Tuesday, 29 January 2019
Saincheisteanna Tráthúla - Topical Issue Debate
Hospital Accommodation Provision
There is annoyance, frustration and growing anger at the delay in the completion and opening of the 40-bed modular unit at South Tipperary General Hospital. The Minister promised that it would be opened in June 2018 but the date was pushed back to September, then December, then March and finally July. The Save Our Acute Hospitals Services Committee and Oireachtas Members met hospital management and HSE officials last Friday week. While I am satisfied that the construction of the unit will be completed later this year, we were given information that has given rise to serious concerns to the effect that the HSE is not committed to the opening of the unit when it is ready. We were advised that no funding allocation has been made for staffing despite business cases - at a total cost of €7 million - being last June. Furthermore, equipment costing €1.4 million is required and only €250,000 in funding has been allocated. We need specific answers and specific commitments from the Minister of State that funding for staffing and equipment will be made available immediately.
The modular unit that is being provided for South Tipperary General Hospital will be finished by July. It is being provided to ease the pressure until such time as proper capital investment is made in order to provide proper and permanent structures at the facility. The hospital in Clonmel and University Hospital Limerick are regularly listed as having the highest number of patients on trolleys on any given day that the numbers are reported. This means that the hospitals serving Tipperary are the most crowded in the country. This cannot be tolerated much longer by the people of our county. When the modular unit is ready in July, it must be staffed and made operational immediately.
The overcrowding at South Tipperary General Hospital does not exist in a vacuum. Unfortunately, there are many other health service issues in our county which are making the situation worse for the public and for the staff. We have no acute mental health beds in the county despite promises of action. We have little or no step-down beds which is causing bed blocking in the acute system. The ongoing shortage of occupational therapists in our county is holding up the provision of home help hours.
I am disgusted that the Minister is not here. He visited this hospital. I brought the issue of the modular unit raised by the consultants in Clonmel hospital to the attention of the Taoiseach during the programme for Government talks in early 2016. Deputy Lowry announced that the unit would be open in the winter of 2016, then in the winter of 2017 and then in the winter of 2018. We are promised it will be open this year but I do not believe it. The modular unit to be brought to Clonmel seems to be abandoned. It would be something if we could get it built, which I hope we do, but no money has been allocated to staff it. We are not allowed to recruit staff for it. It is worst to have more space but fewer staff. Nobody can accept that. This is a serious matter. Funding of €1.4 million for equipment is required but only a few hundred thousand has been allocated.
The fiasco of the national children's hospital - I railed against the proposed location here but none of the parties supported me - is draining every project dry. The Minister is not accountable to anybody for the cervical cancer scandal, for the cost overrun on the national children's hospital or for anything else.
The hospital in Tipperary has the highest number of patients on trolleys last week on trolleys after Cork University Hospital. The latter is twice the size of our hospital. What is happening is outrageous.
I thank Deputies Healy, Cahill and Mattie McGrath for raising this very important issue concerning South Tipperary General Hospital.
The Minister and I fully recognise the importance of increasing bed capacity in our hospitals and the impact this will have on improving access for patients through emergency departments and for hospital inpatient and day case procedures. Hospitals are increasingly operating at or above capacity, with year-round demand pressures that are further challenged over the winter months. Approximately 1.3 million people attended emergency departments last year. South Tipperary General Hospital, as a model 3 hospital, is experiencing similar challenges to similar facilities. In 2018, over 30,000 patients attended the emergency department at South Tipperary General Hospital - a 1.7% reduction on 2017; 9,149 patients were admitted - a 6.5% increase on 2017; and, as a result, the number of patients recorded as waiting on trolleys at 8 a.m. was 3,739 - an increase of 3.1% compared to 2017.
The health service capacity review indicates that Ireland has among the highest acute bed occupancy rates in the developed world at 94%, significantly ahead of the OECD average of 77%. It is against this background that the review recommended an increase in acute hospitals beds of over 2,600 by 2031 to support the projected Increase in demand for services in the years ahead.
The national development plan provides for the full 2,600 beds by 2028 - three years ahead of schedule. As a result, increasing capacity is a priority for the Government. Over the past 12 months, an additional 240 beds have been opened. A capacity programme for 2019 has been agreed and is set out in the national service plan for 2019. This includes: 75 acute beds and 70 community beds to come on stream in 2019 as part of the winter plan for 2018-2019; 78 additional beds planned for quarters 1 and 2 of 2019, including the 40-bed modular build in South Tipperary General Hospital; and preparation of 202 beds, of which 16 are critical care, by quarter 4 of 2019, with a view to bringing this extra capacity into operation in the first quarter of 2020.
On foot of budget 2019 and the national service plan, the necessary funding is in place for the 40-bed modular build for South Tipperary General Hospital. This includes: funding to complete the construction; funding for equipment in the unit; and funding to staff the unit. The HSE is planning for the unit to be operational in the second quarter of this year.
Increasing capacity alone will not address the challenges faced by the health system. Investment and reform must go hand in hand. We have seen in other hospitals in recent years that increased capacity coupled with an ambitious reform programme will deliver improved access for patients. That is why driving improvement processes in line with Sláintecare is a key objective of the Government to ensure that investment is coupled with reform.
I look forward to the completion of this new unit as it represents a significant investment in bed capacity in South Tipperary General Hospital. It will complement the existing 178 inpatient beds and 21 day beds and will support the provision of acute hospital services to the geographically wide catchment area of south Tipperary, west Waterford and varying areas of north Tipperary.
We are getting the usual spin from the Minister of State. We want to know the answers to questions. When will the allocations for equipment and staffing be made and how much will they be? We want those allocations to be made immediately. We have already been waiting for seven months for something to happen. It appears that the HSE may be intent on not opening this unit when it is completed. The Save Our Acute Hospital Services Committee got 15,000 people onto the streets of Clonmel with regard to a previous hospital issue and we will do the same again if the proper allocation for staffing and equipment is not put in place. I remind the Minister of State that we have local, European and possibly general elections on the way so the sooner he makes the allocations, the better. They need to be full allocations so this unit can be fully operational for at least the next autumn and winter period.
The Minister of State is sitting on necessary funding. We had a meeting last Friday with the management of South Tipperary General Hospital. The view from the management of that hospital was that there has been no provision for the needed funding. I would have expected the answer to the three Deputies here to include exactly how much money has been allocated.
"Necessary funding" is a very loose statement. We will hold the Minister of State accountable. This unit will be completed on 1 July after long years of being promised. We will insist that it is fully operational on that date, with funding in place. I have no confidence that that will be the case but the Minister of State gave a commitment here this evening and we will hold this Government responsible for that commitment being adhered to.
Ar an gcéad dul síos, gabhaim mo bhuíochas leis na daoine go léir ag obair in St. Joseph's Hospital. I thank and compliment the staff, including the people at the doors, consultants, management, nurses, front-line staff and everybody else for the work they do in appalling conditions. The last thing they want is a diatribe such as the Minister of State read out. He knows in his heart and soul, having sat over here three or four years ago, that he would not have accepted it. The Minister is in hiding and would not come here to talk to us. He can run but he cannot hide. He saw Cashel hospital and the splendid conditions there and refused to open a bed there. We know we will not have the money to staff it. We cannot get staff for the children's hospital or anywhere else. I believe the Minister of State is going to Nicaragua on St. Patrick's Day. I do not know where the man beside him, the Minister, Deputy Ross, is going, but wherever the two of them go, they should go on a one-way ticket and not come back because they are propping up this disastrous Fine Gael Government which is wreaking havoc on the people and does not care about ordinary people. Off with the two of them. I hope they will not get a return ticket because they are destroying rural Ireland single-handedly. When they were in opposition here, they would do everything, and now they do nothing. Reading out the diatribe is a scandal and the Minister of State knows that.
I thank the Deputies for taking this issue seriously and discussing the plans of the capacity of South Tipperary General Hospital. As I have said, the HSE has confirmed that the 40-bed modular build for south Tipperary is planned to be operational in the second quarter of 2019.
-----and to open in 2018. The funding was in place. As the Deputies will be aware, the HSE advised in June 2018 that the process was delayed and I accept the point that the facility would not come into operation until early 2019. It is coming into operation now. To give assurances to the Deputies, I confirm that the HSE has advised the Department that the enabling works are well under way. That amending tender took place in February 2018 and the HSE awarded a contract to the successful company in April 2018.