Marie Moloney (Labour) | Oireachtas source

I welcome the Minister to the House and the opportunity to say a few words about hospital services. At the outset I acknowledge the progress made in the terms of delivery of hospital services recently, particularly in my county. At long last, Kerry General Hospital in Tralee is home to one of the finest accident and emergency departments in the country and it is a wonderful facility for patients and staff alike. The old department is being converted into a cardiac care unit, and the new medical assessment unit is also working well, taking the strain from the accident and emergency department. We also saw the opening of the new west Kerry community hospital in Dingle and earlier this week we had the transfer of patients from the old Kenmare community hospital to a new facility in the town. It is important to acknowledge the progress that has been made. I understand that one of the two newly appointed accident and emergency consultants at Kerry General Hospital is to leave his post and I would like an assurance from the Minister that he will be replaced as soon as possible.

Although much progress and reform has been made, I sometimes wonder why it takes so long for some people to see a consultant in our public health services. An 83-year-old constituent recently received a letter from Cork University Hospital advising her of an appointment to see an ophthalmologist a year and a half from now. Nothing can justify keeping somebody waiting that long for a relatively routine appointment, and that women will be 85 by the time she gets to see the consultant. If she requires surgery or further medical intervention, how long more will she have to wait?

The average waiting time in Kerry for rheumatology is three years and two years for neurology, although an appointment can be made for a neurologist in nine months if the case is very urgent. These departments only have a visiting consultant but the waiting times are not acceptable, so there is more work to be done in this regard.

The major problem we now seem to have is the shortage of junior doctors or the inability to attract newly-qualified doctors into our hospital services. Sadly, too many of our new graduates are going overseas to better pay and conditions and our health services are suffering as a result. I would welcome the Minister's comments on an issue I heard about on the radio the other day. She may correct me if I am wrong, but I heard that of the 39 consultant posts advertised, only two or three have been filled. With the best will in the world, if we do not have the consultants we cannot deal with the problems of waiting lists, etc.

I would like to raise one other matter, namely, the long-stay facilities for the elderly and how it impacts on our acute hospital services. Last year alone nearly 250,000 hospital bed days were lost due to delayed discharges. I do not like to use the phrase "bed blockers" as it seems to imply that the patient is the problem, rather than the system. According to HSE data, of the 119 public long-stay facilities in this country, only ten will be fully compliant with Health Information and Quality Authority, HIQA, standards post-2015 if there is no further investment in those facilities. The ESRI projects an additional requirement for 888 places per annum up to 2021 to meet the needs of the growing elderly population. What steps are the Department and the HSE taking to plan for the long-term care of our older population in light of recent statements that indicate that up to €38 million is required to have public long-stay facilities fully compliant with HIQA standards by 2015? It is one thing to have all the standards laid down by HIQA - and I sincerely welcome those standards and provisions - but it is another thing to put the necessary resources in place to allow the facilities to meet those requirements. This would take major pressure off our acute hospital services.

I welcome the calls by the Irish Nurses and Midwives Organisation, INMO, and Nursing Homes Ireland for the establishment of a Department of Health-led forum on long-term residential care. For the vast majority of people, their interaction with our public hospital services and the staff who work there is usually a very positive one. The bottleneck seems to remain in accident and emergency departments and I look forward to hearing more from the Minister on what further progress we can make in that area. I commend Professor Higgins on his report and look forward to the progress of the new and reformed programme which will hopefully deal with some or all of the issues I have outlined. I recognise that the Minister has done much work in reforming the health services. I realise it is not an easy task. We will continue to work with him as best we can on that matter.