Seanad debates
Thursday, 1 December 2016
Commencement Matters
Hospital Services
10:30 am
Paul Coghlan (Fine Gael)
Link to this: Individually | In context | Oireachtas source
I welcome the Minister of State, Deputy Catherine Byrne, the House.
Colm Burke (Fine Gael)
Link to this: Individually | In context | Oireachtas source
I thank the Minister of State for coming to the House to deal with this matter. There is a major problem in Cork at present as the medical consultants and nursing staff on the front line have a difficulty providing gynaecological services. I understand there is quite a long waiting list of more than 4,000 people for either appointments or surgery. When all the maternity services in Cork were transferred, and three hospitals providing maternity services, the Bon Secours Hospital, the Eirnville Hospital and St. Finbarr's Hospital, were closed and amalgamated to CUH, two operating theatres were to be provided which would work at least five days a week. What has occurred is only one has opened and this works three and a half days a week. As a result, for a day and a half there is no access to the theatre. What is required for the theatre to be open for the extra day and a half is three more nurses. This would help to alleviate the list. What would also help to alleviate it is if the second theatre was opened. At present, some of the beds are being used with a turnover of three patients per day per bed for day cases. It is working fully to try to accommodate everyone. There is also a proposal for a day care unit with six beds, and the costings have been done on this. It would help to alleviate the problem.
When cancer services from the South Infirmary Victoria University Hospital were transferred to CUH it was agreed a gynaecological unit would open there and a building was identified which would have had four beds for day care procedures. This has not been done. We now have a huge number of items not provided for although a commitment was given, and as a result the biggest maternity gynaecological unit outside of Dublin is running at half capacity. I ask that something be done about this.
Colette Kelleher (Independent)
Link to this: Individually | In context | Oireachtas source
I welcome the Minister of State but it is disappointing the Minister, Deputy Harris, is not here.While the Minister of State has a big brief, I do not believe gynaecology is part of it. Women in Cork city are waiting longer for gynaecology services than women in any other part of Ireland. It is utterly unacceptable.
There are 4,193 women waiting for an outpatient appointment in Cork, the longest waiting list of all gynaecology units and twice the next longest waiting list. There are 557 women waiting for gynaecology surgeries, again the longest such waiting list. As Senator Colm Burke outlined, the gynaecology theatres are functioning at 40% of their capacity. Although we have two fully commissioned, state-of-the-art gynaecology theatres, they are not operating to full capacity. As Senator Colm Burke said, a small investment could have them fully operational. No new consultant gynaecologist posts have been created in Cork in the past decade, despite the fact that 26 posts were filled nationwide. The waiting lists are having devastating consequences for women. Women are in pain, bleeding and turning up at accident and emergency units in crisis. As a woman, the Minister of State knows a delayed diagnosis means cancer that could be treated might be growing. It is a life and death matter for women in Cork.
The solutions are clear. The Government must increase the gynaecology theatre to a five-day service, open the second theatre, develop the proposed gynaecology unit with Cork University Maternity Hospital, CUMH, bring forward the one-stop shop which was in the 2014 service plan and increase the number of gynaecologists. At the end of September, I raised the matter at the health committee, and the Minister for Health, Deputy Harris, asked me to write to him, which I did. He still has not had the courtesy to respond to me. It is very similar to what is happening locally. People have raised these matters and Senator Colm Burke is correct that relationships are very poor locally. We need the Minister to intervene to get the situation rectified for the women of Cork.
These unacceptable waiting lists will not go away on their own. If ignored, they will get worse, creating hardship and ill-health and putting the lives of women in Cork and surrounding areas at risk. Consultants in the hospital have been forced to say they cannot take responsibility for the adverse health outcomes arising from a well-documented chronic lack of investment which has resulted in the longest waiting lists in the country. Therefore, I ask the Minister of State to take back a message to the Minister for Health, Deputy Harris, namely, will he take responsibility, take action and resolve the issue?
Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source
I am not the Minister for Health, Deputy Harris. I have been asked to take the Commencement matter on his behalf. However, I am a woman and given that I have five children and have been obliged many times to go to accident and emergency units for gynaecology, I understand. I know how important it is to have a service up and running.
On behalf of the Minister, I thank Senators Colm Burke and Kelleher for raising the issue. I fully recognise the need to ensure patients have timely access to health services. The Department works closely with the HSE and the National Treatment Purchase Fund, NTPF, to implement measures to reduce waiting times. At the Minister's request, the HSE developed an action plan to reduce, by year end, the number of patients waiting 18 months or more for an inpatient or day case procedure.
It is important that the number of patients who are waiting to be seen or treated is considered in the context of the total numbers of patients actually seen and treated. Every year, there are more than 3.2 million outpatient attendances at our hospitals, 94,000 patients have an elective inpatient procedure and 1 million patients have a planned day case procedure. The budget for 2017 provides evidence of the Government’s commitment to a sustained focus on improving waiting times, particularly for those waiting longest. The Government has allocated €20 million to the NTPF for the treatment of our longest-waiting patients. This will be increased to €55 million in 2018.
I am aware there is a difficulty with waiting times for gynaecology services in Cork University Hospital. The south-south west hospital group has confirmed its commitment to obstetrics and gynaecology services as demonstrated by the establishment of a group clinical directorate for these services. The HSE has also advised that Cork University Hospital is undertaking a number of initiatives to address both inpatient and outpatient waiting times for gynaecology services. This includes additional evening outpatient review clinics, which are led by a member of the consultant gynaecology team. The hospital has recently appointed a gynaecology sonographer, who will lead an ultrasound service in liaison with the consultant gynaecology team. With the additional scheduled consultant-led evening sessions, the hospital management anticipates that the gynaecology ultrasound waiting list will be cleared by December 2016. My Department has been assured that to address the current difficulties, the hospital will maximise the use of existing theatre and other gynaecology resources within the hospital, as well as those in other hospitals across the south-south west hospital group.
In line with the national maternity strategy, a national women and infants health programme is being established within the HSE to lead the management, organisation and delivery of maternity, gynaecological and neonatal services. The programme will drive implementation of the national maternity strategy and ensure the consistent delivery of high-quality care. Noting that the international trend in gynaecology service provision is moving towards more day-case services and the provision of community one-stop shop type facilities, it is intended that the programme will drive much-needed reform of gynaecology services. This will include the potential to adopt a multidisciplinary approach and move some service delivery to community settings. Work to establish the programme is ongoing.
Colm Burke (Fine Gael)
Link to this: Individually | In context | Oireachtas source
I am disappointed in the reply. It is like what I get at the health committee. At the last meeting of the health committee, I raised four questions to which I got answers to only two. There seems to be a problem with the HSE in the south giving the truth. The truth is not contained in this answer. The answer to the problem is to open the operating theatre five days a week, not three and half days a week, and to move towards providing additional day-case beds for patients so the hospital can turn over far bigger numbers. The response is extremely disappointing. It does not deal with the issue. What the Minister of State set out will not do one thing for the waiting list.
If something is not done immediately, within six months the waiting list will increase from 4,000 to 5,000 or 6,000. The list increases every day. There seems to be a stand off between people in different sections of the hospital, between people at the front line and those in management. The people in management do not appear to be taking the matter seriously. The Minister of State's response is inadequate and a clear message should be sent to the manager in Cork University Hospital that it is unacceptable. I will raise this again and again, next week and the week after, as long as we are sitting up to Christmas. It is not going to go away.
Colette Kelleher (Independent)
Link to this: Individually | In context | Oireachtas source
I concur with Senator Colm Burke. This matter is not being taken seriously. I wrote in September and have not had the courtesy of a response. The local consultants have been tearing their hair out trying to get a response. Yet, women are waiting, getting more ill and are bleeding and suffering. The fact that the Minister for Health is not here shows that it is not a priority for him or for the Government. Senator Colm Burke is right. It is not going to go away. There will be a "Prime Time Investigates" programme on the issue. Will we wait for that before we take action? We have the facts. While I thank the Minister of State for coming, there is nothing in her response that gives me any comfort to expect that any action will be taken or that the issue has registered as any kind of priority for the Minister for Health or the Government.
Catherine Byrne (Dublin South Central, Fine Gael)
Link to this: Individually | In context | Oireachtas source
I understand the Senators' frustration and concur with some of the things they have said. My response did not specifically identify some of the issues they raised. However, things are happening in Cork University Hospital. Let us not be in any doubt that the Government is committed to providing a better service for women, particularly in gynaecology. The money that is being set aside and allocated to the NTPF will alleviate long waiting lists. Moreover, the new service will continue in some evenings in the hospital.According to this statement form the Minister's office, the gynaecology ultrasound department hopes to clear its waiting list by December. I have taken note of all the issues both Senators have raised and I will bring them back to the Minister. As a woman, I believe that delayed diagnosis in any gynaecological area can be fatal. I will stress that to the Minister. I will also ask why the Senator has not received a reply to her letter. Out of courtesy, that should be done straightaway. I will raise the issue of the theatre only being used for 3.5 days a week. Apart from that I cannot give any other message on what is happening in Cork until I go back to the Minister and relay the Senators' deep concerns.
Colm Burke (Fine Gael)
Link to this: Individually | In context | Oireachtas source
A Leas-Chathaoirligh----
Paul Coghlan (Fine Gael)
Link to this: Individually | In context | Oireachtas source
There are no further supplementary questions now.
Colm Burke (Fine Gael)
Link to this: Individually | In context | Oireachtas source
I really think we should open the theatre for five days.
Paul Coghlan (Fine Gael)
Link to this: Individually | In context | Oireachtas source
There is no facility for further supplementary questions.