Dáil debates
Wednesday, 28 March 2018
Topical Issue Debate
Hospital Staff
4:05 pm
Martin Ferris (Kerry, Sinn Fein)
Link to this: Individually | In context | Oireachtas source
On 29 January last, I met the management of University Hospital Kerry. I did so after being contacted by staff members from various departments in the hospital, primarily with regard to morale being low and the lack of resources. I requested the meeting following numerous complaints. I wish to put it on the record that the staff in the hospital are excellent people. They do a fantastic job, as does the management. I met the new manager and I was very impressed by him. They do a fantastic job in very difficult circumstances. They are dedicated professionals who wish to provide the best services possible, but they are unable to do so due to chronic understaffing and a lack of resources.
They find their work environment extremely stressful, to the extent that some agency staff are refusing shifts in the accident and emergency department due to the severe and overwhelming workload there. I am also told that several members of staff are out of work due to stress-related illnesses, with more likely to follow. At the meeting, I was given assurances that workplace conditions are being addressed. The reality, however, is that the hospital is so under-resourced and the workplace conditions are so stressful that a serious injection of resources will be required to deal with the problems.
In the meantime, the cardiologist, Dr. Louis Keary, has resigned. The Department says he has tendered his resignation but has not resigned. However, I am informed that he has resigned his position at University Hospital Kerry. This means the hospital will be operating with just one part-time cardiologist tending to hundreds of heart patients. Dr. Keary was working in Bon Secours Hospital in Tralee and for two days per week in University Hospital Kerry. It is totally unacceptable that a hospital with a huge catchment area, comprising parts of west Limerick, parts of west Cork and the entire county of Kerry, does not have a full-time cardiologist. That is an indictment of the system. The Minister of State will be aware that there has recently been a review of the 46,235 scans carried out by a consultant radiologist who no longer works at the hospital.
An investigation of workplace practices is needed now more than ever. This must be dealt with. There must be an examination of the workload of consultants and staff at the hospital. We must ensure there are the facilities and resources to ensure the morale of the staff in the hospital is in a good place. That requires a proactive approach on the part of the Minister for Health and his Department to address the difficulties currently being experienced at University Hospital Kerry. I ask the Minister of State to speak with the Minister and the staff about this. It is something that can be resolved but there must be a political commitment to doing that. The people of Kerry appreciate the work done by the hospital and the staff but the Government, the Minister and the Department must step up to the plate and ensure that they get the resources they require and deserve.
Jim Daly (Cork South West, Fine Gael)
Link to this: Individually | In context | Oireachtas source
I thank Deputy Ferris for raising the issue of staffing at University Hospital Kerry. I understand that the Deputy’s concerns relate, in particular, to the provision of cardiology services in the hospital, notwithstanding the wider issues he has raised. He specifically focused on that.
The cardiology department in University Hospital Kerry performs a variety of heart tests such as electrocardiograms, echocardiograms, stress testing, Holter and blood pressure monitoring and pacemaker checks. The current cardiology department staffing complement comprises one consultant cardiologist, one chief cardiology technician, two senior cardiology technicians, one basic grade cardiology technician and an electrocardiography, ECG, technician. From a nursing perspective, the department is supported by a cardiac rehabilitation co-ordinator and a cardiology staff nurse. Furthermore, the department is supported by a health care assistant and administration staff.
In terms of additional cardiology supports, the HSE has advised that over the past number of months two visiting consultants from the South/South West hospital group have commenced attending the hospital on a regular basis. One is scheduled on a weekly-fortnightly basis and the other is scheduled on a monthly basis. These two consultants run additional outpatient clinics with a view to reducing long waiting times for new patients. I understand from the HSE that these clinics are having a significant positive impact on waiting periods. The HSE has further advised that University Hospital Kerry also has links with the cardiology department at University Hospital Limerick. Consistent with the recommendations in the national acute medicine programme for model 3 hospitals such as University Hospital Kerry, patients with acute coronary syndrome are transferred to the primary coronary intervention centre in University Hospital Limerick. Cork University Hospital is the tertiary referral centre for more complex cardiology patients.
I am aware that there have been reports recently about the resignation of the cardiologist from University Hospital Kerry. The Minister, Deputy Harris, has been informed by the HSE that no formal resignations have been received in this regard. The HSE has further assured the Minister that if a formal resignation is received, the hospital will immediately seek to commence the process of recruiting a replacement and will seek to appoint a locum consultant cardiologist in the interim.
With regard to the recruitment of medical staff, in July 2013 a working group chaired by Professor Brian MacCraith, president of Dublin City University, was established to carry out a strategic review of medical training and career structure. The group made 25 recommendations relating to training and career pathways for doctors with a focus on improving graduate retention in the public health system and planning for future service needs. It is significant that, overall, the number of consultants has increased by 109 in the 12 months ending December 2017 to a total of 2,971 whole-time equivalents and by 415 in the four years since December 2013.
The Minister for Health is deeply committed to ensuring that we have the necessary resources in place at all times for the delivery of safe patient care, both at University Hospital Kerry and throughout the health services. On the recruitment of consultants in particular, the HSE has streamlined the approval process for consultant posts in our hospitals and, notwithstanding significant recruitment and retention challenges, considerable progress has been made in the past four years in growing the numbers of doctors in the public health services as additional resources have become available.
Martin Ferris (Kerry, Sinn Fein)
Link to this: Individually | In context | Oireachtas source
I find it difficult to understand how the HSE can say it received no formal resignation, yet it says it has a consultant on a weekly basis and another on a monthly basis treating cardiac patients in Kerry. My information is that a part-time cardiologist comes to the hospital for one day or perhaps two days per week. That is deemed to be sufficient despite the huge waiting lists in the hospital. That is not accurate. Another consultant is on a monthly basis. The Minister of State says they "run additional outpatient clinics with a view to reducing long waiting times for new patients". Somebody is being economical with the truth here. My information is that Dr. Keary has resigned and that nobody has replaced him. Somebody is coming from Cork once or twice a week in order to try to deal with the backlog.
It also says here that people can go to the hospitals in Limerick or Cork for treatment. We are talking here about a situation where a person with severe coronary attack has to travel by ambulance - if they are lucky enough to survive - and that journey is 65 miles one way and 80 miles another way. That is not acceptable in this day and age.
I will now turn to the issues regarding the accident and emergency department in the hospital in Kerry, which was raised in the House during this morning's discussion on promised legislation. People contacted my office at 3 a.m. and described that accident and emergency department as a war zone with so many people on hospital beds and so forth. At 4.45 a.m this morning, a great friend of mine passed away in a nursing home at the age of 90. Three weeks ago he had been on a trolley in the accident and emergency department in Tralee for more than 36 hours.
4:15 pm
John Lahart (Dublin South West, Fianna Fail)
Link to this: Individually | In context | Oireachtas source
I thank the Deputy.
Martin Ferris (Kerry, Sinn Fein)
Link to this: Individually | In context | Oireachtas source
He was released but was back in again on a trolley a week later. The man was 90 years of age and passed away this morning. I am not saying that was the reason he passed away but it is not acceptable that we have people of that age-----
John Lahart (Dublin South West, Fianna Fail)
Link to this: Individually | In context | Oireachtas source
The Deputy is well over the time.
Martin Ferris (Kerry, Sinn Fein)
Link to this: Individually | In context | Oireachtas source
-----not being treated properly and by not having a cardiologist in that hospital.
Jim Daly (Cork South West, Fine Gael)
Link to this: Individually | In context | Oireachtas source
I appreciate there is confusion around the current status of that situation. The HSE has informed me that no formal resignation has been received to date from the cardiologist in question in University Hospital Kerry. To avoid confusion, the purpose of the cardiologists who go there weekly, fortnightly and monthly is to deal with outpatient clinics and to reduce the waiting times, whereas the cardiologist who is permanently appointed to the hospital deals with the procedures within it.
Deputy Ferris spoke of people having to travel for treatment. That is just a medical decision and a clinical decision. When a patient is triaged and is deemed to require more complex coronary care, better care and more facilities are available in Cork University Hospital. This is why some people have to travel. I absolutely accept that this winter has presented difficulties and challenges to the emergency departments in hospitals and University Hospital Kerry is no exception. There was a significant increase in presentations at the hospital. I believe that 36,000 people presented at University Hospital Kerry this year. These increases are proving challenging. The increases are more than just demographic increases. There are more presentations to our emergency departments and it is quite a significant challenge. This winter has been no exception. The Government has taken a number of measures to try to alleviate this with funding. An allocation of €85 million was made, with €40 million allocated specifically for winter measures this year and an additional €11.6 million was allocated for waiting list initiatives such as opening new beds and transitional care beds. A total of 189 beds have been opened overall in the system but I appreciate there is a lot more to do. We will continue to work with, and keep the pressure on, the HSE try to alleviate those situations of which Deputy Ferris has spoken and in many hospitals across the country.