Dáil debates

Thursday, 10 September 2020

Saincheisteanna Tráthúla - Topical Issue Debate

Hospital Services

5:05 pm

Photo of Pat BuckleyPat Buckley (Cork East, Sinn Fein)
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I want to speak about the ongoing issues in the geriatric ward in Cork University Hospital. I also want to talk about patient and staff safety. For the past four days, I have been listening to stories on "The Neil Prendeville Show" on RedFM about what witnesses have experienced in the geriatric ward. I am sure the Minister of State is familiar with the station.

In the past number of days, I have received numerous pieces of information about managers at the top level not coming down onto the floor and inspecting the place. I have heard about issues where if front-line staff, including nurses, seek help, or tell their managers they cannot cope, they are classed as troublemakers. How does one run a service when the top and the middle do not link up, never mind bottom?

Obviously, the issue here is long-term underfunding. Recruitment has been an awful issue here and there have been many health and safety issues. I listened to one poor woman who said there was no seating for the patient in the shower unit in the geriatric ward. It was a simple little handrail, that was it. The same lady witnessed a gentleman mopping the floor. Once he had finished mopping the floor, he proceeded to clean the shower tray with the same mop. Health and safety seems to be a big issue there.

I want the Minister of State to investigate a number of issues. The number one issue is that I have heard the conditions in this ward are absolutely appalling. It is 2020 and we are letting down our elderly and most frail. I listened to another woman who said she will never go back to that ward or even go to the hospital. She is in her 80s and said she will take her chances if she breaks something. If she can get to her armchair in her living room, she will happily die there. Those are not my words and, as I said, I have listened to this debate on the radio for past number days. I am not taking the side of patients and families, or staff and their families. I am here to ask the Minister of State to investigate, so we can help everybody here, that is, the staff and patients in Cork University Hospital, CUH.

I want to raise the issue of penny-pinching. Again, it is not picking on particular staff but this is down to contracts and management whereby agency staff are given time slots of two minutes to clean area A, five minutes for area B, and so forth. It is totally inadequate. Then we wonder why people are getting sicker when they go to hospital.

Another issue I wish to raise in this short time, which I will revisit, is that of the so-called unannounced visits by HIQA. Many of these so-called unannounced visits are not unannounced. I learned today that the so-called unannounced visit to the Cork geriatric ward is next Monday. I have been told that staff will be brought in over the weekend to move trolleys into empty wards and clean the place before this visit. How are we to help patients and ensure the safety of staff who genuinely want to work there when nobody is taking responsibility? If HIQA is not doing its job properly, then somebody has to be responsible for it. That is what I want to get to the bottom of here. We need to help everybody in this scenario, that is, the staff and patients in CUH. I hope to God it is not happening in other places around the country but if this is what I have been told about so-called unannounced inspections, then I fear there could be a domino effect.

5:15 pm

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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I thank the Deputy for raising this issue and giving me the opportunity, on behalf of the Minister, Deputy Donnelly, to provide an update to the House regarding concerns over hygiene and infection control standards a Cork University Hospital's geriatric unit.

First, I assure the Deputy that infection prevention and control is generally well-developed in acute hospitals. Indeed, prior to the pandemic all acute hospitals had outbreak teams in place. However, while it was clear that systems were in place to manage outbreaks and control further spread of the virus within hospital settings, questions arose as to the whether there was sufficient focus an outbreak prevention.

Given the insidious nature of the coronavirus, at its meeting on 31 March NPHET accepted that more can and should be done. It mandated the implementation of a suite of 29 measures to prevent transmission of the virus in acute hospitals to slow the demand for specialised healthcare, safeguard risk groups, protect healthcare workers and minimise the export of cases to other healthcare facilities and the wider community.

The HSE has established an overarching governance structure to provide oversight for all issues related to Covid-19 infection control. In addition, the Department of Health has been working with the hospital groups to implement these NPHET mandated measures across a number of different action areas, namely, governance, risk management, outbreak management, staff symptom declaration, staff segregation and adoption of social distancing guidelines.

One of the measures mandated by NPHET was a desktop review by HIQA of acute hospital infection prevention and control preparedness for Covid-19. The report of that review has now been published. While this report highlighted the progress that has been made in recent times to expand infection prevention and control, IPC, capacity and capability at acute hospitals, deficits in IPC capacity were identified. Following discussions in the Department and with the HSE, it was agreed that there was a need to consider an integrated approach to address IPC deficiencies across acute hospital and community sectors. In that regard, I am pleased, on behalf of the Minister, Deputy Donnelly, to inform the House that funding of almost €4 million was recently approved to address immediate IPC requirements in acute hospital and community services. This will help to minimise and mitigate the risks of staff, patients and service users and facilitate the delivery of safe health services.

In Cork University Hospital, the care of the elderly service is delivered on Ward 1A, which is a 35-bed ward. With regard to hygiene and infection control standards, the HSE has advised that cleaning staff are based in the ward from 8 a.m. to 8 p.m. with hygienic service available throughout the night as necessary. The HSE has also advised that monthly hygiene audits are carried out along with annual environmental hygiene audits and that prevention and control of healthcare associated infection training is provided on a continuous basis for all staff which has been enhanced throughout the Covid-19 period.

Photo of Pat BuckleyPat Buckley (Cork East, Sinn Fein)
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I thank the Minister of State for his reply. He knows I am straight-talking. Can we stop blaming Covid-19 for this? I never mentioned Covid-19 in my opening remarks. Some of this is historic and goes back to 2016. We cannot blame Covid-19 and we probably cannot blame Brexit.

It is my job as a public representative to say to the Minister of State that if a patient or staff member is not being fully supported and his or her health, well-being, mental health and physical safety is being put at risk, it has nothing to do with Covid-19. It has to do with management of the area, misrepresentation and what I said to the Minister of State about so-called unannounced visits. The Minister of State mentioned risk management, outbreak management, staff symptom declaration and staff segregation. We are not talking about that but about elderly patients being left in their soiled beds without help. We are talking about patients who cannot feed themselves. When the server puts the plate on the table, walks away and comes back in an hour later, he or she sees the plate is still full and assumes the patient is not hungry. Certain protocols are not being properly pushed here and the public are aggrieved and they are blaming the staff who are overworked and under-resourced.

I ask the Minister of State to forget Covid-19 as an excuse. One of the safest places on the planet is supposed to be one's hospital but the patients and the staff here are not being looked after. Will the Minister of State carry out a full review and find out if this so-called announced HIQA visit is actually happening next Monday? Is that true? If it is true, it is lying to the Minister of State. I have said that to other Ministers over the years in regard to mental health. The Minister of State cannot then do his job properly. He cannot come into this House and say to me that this is what he has been told. It might be what he has been told but he should listen to four days of people ringing in to a radio show and listen to mothers, patients and staff crying. However, he has said to me that we will blame Covid-19, throw in a few measures, thank HIQA and NPHET and everything will be grand but it is not grand.

I ask the Minister of State one more time on behalf of the staff in the unit, the patients and their families to investigate with HIQA and who put out that report. If it is true, who said that there is an unannounced visit by HIQA into ward 1A in CUH? There will be staff there over the weekend to sort things out and I can guarantee that there will be a chair in the shower, there will not be a smell out of the toilet bowl, people will be fed and everybody will be happy. If that is true, we should be ashamed of ourselves.

We are here to represent people and get things right. I am not here long enough, but the Minister of State can hear that I am angry. I am fed up of getting these one-liners. It is not his fault and it is not a personal attack on him, but on the system. I do not trust the HSE or HIQA, but I trust the parents and the service users who have had their testimonies on air. I trust the staff and their testimonies on air. Somebody must be telling the truth and somebody must be telling lies, which is why I am asking the Minister of State to investigate it. I believe that the staff, the patients and their families are telling the truth. The Minister of State is being misinformed by HIQA and the HSE.

5:25 pm

Photo of Frank FeighanFrank Feighan (Sligo-Leitrim, Fine Gael)
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I will bring the Deputy's observations back to the Minister, Deputy Donnelly. The upset of the staff, patients and their families has been noted. The Deputy also called for various protocols to be introduced. He also spoke about an unannounced visit by HIQA that may happen on Monday. I will try to clarify those issues for him. It is now clear that in order to safely and sustainably manage the provision of the health service into the future, significant investment will be required to build the IPC capacity in the coming years. We want to ensure our health service provides safe, quality and timely care. It is a priority for the Government. In that regard the HSE has provided assurance that all hygiene standards are adhered to on ward 1A and throughout Cork University Hospital. I will bring the Deputy's views and concerns to the Minister. I again thank him for raising this important issue.