Seanad debates

Wednesday, 29 June 2005

Accident and Emergency Services.


10:00 am

Fergal Browne (Fine Gael)
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Last week, the Government made one of its most embarrassing mistakes in its eight year record, which is some achievement, when the Minister for Health and Children finally announced the €564 million capital programme for hospitals throughout the country. In the meantime, St. Luke's hospital, Kilkenny, was being praised at the Cabinet table for having managed its limited resources so well that there were no patients on trolleys. It was cited as a model hospital because of the way it liaises with its local GPs and uses its minor injuries and accident and emergency units and outpatients department. It is worth putting on the record that the accident and emergency unit in the hospital was formerly a laundry room and there is currently no fire exit. It was condemned in the health and safety audit.

There is no canteen for visitors in the hospital, which might sound a small matter, but it is a significant issue, particularly considering that St. Luke's hospital, Kilkenny, services an area from Carlow to south Kilkenny. As people must travel quite a distance to the hospital, there should be a canteen facility where patients could take a break when relatives visit them. These people could visit the canteen for a cup of tea or refreshments.

Last Wednesday, when the programme was finally announced, I went through the list three times only to find that St. Luke's hospital got nothing. I even checked with a Government Deputy to see did I miss something. To make matters worse, the day after announcing funding of €564 million, we learned that the Tánaiste was visiting the one hospital in the country that received nothing. It is worth noting that many hospitals received two or three allocations for different projects. I am not sure who is the Tánaiste's programme manager, but someone tried to make her look stupid. With friends like that, who needs enemies? The one hospital she visited the day after announcing a €564 million capital funding programme received nothing the previous day.

I must compliment the Tánaiste on visiting Kilkenny, because she displayed much bravery in doing so. Most Ministers would have found a reason not to visit the hospital. She was irate because of what happened and, as far as I am aware, she promised to upgrade the accident and emergency unit, the outpatients department and there is a possibility that a stroke unit will be established, even though this has not been clarified. I hope the Minister of State will clarify exactly what St. Luke's Hospital will receive.

This issue was a front page story today in the Kilkenny People. The editorial refers to a victory for St. Luke's and the editor speaks about the Minister, Deputy Harney, walking into a booby trap last week. The question must be asked, why was St. Luke's omitted in the first instance? We were lucky that by pure coincidence, the Tánaiste happened to be visiting St. Luke's the following day. The question remains, had the Tánaiste not been visiting St. Luke's, what would be the situation this week? It worked in her favour that she happened to be visiting the hospital thatday.

It is my view that some official within the HSE, who had close ties to Waterford Regional Hospital, was doing his utmost to ensure that St. Luke's did not get its fair share of the cake. I have made a freedom of information request, which I will pursue further. I will name the individual in the House when I have proof.

The Minister, Deputy Harney, was very vague about the future of St. Luke's in terms of the Hanly report. As far as I understand, the accident and emergency unit in St. Luke's could be downgraded as a result of the Hanly report. Perhaps the Minister of State will clarify the situation tonight. He might also refer to the plan that consultants will come to Carlow and save patients travelling from Carlow to Kilkenny by increasing the outpatient clinics. I look forward to the Minister of State's reply, as do many other people in Carlow and Kilkenny.

Photo of Brian Lenihan JnrBrian Lenihan Jnr (Minister of State, Department of Education and Science; Minister of State, Department of Justice, Equality and Law Reform; Minister of State, Department of Health and Children; Dublin West, Fianna Fail)
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I thank Senator Browne for raising this matter on the Adjournment. I am making this reply on behalf of the Tánaiste who was very impressed with the facilities at St. Luke's. She is very committed to the proper provision of hospital services in Kilkenny and Carlow. I thank the Senator for raising this matter because it provides the Minister with an opportunity to outline to the House her position on the matter.

The 2004 Act provided for the Health Service Executive, which was established on 1 January 2005, to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes the bulk of the health capital programme. The question of new capital funding commitments for St. Luke's hospital, Kilkenny, will, therefore, have to be considered in this context.

The HSE service plan for 2005 was approved earlier in the year by the Tánaiste. She has recently indicated her agreement to the HSE to progress its capital programme. In assessing the needs for this year, the HSE had to take into account commitments carrying forward from last year before initiating new contractual commitments for individual projects in line with the overall funding resources available for this year and beyond. The Senator will be aware that a number of significant capital projects are at present under way in the south-east area. These are at various stages of planning or construction or have recently been completed. These include, for example, phases 1 and 2 of Our Lady's Hospital in Cashel; a unit for older persons in St. John's Hospital in Enniscorthy; an MRI unit in Waterford Regional hospital; extension and on-call accommodation in Wexford General Hospital; and a surgical department, radiology department, accident and emergency department, day ward, CSSD, ICU and ward upgrade in South Tipperary General Hospital.

A whole hospital brief was prepared in 2003 covering all the perceived deficiencies in the departments of St. Luke's Hospital. If carried out, the proposed major development on the site would have significant capital, revenue and staffing implications. It is important to remember when discussing the health service that capital expenditure often has serious staffing and expenditure implications.

The priorities within this brief must be established for any proposed first phase of development. These would probably cover, for example, the outpatients' department and the extension of the accident and emergency unit. Any interim capital proposal that might be put forward for the hospital would also be a matter for consideration in the first instance by the HSE under the multi-annual capital investment framework initiated by the Government.

I am pleased to inform the House that, arising from a recent visit by the Tánaiste to the hospital, she agreed to funding of €450,000 for St. Luke's relating to the appointment of a design team to progress a development control plan for the site, the completion of contract drawings for the outpatient department and development of services for a stroke unit. I hope that provides clarification for the Senator on matters he asked me to deal with.

Notwithstanding the above, it should be noted that the Kilkenny region has received significant health capital investment in recent years. Under the bed capacity review in 2002, an additional 52 beds were provided, with 28 at St. Luke's and 24 at Kilcreene. Together with the new medical admissions unit and with improved service protocols, this has greatly relieved pressure on the accident and emergency and ward accommodation at St. Luke's. This is a fact that the Senator fairly acknowledged. In addition, capital initiatives have been undertaken on the St. Luke's campus. These include a CT suite commissioned in 2000; a coronary care unit commissioned in 2001; a cardiac diagnostic unit commissioned in 2002; and an acute psychiatric unit commissioned in 2002.

Fergal Browne (Fine Gael)
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Can the canteen issue be re-examined? It is a small matter that could make a major difference.

A problem exists within the HSE. Some in the HSE are claiming that the application went in before the final announcement, which makes no sense. Even in the Minister of State's reply it was stated that a whole hospital brief was prepared in 2003. This is an issue that should be examined, as somebody with close connections to the Waterford Regional Hospital has not moved on from that role and should remember he has a brief for the whole south east. The Tánaiste may be aware of this already.

Mary Henry (Independent)
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I am sure the Minister of State will take note of the Senator's comments.