Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I thank the Minister of State for attending.

Carlow is one of the fastest growing counties in Leinster according to the Central Statistics Office, CSO, figures. Although Carlow town now has more people living in it than has Kilkenny city, we have no hospital. Earlier this year, the Minister, Deputy Stephen Donnelly, came to Carlow and saw the pressure on our out-of-hours service and the limited use of a perfectly good X-ray facility in St. Dympna's Hospital.

We need an injury clinic in Carlow to make use of the good facilities already there and to allow for the expansion of the services to properly serve the people of Carlow. As for the growth in population and demand on the service, I note the population of Carlow has had the biggest growth since 2016, at 9%, bringing the county of Carlow to a total of 61, 968. Again, were the Minister of State to look at the CSO figures, he would see Carlow town has a bigger population than Kilkenny city. That, in itself, leads the way for a very significant injury clinic to be put into Carlow because of the population.

The CSO figures have the population of Carlow town at 27,351 and Kilkenny city’s population is at 27,184. The Carlow town population figures include Graiguecullen.

Part of Graiguecullen is in Laois, but it is just a short walk across the River Barrow and these people use the services in Carlow; they do not go to Portlaoise and instead use all the Carlow services. If there was a minor injury unit in Carlow, and of course in other towns that need them across the country, pressure would be taken off regional accident and emergency departments. It would alleviate the situation of people waiting hours just to get an X-ray. This is something that concerned me. I am not blaming the staff in Kilkenny hospital, but over the last bank holiday weekend St. Luke's General Hospital Kilkenny asked that people not attend the accident and emergency department unless they really had to because of staff pressures. I appreciate the staff are doing an excellent job, but they announced people should not go to the accident and emergency department in Kilkenny unless they needed to because the staff were under so much pressure.

We have an excellent X-ray department, a vaccination clinic and out-of-hours services, yet the people are being sent to Kilkenny hospital. It is unfair on people and on the hospital. The X-ray department in Carlow operates on a part-time basis with limited daily X-ray facilities. It needs to be open five days a week. This would again take the pressure off Kilkenny. I do not want the staff of Kilkenny to think I do not appreciate the good work they are doing. What is the plan for increased resources for St. Dympna's Hospital? Is the Minister going to look at a build for a minor injury clinic elsewhere? We need to look at a primary care centre. I am aware it is part of the plan going forward. I was told the HSE proposed to deliver a primary care centre for Tullow, Rathvilly and Hacketstown using its own direct build mechanism. The HSE said its capital plan would fund it. The HSE then told me this was only identified last year. Then I was told it was to begin in quarter 4. It is still not there. This is a huge centre promised for a long time. I ask the Minister of State to go back to the Minister, Deputy Donnelly, to see if this can be pushed urgently.

Dara Calleary (Mayo, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I thank the Deputy. I am taking this matter on behalf of the Minister, Deputy Donnelly.

In 2012 the emergency medicine programme recommended the establishment of injury units in model 2 hospitals to provide unscheduled emergency care for patients with non-life threatening or limb threatening injuries. It was envisaged that due to their locations these injury units would provide a convenient level of emergency care while ensuring patient safety and equitable standards of care within an emergency care network. Some 15 local injury units are now open around the country and each one is providing an important service to its local community. There is clearly a large and growing demand for these services. Approximately 140,000 patients attended injury units in 2022. This is an increase of over 30% since 2019 and represents around 7% of all urgent and emergency activity in Ireland. However, the impact of this level of service is not just local. These injury units also play an important role in reducing the waiting times for patients in emergency departments throughout the country by providing a level of care locally and the Deputy referenced this. Injury units are for the treatment of minor injuries that are unlikely to need admission to hospital, such as broken bones, dislocations and burns. Patients may be referred to an injury unit by a GP or sent to one from an emergency department. Injury units require access to appropriate clinical space and onsite access to X-ray facilities.

I am advised the HSE commenced a review of injury units and medical assessment units in October 2022 with the aim of identifying areas of best practice that could be rolled out across the country. This review also looked in detail at the activity, capacity, staffing and operation of existing units across the model 2 Hospitals, as well as areas having the most potential need for additional injury units. An implementation plan for the recommendations from the review is now being developed. While all recommendations will of course be subject to resource and other considerations, including alignment with urgent and emergency care national and local plans, the development of these services in areas such as Carlow will be considered as part of the implementation plan.

Unfortunately, I do not have an update on the primary care issue, but I will get one from the Minister for the Deputy.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I know the Minister of State will go back to the Minister. As I said, I have had him in Carlow, we met different groups and given our population growth an injury clinic has to be part of the plan going forward. The Minister of State said an implementation plan for the recommendations from the review is now being developed and areas such as Carlow will be considered as part of the implementation plan. What is the timescale on this and is there a date? The good people of Carlow are so lucky to have a hospital as good as the one in Kilkenny, but it is half an hour away. Our population has grown so much. We need an injury clinic in Carlow as soon as possible. I am sure the Minister of State will come back to me on the primary care, but the reason I spoke about it is we were promised a centre that would include Tullow, Hacketstown, Rathvilly and all that area, yet I am worn out talking to CHO 5. I might as well tell the Minister of State I am constantly ringing the organisation and trying to get an update and I just do not seem to be getting anywhere. I again ask that he talk to the Minister and I will speak to him as well.

I met some councillors from the Borris area recently. The census showed the area has one of the oldest populations in Carlow, with an average age of 44.9 years. It is also looking for a primary care centre because it is one of the most rural parts of Carlow. These facilities are going to be so important going forward, because people are living longer, which we are all delighted about, but we need to be able to facilitate people in that. We must be able to ensure people can access these things.

I was in St. Mullins last night at a big public meeting. It is very close to Borris. It is the most beautiful part of Carlow. We have so much to offer in Carlow. I am looking for two primary care units and an injury clinic.

Dara Calleary (Mayo, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I thank the Deputy for the weekly tour of Carlow. I can assure her the review of the current injury and medical assessment units that was begun last October has been finalised and an implementation plan is now being developed. That is particularly quick for the HSE. It would be useful for the Deputy to supply to the Minister the census figures she referenced, including for Graiguecullen and the portion in Laois, to back up the work that might be underway with the implementation plan. The Minister is clear Carlow will be considered as part of the implementation plan, but that is of course subject to resource and other considerations, including the alignment with urgent and emergency care national and local plans. It would be useful for the Deputy to provide that up-to-date information to the Minister directly. I will advise him to expect it from her.