Seanad debates

Thursday, 8 November 2018

Commencement Matters

Hospital Facilities

10:30 am

Photo of Gerald NashGerald Nash (Labour)
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The capital programme for health projects, approved by the previous Government, included provision for a badly needed extension to the emergency department at Our Lady of Lourdes Hospital in Drogheda, my local hospital. The hospital has been synonymous with serious overcrowding. This project, worth more than €20 million, was a welcome addition to the health infrastructure in the area and was welcomed by the hard-working staff at the hospital and by the patients.

The project involves a four storey extension, 9,000 m2 which included the addition of additional theatre space, and of 83 inpatient beds. Nowhere in the country is this facility more needed. Our Lady of Lourdes Hospital is the de facto regional hospital and serves a rapidly growing area, Louth, Meath, Cavan, Monaghan and Fingal. The emergency department, ED, needs all the facilities, equipment and staff that a modern department needs to allow it function to the maximum. One such critical facility is an X-ray room. I was alarmed to learn this week that the plans to include a new X-ray facility at the expanded ED have been ditched in what appears to be a cost-cutting exercise. To add insult to injury, this appears to have been a unilateral decision that was taken without any consultation whatsoever with front-line staff at the hospital.

The new section opened this week but the bird is in effect flying on one wing. The space is there and the full expectation was that the new X-ray room would be provided but it was pulled at the eleventh hour. Now we have a spanking new emergency department extension in Drogheda but no additional X-ray room. The existing X-ray room processes 53,000 images annually. Patient figures for throughput at the new emergency department extension would suggest that there would be an annual increase of 5% in patients going through that facility year on year for the foreseeable future. The existing room is operating above capacity. EDs of a similar scale in Limerick and Cork deal with 49,000 and 42,000 images, respectively, annually. The figures speak for themselves.

The Lourdes needs a second X-ray room in ED. It is not too late in the building project to revisit this and for the sake of the €1 million that I understand it would cost, the new room needs to be built now. If it is not, the good work done by staff and management at the hospital in recent years to address the overcrowding problems will be compromised. Patients will suffer as, to paraphrase the Taoiseach, a hospital cannot function at full whack if it does not have the full diagnostic capacity to move people through the system efficiently and get them well as quickly as possible. The space is there and it will be impossible to retrofit a new X-ray room into the ED building. This has to be reviewed. It is a short-sighted decision to pull this project now, a decision made by the bean counters in the HSE and it must be reversed.

Photo of Ciarán CannonCiarán Cannon (Galway East, Fine Gael)
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On behalf of the Minister for Health, Deputy Harris, I thank the Senator for raising this issue and for the opportunity to provide an update to the House on the planned new X-ray facility to support the expanded ED at Our Lady of Lourdes Hospital, Drogheda. As the Senator is aware, the new emergency department is a part of the major capital infrastructure project that is taking place at Our Lady of Lourdes Hospital, which includes additional beds, theatres as well as the expanded ED. The Department of Public Expenditure and Reform governs the processes surrounding the development of healthcare projects by way of guidelines, principally the public spending code. Further rigour is demanded by, and set out in, relevant EU directives. All proposed projects must be submitted to the HSE's capital and property steering committee for approval and prioritisation prior to inclusion in its multi-annual capital plans.

The national development plan, announced earlier this year as part of the Project Ireland 2040 policy initiative, provides €10.9 billion for health capital developments throughout the country, including national programmes and individual projects, across acute, primary and social care. Health capital projects and programmes currently under way will continue. With regard to progress on this project, the Minister has been advised by the HSE that the new emergency department, which will be located on the ground floor of the hospital, will be completed and available to open in early 2019.The HSE has further advised that some work is still to be completed in the old emergency department to allow for the installation of a new paediatric emergency department and an extension to radiology services. The HSE anticipates that the full extension will be ready in early 2019. The Department, the HSE, the RCSI hospital group and Our Lady of Lourdes Hospital are supportive of this project. It is recognised that this capital development is needed in order that the delivery of key services to patients served by Our Lady of Lourdes Hospital in Drogheda and the surrounding areas can be supported.

Photo of Gerald NashGerald Nash (Labour)
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I hope that health service staff in Drogheda and elsewhere in the north east, particularly staff across all disciplines at Our Lady of Lourdes Hospital, will be reassured by what the Minister of State said. The additional X-ray room is critically important if the full diagnostic capacity of the hospital is to work. We have additional new beds. As I said in my opening remarks, if a new X-ray facility is not provided, the hard work that is done by staff day in, day out to address the trolley crisis and the overcrowding in the emergency department will come to naught. It will be difficult to move people through the hospital efficiently and efficaciously in the absence of a new X-ray room.

I am somewhat reassured by what the Minister of State said, having been alarmed to hear earlier this week that the estates section of the HSE appeared to have decided to pull this project. I will hold the Government and the HSE to account to make sure the commitment the Minister of State appeared to make when he said "that the full extension [to radiology services] will be ready in early 2019" will be delivered on. When he refers to a full extension, I hope he means the inclusion of the X-ray department. My understanding is that the new emergency department block at Our Lady of Lourdes Hospital became operational earlier this week. However, we are still waiting for a new X-ray room. I have referred to the number of images managed at the small X-ray room in the existing emergency department. That needs to be enhanced to allow the hospital to meet its commitments and targets. As already stated, the level of throughput at the emergency department is expected to increase by 5% per annum in the coming years. The emergency department at Our Lady of Lourdes Hospital cannot fly on one wing. This additional X-ray room is needed to enable the hospital to meet its targets and fulfil its obligations to the people of counties Louth, Meath, Cavan and Monaghan and north County Dublin.

Photo of Ciarán CannonCiarán Cannon (Galway East, Fine Gael)
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The development that is under way at Our Lady of Lourdes Hospital in Drogheda is taking place in the context of the national development plan, under which capital funding for our health services will be 165% higher over the next ten years than it was in the last ten years. Such a commitment to capital investment in our health services marks a serious sea change. As I have outlined, the development of a new emergency department at the hospital includes a new paediatric emergency department and an extension to the radiology service. Both of those developments are at a very advanced stage and will become operational early next year.