Seanad debates
Thursday, 3 June 2010
Hospital Accommodation
1:00 pm
John Paul Phelan (Fine Gael)
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I also welcome the Minister of State, Deputy Calleary. I once referred to him in the House as "Minister Callely" shortly after his appointment to his position.
John Paul Phelan (Fine Gael)
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This is an extremely important issue and I am a little disappointed that it is not being dealt with by the Minister for Health and Children or a Minister of State from that Department.
Kilcreene Orthopaedic Hospital is the regional orthopaedic hospital for the south east and, together with Waterford Regional Hospital, St. Luke's General Hospital, Kilkenny, Clonmel General Hospital and the general hospital located in Wexford town, comprises one of the five parts of the acute health service infrastructure for the south-eastern region. It is a fantastic facility that processes a large number of orthopaedic procedures every year and a remarkably successful hospital. In particular, it has managed to control better the number of infections which can be so damaging to elderly people who are hospitalised to undergo orthopaedic procedures than nearly every other orthopaedic facility in the country. It is an example that should be used across the rest of the country.
I was particularly shocked and disappointed by the actions of the Health Service Executive. It issued a press release dated 2 June in which it tried to couch the closure of 20 beds in Kilcreene hospital as something that was a success for the HSE in that it would increase and meet its target for day case procedures because it was closing 20 of the 51 beds available in Kilcreene hospital.
A number of facts were included in that press release which are frankly wrong and are downright lies. The HSE states the closure of the 20 beds is to facilitate the staff of the hospital to go on annual leave. That is not the truth. Staff at the hospital are not seeking such closures to facilitate annual leave.
It is worth pointing out that in recent years the number of times the hospital beds have been closed has increased, particularly the Christmas closing which appears to come earlier in the month of December every year. The emphasis is on budgets and we are all aware that the HSE, no more than any other Government agency, must strive to operate within its budget but there is also the greater public health issue. I strongly believe in the free market and that the State should not be involved in every aspect of people's lives but education, health and transport are the three core pillar areas where the State must have an involvement.
As part of our public health facilities Kilcreene hospital is an example of how people who cannot afford to pay for them, public patients, can get a very good health service. The many people who get access to our public health service are very pleased with the service they get. The difficulty is in getting access to that service.
Kilcreene currently operates with six consultants who come from Waterford, one each day, to carry out the procedures at the hospital. They have been told to reduce the number of joint replacement operations to two per day rather than four or five, which currently takes place. These cuts are proposed to come into place from 1 July which would see a reduction from 51 beds to 31 beds until the end of the year at least.
I have already mentioned that this has been couched in terms that it is facilitating the staff of the hospital. That is not the case. The real difficulty for Kilcreene is that its income has been affected because of the sharp decline in the number of private operations taking place at the hospital. I understand there are ten private rooms and occupancy of those rooms has fallen dramatically in recent months. I suppose it is a symptom of the economic climate in which we live currently but because of those private rooms not being utilised as much as they were previously, the funding for the hospital has been reduced. Despite the fact that orthopaedic and joint replacement procedures have increased in the past ten years from over 300 to over 700 the hospital never got what one would call a proper budget. That is the difficulty in which it now finds itself.
If we are to believe in a future for public health Kilcreene hospital, which is a shining example for the entire country in terms of orthopaedic surgery, should not be cut back by way of the drastic measure the HSE is proposing. I hope it will reconsider the provision of health care for public patients because if this comes into play, there are many people on waiting lists who will wait a lot longer for the urgent hip, knee and other joint replacement operations they require.
Dara Calleary (Mayo, Fianna Fail)
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I am taking this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Harney, who is in the Dáil Chamber.
As is happening in all developed countries, management of the performance of our health service is increasingly focused on the outputs achieved, rather than simply the inputs. Service delivery is about access to appropriate care for patients, not necessarily the number of beds in a hospital system or the number of consultants employed.
The 2010 national service plan commits the HSE to treating people more effectively, without reducing access to appropriate services, by reducing costs and reforming the way services are provided. In particular, undertaking more hospital activity on a day basis is in line with national and international best practice. There is considerable scope within existing resources to move inpatient cases to day treatment.
As the regional elective orthopaedic centre in the south east, as Senator Phelan referred to, Kilcreene provides inpatient, day case, outpatient and extensive after-care services. The HSE is satisfied that its 2010 service plan target of over 600 day case procedures at Kilcreene will be achieved, if not exceeded. In addition to these 600 day case procedures, some 750 other cases will be treated on an inpatient basis and over 5,000 outpatient consultations will be provided.
As has been standard practice in hospitals for many years, during the months of July and August a number of theatre and temporary bed closures are planned at Kilcreene. This enables efficiencies to be achieved and facilitates hospital staff to avail of leave during the peak summer period. It is also a time of year when many people prefer not to be in hospital for planned procedures.
To ensure the continuation of the planned level of elective inpatient and day case services for 2010, it will be necessary to continue the closure of 20 beds for the remainder of this year. In conjunction with this, a small number of nursing and support staff will be redeployed to the HSE's community services in the Carlow-Kilkenny area. This will result in additional resources for elderly care and will enable enhanced support for people who can remain at home and receive treatment without requiring admission to a hospital or a residential nursing facility.
I wish to emphasise that while the number of inpatient beds at Kilcreene will be reduced, the HSE is working to maximise the number of patients treated within the resources available. These are challenging times for all involved in the provision of health services. However, the Minister is satisfied that the measures the HSE is adopting in Kilcreene are appropriate to ensure the maximum number of patients benefit from the resources available to Kilcreene in 2010.
John Paul Phelan (Fine Gael)
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I want to express my disappointment, and it is not the fault of the Minister of State, that much of what is contained in his reply is what was contained in the press release from the HSE yesterday. That is not satisfactory. Repeating the line that this is being done to facilitate the staff of the hospital is wrong because that is not the case. Does the Minister believe that increasing the number of day procedures will do something for a person who needs a hip or knee replacement operation? Those are the people I speak with primarily. Those people require inpatient care. They will not walk into the hospital in the morning, get a hip replaced and walk out again in the evening. Those are the people who will suffer because of this announcement. I fully agree with the Minister that we must examine the results from our health service and not focus on beds and consultants.
John Paul Phelan (Fine Gael)
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Ultimately, when it comes to critical services such as joint replacement procedures it is about beds and consultants.
Dara Calleary (Mayo, Fianna Fail)
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I will ask the Minister, Deputy Harney, to revert directly to the Senator.