Seanad debates
Tuesday, 11 December 2018
Commencement Matters
Hospital Services
10:30 am
Robbie Gallagher (Fianna Fail)
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I, too, welcome the Minister of State. I raise the issue of waiting lists in hospitals. Unfortunately, records show that November was one of the worst months in history for overcrowding. I am sure the Minister of State will agree that that is very unfair for patients and their families, as well as the hard-working staff in the hospital network, to whom I pay great credit. As I am sure the Minister of State will agree, this is a time of crisis. It may be time to think outside the box in terms of what we can do to alleviate the crisis, particularly in smaller hospitals throughout the country such as Monaghan Hospital. The injury unit at the hospital operates from 9 a.m. to 5 p.m., five days a week. It functions very well and provides an excellent service. However, its opening hours should be extended to seven days a week in order to alleviate the pressure on hospitals in Cavan, Drogheda and elsewhere in the region. Last year I pointed out that approximately 4,500 people had passed through the doors of the injury unit. This year more than 4,000 patients had been treated by the end of October.
I compliment the HSE on its campaign to raise awareness of the services available at the injury unit. People may be treated for injuries such as broken bones and have casts supplied and X-rays taken. The turnaround times and the speed at which people are seen are testimony to its great staff. More than 91% of respondents in a recent HSE survey stated they had had an excellent or very good experience at the unit. Many were unaware of the full range of services available, which indicates that a further awareness campaign is needed. Many complained about the restricted 9 a.m. to 5 p.m., Monday to Friday, opening hours. It is worth noting that it has the shortest opening hours of the 11 minor injury units throughout the country. It treats as many patients as some injury units which open for seven days a week. I encourage more people to use it and the Government to explore the services available at Monaghan Hospital. In particular, consideration should be given to an extension of the opening hours of the minor injury unit for the benefit of all citizens in counties Monaghan and Cavan and elsewhere. At a time when more than 700,000 people are on waiting lists, surely, smaller hospitals could be providing additional services to alleviate the waiting lists. An audit of all hospitals should be carried out to identify the additional work they could do to alleviate the problems in the health service.
Catherine Byrne (Dublin South Central, Fine Gael)
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I apologise on behalf of the Minister for Health, Deputy Harris, for his absence owing to Cabinet commitments.
I thank the Senator for giving me the opportunity to address the Seanad on services at Monaghan Hospital. Monaghan Hospital and Cavan General Hospital operate as a single entity, with an integrated managerial and clinical governance system, care pathways and support functions. The emergency department is located at Cavan General Hospital, while the facilities at Monaghan Hospital are focused on the provision of elective care and the streaming of appropriate patients to the minor injury unit located on site.
The smaller hospitals framework defined the role of smaller hospitals and outlined the need for smaller and larger hospitals to operate within hospital groups. It identified the activities that could be performed in smaller model 2 hospitals such as Monaghan Hospital in a safe and sustainable manner. In developing smaller hospitals the safety of patients is the first and over-riding concern. Significant progress has been made in recent years in the establishment and development of hospital groups. Hospitals are now working together and supporting each other in groups.This new way of working provides a stronger role for smaller hospitals, like Monaghan Hospital, in delivering a higher volume of less complex care in many cases closer to patients' homes. It also ensures that patients who require true emergency or complex planned care are managed safely in a larger hospital environment. Through reconfiguration and consolidation of services, demonstrably better outcomes can be achieved for patients, as has already been shown and broadly accepted by the public in the case of cancer treatment. With regards to the minor injuries unit, as outlined in the programme for a partnership Government, the Department of Health is committed to undertaking a review of medical assessment units, minor injuries units and similar units with a view to extending their opening hours. Minor injuries clinics and similar units provide valuable services to local communities and alleviate the pressures on emergency departments. The minor injury unit in Monaghan Hospital is open Monday to Friday, 9 a.m. to 5 p.m. and can treat both adults and children over five years with non-life-threatening or limb-threatening injuries.
The Department of Health review of opening hours will have particular regard to distance from the nearest emergency department and existing workloads. Work on this review is at an early stage. The Minister for Health, Deputy Harris visited Monaghan Hospital in July of this year to engage with staff and to view the hospital's facilities. The Government is committed to securing and further developing the role of our smaller hospitals with the expansion of services delivered in these hospitals, especially in services such as day surgery; ambulatory care; medical services and diagnostics.
Robbie Gallagher (Fianna Fail)
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I thank the Minister of State for her response. Is there a timeframe for the review? When does the Minister expect it will be completed? We are aware that the Minister visited the hospital in July of this year and we met him that Saturday morning. We are disappointed he has not come back yet with his plans. There is a degree of urgency attaching to this. There are people lying on trolleys for hours on end. It is very unfair and I have no doubt that there are people going to Cavan Hospital and Drogheda Hospital who could easily be treated in the Monaghan minor injuries unit. It makes perfect sense to extend its opening hours to seven days a week. I implore the Minister of State to do that as a matter of urgency.
Catherine Byrne (Dublin South Central, Fine Gael)
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I do not have the timeframe for the review but I will ask the Minister's office to tell the Senator. I support what the Senator is saying. Having sat in the accident and emergency department for 13 hours two weeks ago with my daughter I understand the difficulties, particularly for people who have minor injuries. The overcrowding does lead to people having to be there for a long time. Minor injury clinics deliver a positive outcome to people living local to them who do not have to travel further to major hospitals. We want to make sure that people who are seriously ill go to the accident and emergency department and that those who are not are filtered into the minor unit. I will relay the Senator's concerns to the Minister about the opening hours and the timeframe for the review.