Tuesday, 13 February 2018
Hospital Waiting Lists
Last night, a group of parents with children who are inpatients at Our Lady’s Children’s Hospital, Crumlin, along with some older children, held a candlelight vigil outside the hospital to highlight the crisis of waiting times for beds there. Ms Hazel Robinson is the parent of a 15 year old daughter with cystic fibrosis. She started this vigil because her daughter was recently obliged to wait over a week to secure a bed in the hospital after she contracted influenza, which compromised her health further. Ms Robinson has faced the same problem on numerous occasions when trying to source a bed for treatment for her very sick daughter. Many of the parents there last night share that experience. What are we doing wrong? Are we doing anything right?
I have been working on a document, now ready for publication, which specifically focuses on Our Lady’s Children’s Hospital, Crumlin, and what investment is needed and where it needs to go. The stark figures and data, from parliamentary questions and from the Department itself, show that the inpatient waiting times for the hospital are unacceptably high. The total inpatient day case waiting number for the entire children's hospital, which includes the other two hospitals, is at almost 5,000. Our Lady’s Children’s Hospital, Crumlin, accounts for over half of these. The position is unacceptable, especially considering that many of the children are waiting with life-threatening and progressively deteriorating conditions. The waiting list for children with musculoskeletal problems to access the orthopaedic unit is often 18 months. That issue has been highlighted several times by the national public broadcaster.
I want to know what plans are in place to tackle the trolley crisis in our children's hospital system. We know all about it in the adult accident and emergency departments, but the children and their parents deserve as much attention and dedication to solving the problem. Is it the case that we are going to have to wait until the establishment of the national children's hospital in 2020 or 2021? There is a significant timeframe involved here for sick children. They do not have that time available. I hope that the national children's hospital will be fit for purpose and have sufficient capacity, but what can we do in the meantime?
The Minister, who unfortunately cannot be here, has asked me to answer on his behalf.
I acknowledge that there are some challenges in accessing services in the three children’s hospitals at present. The Children’s hospital group works with the each of the three paediatric hospitals to manage capacity challenges, providing support in terms of bed utilisation on a daily basis. Within Our Lady's Children’s Hospital, Crumlin, all funded beds are open and currently in use, with the exception of one bed closed for renovation purposes. The hospital group is working with the National Treatment Purchase Fund to identify clinically appropriate groups of patients for treatment as part of a waiting list initiative. The hospital group also continues to work with the acute hospital division in the HSE as well as with staff in the mental health primary care and disability services to reduce the length of stay of patients in hospital and to improve pathways of care for children and adolescents, which will, in turn, ease pressures on hospital capacity.
The Minister is committed to significantly improving health care for all children in Ireland. We have already taken enormous strides to achieve this.For example, an additional €9 million has been provided to the HSE in its 2018 budget allocation, specifically to develop paediatric orthopaedic services, including further increasing access to scoliosis services. As Members will know, the project to develop the new children’s hospital is an extraordinary opportunity to enhance paediatric services for children. Indeed, part of the rationale for the development of the new children’s hospital was to address the existing physical infrastructure across the three children’s hospitals in the group. There is limited ability to increase bed capacity in the existing hospitals between now and the opening of the new hospital. The design of the new children’s hospital and two outpatient and urgent care centres at Tallaght Hospital and Connolly Hospital was based on a thorough analysis of capacity and demand, and is in line with best practice.
The new children’s hospital is due to be completed in 2022. This will be preceded by the opening of the centres in Connolly and Tallaght hospitals in 2019 and 2020 to provide consultant-led urgent care and secondary outpatient services, including rapid access general paediatric clinics. Each centre is projected to deal with 25,000 urgent care and 15,000 outpatient attendances annually, resulting in a significant improvement in access to services. Overall, the new facilities are expected to provide an increase in capacity of 16% for inpatients, 26% for day cases, 47% for outpatient attendances and 7% for emergency department, ED, attendances. My Department is also progressing the Children’s Health Bill 2018 to establish a single body to govern and manage paediatric services across the three hospitals in Dublin in advance of the move to the new facilities. A clinical integration strategy has been developed to integrate the clinical services across the hospital in advance of the move and to ensure a smooth transition to the new facilities. There will be significant advantages to having integrated clinical and non-clinical services across the existing sites, one of which is the introduction of a central referrals system for all patients requiring paediatric services to maximise available capacity. The transition of staff and services to the new children’s hospital will ultimately mean that all specialist services will be provided under one roof, tri-located with adult acute facilities.
I thank the Senator. I will respond further on some of the other issues she raised.
I thank the Minister of State. I mean no disrespect to the Minister of State, but I thought that the Minister for Health, Deputy Simon Harris, would have a response as well. I note that the Irish Nurses and Midwives Organisation, INMO, has announced that it will include the national children's hospital in its daily Trolley Watch and started doing so at the beginning of the year. For the first two weeks at the beginning of the year the INMO counted 23 children on trolleys. This must be a focus for the Government again.
Our Lady's Children's Hospital in Crumlin went over budget by €500,000 last year. It has clearly not been getting the resources that it requires, and a lot of that money is spent on agency staff because of the moratorium and its effects. Some 2,818 more children attended the ED in 2017, but the capacity levels in the hospital have only now returned to 2012 figures. There is a significant increase in our child population, and in the last decade many more births were recorded in Ireland. We are not matching capacity to the birth rate and the increase in population. We are doing an absolute disservice to our children.
I thank the Senator again. I absolutely agree with her that it is unacceptable that adults or children should have to wait any length of time to be facilitated in a hospital. I have outlined in the response from the Minister that a lot of money has gone into this service, and a lot of things are happening in Our Lady's Children's Hospital, Crumlin. That must be said in all fairness to the staff and doctors there, who deal on a daily basis with children from right across the country with very serious illnesses.
The Government is committed to doing all it can to support and ensure that the needs of children who are ill can be addressed as quickly as possible. Unfortunately in the three children's hospitals available to us at present, the facilities do not have the capacity at this time to avail of it. There are no options left in children's hospitals, to my knowledge and to that of the Minister, whereby more beds can be made available.
In saying that, I do think it is unacceptable that any child should be left to wait for any amount of time. Going over its budget does not really reflect on Our Lady's Children's Hospital, because a lot of hospitals go over budget for many different reasons.There are many reasons a hospital might go over budget and it is not something that only applies to Crumlin. Since the beginning of October, we have had a long winter and a lot of children have been sick with respiratory complaints.
I have taken note of what the Senator said and I will forward her points to the Minister. As the children's hospital is in my own constituency, I will make it my business to correspond with it on the management of beds, particularly in respect of the services that are available at present. As the Senator said, parents have deemed this to be of such interest to them that they feel they have to hold a candlelight vigil.