roscommon, Galway University Hospital and Portiuncula, yet in regard to non-consultant hospital doctors, it is specific to the hospital in Roscommon. This situation could be addressed overnight and reduce the 22% deficit of non-consultant hospital doctors to 3%.
There is a specific crisis in respect of theatre nurses in Roscommon. If two theatre nurses are appointed, we can deal with the colonoscopy backlog in Galway University Hospital. Theatre nurses are critical health staff and their absence is jeopardising the 24-hour service. In light of the commitment given by the Minister in respect of the 24-7 service, will she ensure non-consultant hospital doctors are appointed on the basis of a group of hospitals and will she make two theatre nurse appointments to ensure the services continue?
The HSE is changing the manner in which non-consultant hospital doctors are appointed. This week, I met with Dr. White and others on this point. It is becoming difficult in an environment where there is a global shortage to get non-consultant hospital doctors for smaller, non-training hospitals. The most effective way of overcoming the difficulty is to have smaller hospitals combined with larger hospitals. This is already happening in regard to some of the midlands hospitals and St. James's Hospital. It should also happen in regard to Galway University Hospital. I will pursue the matter.
I am aware there is a shortage of nurses in Roscommon. I have spoken to the HSE about the quantum of nurses in the region to ensure Roscommon can function. I do not want to see a hospital with a deficit because of a particular problem in regard to nurses. We have a high ratio of nurses. Every time I say this, Mr. Doran talks to me about it. We have a high proportion of nurses in the Irish health care system, notwithstanding the moratorium and retirements. The comparison with Canada in The Irish Times supplement shows we are substantially ahead of Canada in the number of nurses working in our health care system. We have a sufficient number of nurses in the region to assign nurses to Roscommon County Hospital. I will endeavour to ensure that happens.
I thank the Minister for her commitment on these two specific issues. I ask the Minister to assure the House about rumours in Roscommon to the effect that the hospital will be removed from the 24-7 on-call service. In light of the lack of an out of hours GP service, the grossly inadequate ambulance service and the fact that the HSE has publicly committed to addressing both of those issues before considering a reduction in services, can the Minister give a commitment that it will happen?
I understand Deputy Naughten was speaking with Dr. O'Keeffe, who manages the three hospitals, this week and he is familiar with the arrangements. This week, I had a meeting at HSE on this point and others, including emergency units, and I am assured that 24-7 services will continue. I cannot guarantee it will continue forever but I can guarantee the best endeavours are being used as we speak to ensure we maintain services for the region. The future for Roscommon County Hospital, Galway University Hospital and Portiuncula is to work together as a single hospital, albeit on three sites. There is no doubt in my mind on this point in terms of staffing, recruitment of required expertise, the financial perspective and the perspective of patients. Many patients from Roscommon still go to Galway and procedures could be supplied in the local hospital if the three hospitals worked as one. There are a number of benefits when three hospitals work as one and that is the future.