Michael Kitt (Fianna Fail)

I welcome the Min

There has been much mention of University College Hospital, Galway, which is in the news locally and nationally. The Tánaiste announced an extra 32 beds for it some weeks ago, a positive development, although I agree we need even more beds. I am amazed sometimes that the two Galway hospitals are on call every second day and every second weekend. I do not know which day they are on call but I am sure the doctors do and that if people go to one to be assessed they are sent on to the other. This issue needs clarification.

As well as the need for more beds, the availability of doctors is important. In Galway, most of the specialties are dealt with in UCHG while Merlin Park is a fine orthopaedic hospital. However, there is a question with regard to its management and to the availability of doctors. These questions should be addressed. Let me give an example of the situation in Portiuncula Hospital in Ballinasloe. It is not a small hospital and it serves the midlands as well as the western region. Recently, Galway Bay FM visited it and noted it did not have the same problems with regard to queues or waiting lists, which is a positive sign of how the hospital is managing.

Doctors' letters are important and should mean something when a patient takes one to a hospital. They could help alleviate the current situation where many people come straight to accident and emergency units. Deputy Kenny had some interesting points to make in this regard.

Senator Feeney addressed some of the issues I intended to raise, in particular the issue of getting fines from people who must already pay €60 to attend the accident and emergency unit. The Fine Gael Party leader, Deputy Kenny, used the phrase "weekend warriors"— an unfortunate phrase — when referring to how to deal with them. The situation is difficult. Sometimes gardaí must be called when patients or their friends are aggressive with staff. The matter must be addressed.

It is interesting that people who receive a service in our hospitals show a high satisfaction rate of up to 90%, while over 90% show a high satisfaction with their general practitioner service. This is very positive. Senator Feeney suggested we should have a dedicated unit for children. That is important.

Last week the Tánaiste spoke about the problem of the out-of-hours service, particularly in north Dublin. I pointed out that there is also a problem in rural regions with regard to this service — Westdoc in the western region. The area covered by Westdoc is too large. Westdoc doctors from Roscommon and Mayo serve the people of Galway. This is unacceptable. We should have a Westdoc cell in the Mountbellew region, quite a large region. When we had a rota of approximately five doctors, we were probably spoiled for choice. Senator O'Toole made the point that there is sometimes no medication in the doctors' bag. It is not good that when outside doctors come in to offer a service they do not find the proper medication available.

Senator Ulick Burke mentioned the ambulance service. One of the issues in the west is duplication of the services. In an emergency people sometimes phone the ambulance service and Westdoc. It is a case of which service arrives first. Galway city is supposed to look after rural areas but its ambulance service is so busy that it cannot deal with north east Galway. The Minister of State has been very good about providing cancer beds in Tuam. Perhaps he could give us a positive indication on the ambulance service, which has been at the top of the list for a long time. I understand €2 million would provide two ambulance crews to serve the Tuam and north Galway area. Tuam also needs a primary care unit, which could provide excellent backup for people who want to visit general practitioners. Galway, the second largest county in Ireland, has a bad service with regard to community hospitals. The Leas-Chathaoirleach's county of Mayo has far more smaller hospitals, which are essential when it comes to discharging people from the acute hospitals.

The islands off the Galway coast must also be considered. At the recent doctors' conference one doctor mentioned that it was proving difficult to replace her for her maternity leave. In my time on the health board we had a video link between UCHG and the islands, an interesting way for people to see their doctor.

The discharge of patients is a relevant issue with regard to housing aid for the elderly. We must ensure that if the elderly want to remain in their homes that there are schemes which will carry out refurbishments and repairs. Senator Ulick Burke is right that the allocation for Galway is already spent. The allocation for Mayo is under-spent, but it does not seem the system will allow us to move the surplus from one county to another. In the past people used to blame the health boards when one county got more than another. That is not the situation since the HSE took over the region of Galway, Mayo and Roscommon.

We need extra funding for the housing aid for the elderly scheme, which is a successful scheme and I will mention this to the Minister for the Environment, Heritage and Local Government this week. The only other scheme catering for the elderly is the essential repairs scheme. It is necessary to have such schemes so that people who want to stay in their homes can get work done through the local authorities or the HSE.

I thank the Minister of State, Deputy Brian Lenihan, for his work. As someone who has roots in the west, he is aware there are issues to be addressed. I and others have made many proposals. As long as they are practical and workable we will support them, regardless of the side of the House from which they come. If we put those proposals in place, we will have a better system. I hope more progress will be made in dealing with accident and emergency services in particular.