Dáil debates

Thursday, 28 September 2017

Topical Issue Debate

Hospital Facilities

6:05 pm

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I will take this Topical Issue on behalf of the Minister for Health.

Photo of Catherine ConnollyCatherine Connolly (Galway West, Independent)
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I have no difficulty with that, as long as I get an answer.

I wish to raise the issue of the closure of two operating theatres in Merlin Park University Hospital in Galway, which is the sister hospital to University Hospital Galway. The two orthopaedic theatres that have closed for a number of weeks happen to have the longest waiting lists and in recent years, a former consultant has referred to the fact that he was dealing with patients from the last century, bearing in mind that we now are in the second decade of the 21st century.

It is bad enough that the two theatres are closed as a result of a leak but none of us can figure out how the leak was not detected before this, as there was an inspection of the building in 2016. Patients have been left completely at a loss and to bring home the acuteness of this issue to the Minister of State, a mother has written to me about her 20 year old son. He has completed three years at college and took one year out to get a full hip replacement at the age of 20. She has no idea when this operation will happen. He is in receipt of disability allowance at present and this woman is at her wits' end. She and her son have discussed it with the consultant, who informed them that he has no idea as to what is happening, is totally frustrated with the system and that communication seems to be totally absent on this matter. We are reliant on bulletins from the local radio station. We know from this that 60 patients - at the very least - are having their procedures cancelled each week.

This is one specific issue that comes on top of a creaking system, as I highlighted earlier today to the Minister for Health. It would be bad enough were we simply dealing with an exceptional situation but I am afraid it is another symptom in a system that is simply not able to cope. This is why I asked earlier for a specific response with regard to the planning for a new hospital.

We seem to go from crisis to crisis in Galway in this regard. I take no pleasure from standing here today to highlight the bad state of the public health services in Galway. I am firm champion of the public health service. I believe in it passionately. I have seen the good and the bad of it. I have had personal experience of the bad side of it with my family, which is ongoing. These problems have been created by Government after Government who have failed utterly to fund the system and failed utterly to hold to account the Health Service Executive, HSE, in respect of what it is doing there.

To go back to specifics, will the Minister of State explain when the theatres closed? Why did they close? When will they re-open? What is happening in the meantime? What is the communication strategy for the patients who are waiting? What numbers of patients are waiting? At the very least this is basic information that should be at the Minister of State's fingertips and if it is not, my question will be to ask why the Health Service Executive has not come forward with all the facts and a plan of action.

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I thank Deputy Connolly for raising this very serious issue. Saolta University Health Care Group has advised that on 4 September, a leak developed in the roof of a building in Merlin Park University Hospital that houses the hospital’s two orthopaedic theatres. Hospital management temporarily suspended operations for a week to allow the University Hospital Galway building and maintenance unit to make repairs. A second leak was noted on 13 September, however, and the Saolta group advises that a multidisciplinary team consisting of members of the hospital’s management and infection control teams, as well as the HSE, immediately decided in the interest of patient safety to suspend operations in the two theatres. This was done to allow a full assessment of the infrastructural damage and the development of a plan for repairs. As a result, elective orthopaedic surgeries are now being deferred at Merlin Park. Hospital management has contacted patients individually to apologise and provide assurances that their treatment will be rescheduled. It should he noted, however, that no emergency patients have been affected. I am very conscious of the upset and inconvenience that this closure is causing for both patients and their families while the theatres remain closed.

Saolta and the University Hospital Galway management team have engaged an external engineering firm to carry out a full assessment of the damage and to provide a timeframe for the completion of repairs. They are also exploring a range of potential interim solutions including the use of modular theatres, assessing the scope to utilise other theatre capacity in University Hospital Galway and potential outsourcing of some services to the private hospital sector. Saolta and the University Hospital Galway management team have both been in regular contact with the Department of Health to provide updates on the situation at Merlin Park hospital. The Department has requested that the Saolta group formulate and implement a contingency plan to address this incident and the Minister for Health is due to have a meeting with local management on this issue next week.

I assure Members that reducing waiting times for the longest-waiting patients is one of the Government’s key priorities. Consequently, budget 2017 allocated €20 million to the National Treatment Purchase Fund, NTPF, rising to €55 million in 2018. In order to reduce the numbers of long-waiting patients, the HSE, working closely with the NTPF, is currently implementing waiting list action plans for 2017. The inpatient and day-case waiting list action plan is being delivered through a combination of normal hospital activity and in-sourcing and outsourcing waiting list initiatives under the NTPF funding. The NTPF has advised that under its waiting list initiatives, to date approximately 6,000 patients have been authorised for treatment in private hospitals and nearly 3,000 have been authorised for treatment in public hospitals. Of these patients, more than 3,000 have accepted an offer of treatment and some 1,500 have already been treated. Under the NTPF in-sourcing initiative, there has been a particular focus on patients needing orthopaedic procedures and engagement is ongoing with the NTPF with regard to Merlin Park hospital. I will revert to the Deputy on some of the other issues after her response.

Photo of Catherine ConnollyCatherine Connolly (Galway West, Independent)
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I thank the Minister of State for some of the clarification given. On 4 September there was a leak and on 13 September there was a further leak. This facility is a centre of excellence serving nearly 1 million people, if we take in the catchment under Saolta from Letterkenny down to Galway, as well as patients who come from County Clare, which is outside the area. This is a centre of excellence serving 1 million people but a roof is leaking in Merlin Park hospital, where the waiting list was extraordinarily high in the first place. The figures are absent from this response. How many procedures have been put off? How many patients have been affected? Surely this is the most basic thing that should be communicated, together with a full apology. The capacity of the university hospital is number one on the risk register. I shall repeat that; the capacity of the regional hospital, which apparently is in a better state than Merlin Park hospital, is number one on the risk register, as compiled by the hospital. This is why a new hospital in Galway is being sought. Then there is Merlin Park hospital, with extraordinary outpatient lists and people who are in pain. I have only read out one example. I want to work with the Government and I want to champion public health services but this does not help in any way. The HSE could have explained that 1,000 or 500 or 200 patients were waiting and it could have set out what it intended to do and that it would only be a matter of a few weeks. The executive could have clarified that when the hospital was assessed in 2016 the leak was not apparent or was apparent but was ignored. These are basic communication skills in order that we can reassure people and not insult them. I do not mean the Minister of State is insulting them; I realise she is doing her best with this answer. I welcome the fact that the Minister is going to Galway.

Certainly, I would like further details on the contingency plan, what it means, where patients will be treated, how many will be treated and how long they will have to wait. They should also receive a full apology from the Health Service Executive.

6:15 pm

Photo of Catherine ByrneCatherine Byrne (Dublin South Central, Fine Gael)
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I acknowledge the concerns and frustration of the Deputy. Unfortunately, this situation was unforeseen. I acknowledge the matter has gone on for some time but the Minister explained he will be visiting this week. What plan will be put in place will become more apparent at that stage as will the position regarding cancelled procedures and which patients will be brought into the system. I have given the Deputy all the estimated numbers I have here. I cannot give her anything different. I note that on 19 September, the Saolta group said 80 patients had been impacted by this issue. They have been contacted and advised that their procedures will be deferred and rescheduled at a later date. The Saolta group also estimates that 60 patients per week are generally treated in the theatres concerned. As such, there has been a huge impact on an overburdened health service. People with orthopaedic illnesses who need surgery must be attended to as quickly as possible.

I will bring the Deputy's concerns to the attention of the Minister. I emphasise that after he meets the representatives of the hospital group, the Minister will come back to the Deputy with a proper outline of the plan for patient treatment over the coming months and weeks, however long it takes to repair the hospital roof. There may also be other necessary repairs which have to be done and that may add to the time it takes. I will go to the Minister and ask him to revert specifically to the Deputy on this matter when he returns from meeting people in Galway University Hospital.