Séamus Healy (Tipperary, Workers and Unemployed Action Group)
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There is a huge bed capacity deficiency at South Tipperary General Hospital. Put very simply, there are not enough beds to cater for the demand for services at the hospital. This has been accepted in recent years by local hospital management, HSE regional management and the management of the south-south west hospital group of which South Tipperary General Hospital is part. The preferred option for a medium-term solution to this bed deficit is a 40-bed modular or hotel-type accommodation. In October of last year the senior Minister, Deputy Simon Harris visited the hospital and described the conditions there as utterly unacceptable. He further said that solutions must be found. He promised that a decision would be made before the end of the year. We are now six months into the following year and we still have no decision on this very urgent and immediate problem.

As the Minister of State knows well, the hospital is a progressive hospital, forward looking and very efficient. Despite the best efforts of staff, there is horrendous chaos almost on a daily basis, with significant numbers of trolleys on the corridors. The month of May saw a huge number of trolleys and we have had as many as 31 trolleys in the corridors in the current month of June. If this is the case in May and June, what will the situation be like in the coming autumn and winter?

Patients on trolleys have no dignity or privacy and lack access to adequate bathroom and washing facilities. Staff are run off their feet and are struggling to provide a safe service in a highly pressurised atmosphere. South Tipperary General Hospital has been effectively in crisis for more than five years. It has experienced savage budget cuts to funding and staffing while, at the same time, it has increased hospital activity at emergency department, outpatient and inpatient levels. The hospital is bursting at the seams, operating at 130% capacity. The medical department is at the even higher rate of 150% capacity. I remind the Minister of State that full occupancy is defined as 85%. As a priority, the hospital needs 40 additional beds immediately. I ask that the Minister for Health, Deputy Simon Harris, fulfil the promise he made when he visited the hospital nine months ago, to approve and fund a 40-bed inpatient extension to ensure the hospital can deal reasonably and well with its patients on a daily basis.

Finian McGrath (Dublin Bay North, Independent)
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On behalf of the Minister for Health, Deputy Simon Harris, I thank the Deputy for raising this matter and giving me an opportunity to update the House on the current position on South Tipperary General Hospital. I acknowledge the work of the Deputy on this matter and health matters generally. As the Deputy mentioned, the Minister visited South Tipperary General Hospital last year and is aware that there are capacity challenges at the hospital. However, work is under way to address this issue.

The HSE identified that the most immediate and effective response to alleviate pressure at the hospital is through the fit out of additional space for 11 trolley bays on the first floor. Accordingly, this work was prioritised for funding and has been completed recently. A recruitment process is under way to provide additional staff for this new area. Subject to a successful recruitment initiative, it is anticipated that this additional capacity will open in September 2017.

Another option under consideration is the use of the national framework for alternative accommodation at hospital sites to provide additional surge capacity through a temporary inpatient solution at the site. This will receive further consideration in the context of the Estimates of 2018.

The Minister is advised that the south-south west hospital group, recognising that bed utilisation in the hospital has increased significantly in recent times, is conducting a capacity review. This review which is nearing completion will inform the precise level and nature of any additional capacity required to meet current and future needs. The Department of Health’s national capacity review will also help identify service requirements and inform resourcing priorities. It is noted too that the hospital group is preparing a brief for the procurement of a master plan for the hospital campus. The master plan will provide for the orderly development of the South Tipperary General Hospital campus, and ensure the site is not compromised in any way.

Looking beyond acute services, the Minister had asked the HSE to explore what additional supports Our Lady's Hospital, Cashel, could provide to alleviate pressure in south Tipperary. I understand the HSE has recently submitted a proposal for future service provision which is focused particularly on the development of the Cashel health campus to deliver integrated care for the population of south Tipperary through the collaborative efforts of the south-south west hospital group and community healthcare organisation 5. The proposal will have additional resource requirements including specialist staffing and will therefore need to be considered in the context of the Estimates of 2018.

The Department of Health and the HSE are engaged in a process to commence winter planning for next year and to achieve an improvement trajectory in emergency department performance. Alongside this process, the HSE’s special delivery unit continues to work closely with hospitals to identify improvements that can be made to support patient flow, reduce trolley numbers and improve patients’ emergency department experience.

On behalf of the Minister, I can assure the Deputy that there continues to be a very strong focus on reducing emergency department overcrowding both in south Tipperary and across the country.

Séamus Healy (Tipperary, Workers and Unemployed Action Group)
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6 o’clock

This reply is desperately disappointing and unacceptable. It is effectively kicking the can down the road to the Estimates of 2018, which means there will be no movement on this until 2018 at the very earliest. It is condemning patients to life on trolleys in huge numbers over the next autumn-winter period. A trolley bay of 11 has been provided and while it is helpful it is not a solution. It is effectively hiding away the problem in a trolley bay and, worse still, it is robbing Peter to pay Paul because this trolley bay area was already identified for day procedures and minor surgery, so that is also being affected.

I understand a senior medical professional from the South-South West hospital group did a forensic analysis of the bed capacity requirements at the hospital recently. That official has confirmed that 35 to 40 additional beds are needed at the hospital. The report on this has been with the HSE for some time and is being held up at a very senior level in the HSE. Will the Minister of State confirm that this report, which is now with the HSE, will be published and when it will be published? Will he immediately request the senior Minister, Deputy Harris, who made a commitment and a promise in regard to this last October, nine months ago, to approve and provide funding for the 40 additional beds that are needed in this hospital?

Finian McGrath (Dublin Bay North, Independent)
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I thank the Deputy for raising this issue. I agree with him that the trolley bay is effective but I also strongly agree with him that it is a temporary measure and not a long-term solution. I respect the fact that there is an issue regarding patients on trolleys and the Minister, Deputy Simon Harris, and myself would never find that acceptable. I give the Deputy a commitment that I will bring the issues he raised, particularly the bed capacity issue and the report indicating that 35 to 40 beds are urgently needed, to the attention of the Minister. I will follow up on that report and I will ask the Minister, Deputy Harris, about that issue. It is also important to realise that we have difficulties with staffing, nursing and other issues that are all out of our control. In the broader context of inpatient beds at South Tipperary General Hospital, I will convey all the Deputy's concerns to the Minister, Deputy Harris, and, hopefully, we will have action on them soon.