Joe McHugh (Fine Gael)
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I welcome the Minister of State to the House. I wish to highlight the bed shortages and resultant staff problems in Letterkenny General Hospital. While welcoming the announcement of the Minister for Health and Children that there will be an extension, the problem is that the staff and management are between a rock and a hard place. They cannot wait for two to three years for the extension of the accident and emergency unit in Letterkenny and an immediate short-term solution is required. The problems are having negative knock-on consequences for the staff and patients. The patients are not being offered the quality support they could get if there were extra space and there are dignity and privacy issues as they are crammed in close to each other.

I seek the direct intervention of the Minister with the management at Letterkenny General Hospital to come up with a strategic short-term plan to address the problem. A solution may lie in getting some form or pre-fabricated building. We do not want to end up with a problem similar to the recent one in Castlebar that was highlighted by RTE, when a man had to wait three weeks due to problems getting him transported to Dublin. The Irish Nurses Organisation has publicly stated an accident is waiting to happen at Letterkenny General Hospital. That does nothing to improve the morale of staff or uphold the level of patient care.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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It says very little for the INO.

Joe McHugh (Fine Gael)
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I was only quoting what that organisation stated.

I call for a direct intervention with the management at Letterkenny and I know the Minister of State will use his good offices to ensure that such an intervention is made. I do not intend to turn this issue into a political football because there is too much at stake in Letterkenny and the surrounding area.

Perhaps it would be appropriate, before Mr. Hanly, as elsewhere, puts in place a number of super-hospitals in the north west, to point out that we have a top class hospital in Letterkenny and we intend to ensure that it continues to be the main hospital serving the region. I place this pledge on record prior to Mr. Hanly making the long trek up to Donegal.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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I thank Senator McHugh for raising this matter and I am replying to it on behalf of the Minister, Deputy Martin. I was delighted by the Senator's statement that there is a top class hospital in Letterkenny and I know that the staff there work hard to ensure that it retains this status and that there are no accidents waiting to happen. However, I understand the Senator's concerns about the problems that exist at the hospital.

I must point out, in the first instance, that responsibility for Letterkenny General Hospital rests with the North Western Health Board. As the Senator is aware, the population of Donegal is served in the main by Letterkenny General Hospital which provides a full range of acute, support and diagnostic services.

In terms of its physical infrastructure, Letterkenny General Hospital was the subject of a major capital programme over 20 years ago with the construction of the multi-storey block. That was a significant development in terms of positioning the hospital to cope with the development of services during the 1980s and 1990s. During 2002, approval was given by the Department of Health and Children for the provision of an additional eight medical beds, which were commissioned and are fully operational. When the approval for these beds was notified, the Department indicated that there would be further discussions in relation to the requirement for further beds. Informal discussions have since taken place between the Department and the board on the question of further increasing bed capacity in the board's functional area generally.

Arising from these discussions, a proposal for the provision of additional interim beds in Letterkenny General Hospital has been submitted to the Department. This includes three distinct elements: the immediate provision of eight beds in the currently vacant new maternity-theatre extension; 18 beds to support new medical oncology-haematology specialties in the vacated renal unit; and 12 beds attached to the emergency department. This submission is being assessed by the Department.

It is understood from the board that the hospital has experienced an increase in demand for services in recent weeks, particularly in respect of its emergency medicine, accident and emergency, department. Measures implemented by the board to alleviate these pressures include the provision of additional medical support staff and the augmentation of nursing staff: It is also proposed in the board's service plan for 2004 to proceed with the appointment of an advanced nurse practitioner to the emergency department, which again will have a positive impact on services. The Senator will also be aware that approval was given by the Minister for Health and Children, under the winter initiative in 2000-01, for the appointment of a second emergency medicine consultant at the hospital.

An enhanced accident and emergency facility at Letterkenny is a key priority for the board. Approval has been given by the Department of Health and Children to the board to proceed with the planning of an extension to the department. Planning for this development is at an advanced stage and the board hopes to proceed to design brief stage in the coming months. The Minister is confident that this development will enhance and augment the services available to both staff and patients availing of the emergency department's services. The Senator may be assured that hospital management is working closely with medical and nursing staff in the emergency medicine department to address the difficulties being experienced.

I assure Senator McHugh that the Government will continue to invest in the development of high quality, equitable and accessible hospital services so that those availing of such services continue to receive timely and appropriate care.

Joe McHugh (Fine Gael)
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I thank the Minister of State for his reply. I again ask that an intervention be made in respect of 40 new beds and 20 new nurses. The cancellation of elective surgery is a major problem and it is a matter we must monitor. I acknowledge the fact that it is planned to extend the accident and emergency department. I also acknowledge the ongoing work of the Department of Health and Children. However, in light of the way recent difficulties have affected staff morale, etc, I wished to highlight this matter.