Colm Burke (Fine Gael) | Oireachtas source

I welcome the Minister. I appreciate the work he is doing in the health care sector. It is a huge challenge given the large number of hospitals providing services. It is interesting to look at the figures. A total of 1.3 million people attend accident and emergency departments, which is 25,000 per week or 3,571 per day. Over 6,346 people per week are admitted to Irish hospitals through accident and emergency departments. Those figures represent the challenges we face.

We should also consider the demands that exist. In my area of Cork city and county, the population has increased from 410,000 to 542,000, a rise of 130,000 over the past 30 years. In that period, the number of beds in the county and city has decreased. As a result, there is a challenge to ensure that there is an adequate number of beds into the future by planning for a new hospital facility. Such a facility was proposed in the 1960s. The Fitzgerald report referred to two major hospitals for Cork, but the city only ended up with one. We are still trundling along with two hospitals, which have been there for over 100 years, trying to provide a service. As regards waiting times in accident and emergency departments, unless there is an adequate number of beds to be able to admit people and care for them the logjam in those departments will continue. I spoke to management at one of the hospitals over 12 months ago. At that time the hospital was cancelling 40% of elective surgery because the number of people over 80 years of age arriving at the accident and emergency department had increased substantially. That is due to the change in demographics that has occurred in this country. We must plan and cater for that. One good message is that people are living longer. Life expectancy has increased by 2.5 years since 2000, so something is being done correctly in health care. However, much more must be done.

Another issue for accident and emergency services is that the GP contract must be prioritised. We need to get the people who are working in the community to take on an additional workload. They will not take it on unless the necessary support is in place. I can give examples. A GP approached me over two years ago and told me that his practice was offering to provide a service for people who have haemochromatosis. Those people are currently going to hospital outpatient departments. He and his colleagues were prepared to provide a service for those patients, and it is a service they could provide. They offered to set it up, but two years later no progress has been made on it.

The position regarding nursing homes is similar. I have a big issue with the care of people in nursing homes. It relates to where caution is being exercised, and rightly so if the GP is concerned, but admitting an elderly patient from a nursing home through an accident and emergency department should not be the way to deal with it. We should have connectivity between nursing homes and geriatric services in the hospitals. That is something we must do. We also must do far more to help GPs deal with the concerns that nursing homes have about the people in their homes. Rather than bringing them to the accident and emergency department, if enough supports were given to GPs they could look after many more people in the nursing homes. It is all about ensuring that there are adequate supports and remuneration so the GPs can provide the service they currently find it difficult to provide.

Recently, the HSE suggested allowing GPs to provide gynaecological services. The GPs who contacted me said there was no problem doing that but pointed out that it is not covered by the medical card system. That is another area where services could be provided by GPs. Another issue, and I raised it in the health committee this morning, is not properly using the people who have skills. I gave the example of people who have trained up in an area within the hospital system and for one reason or another, be it family commitments or other pressures, they have decided to opt out. I was referring in particular to two doctors who had trained up, one of whom had six years in obstetrics and gynaecology and the other who had nine years. They dropped out of the system to go back to working as GPs. There is no reason that they should not be able to provide an additional service in obstetrics and gynaecology for the community, but they are not allowed to do that under the current GP system. This is something we must work on, where people have huge expertise but are not able to use it at the coalface in the community because the system does not allow them. We must start engaging on that matter. That is why it is so important we put a new and innovative GP contract in place.

I have a final comment with regard to building hospitals. It was 1998 when a major hospital was last built in this country. In the ten years between 1998 and 2008, when there was plenty of cash, not one was built. This is something we must ensure does not recur.