Thursday, 3 October 2019
Nithe i dtosach suíonna - Commencement Matters
Hospital Accommodation Provision
We are approaching next Tuesday's budget. The day after last year's budget, our local Minister in County Donegal, Deputy Joe McHugh, told the people of Donegal on Highland Radio that all 20 beds in a short-stay ward that had been closed would be reopened. He said that recruitment was commencing that day and that he had spoken to the manager of the hospital. We were worried that this commitment was not going to be honoured, but shortly afterwards, the Minister for Health promised the people of Donegal that these beds would be reopened. Since that promise was made by the two Ministers, funding has been received for the reopening of five beds. Thanks to the efforts of the Saolta University Health Care Group, which oversees Letterkenny University Hospital and has been working with public representatives in Donegal, we managed to get funding to increase the number of beds to be reopened to ten. While it has been helpful that half of the beds have been reopened, we still have a serious crisis at Letterkenny University Hospital. It is reported on local radio every day that large numbers of people are on trolleys. Yesterday, 38 people were waiting for beds in the hospital. I find it unfathomable that the Minister has not kept his promise.
Here we are again at budget time. I am led to understand clearly that the recruitment embargo is the only reason we do not have the 20 beds. The management team at the hospital has attempted to put in place a range of people across the hospital spectrum, including cleaners, porters, nurses, doctors and consultants. They are being prevented from appointing new personnel. The embargo has to be waived in Letterkenny. The Minister is watching as large numbers of people, many of whom are elderly, have to wait in the emergency department for long periods before being placed on trolleys. There is a wider issue in the county. Over the past ten years, our community hospitals have lost one in four of their beds and one in four of their nurses. The Government has cut the number of beds in our community hospitals and in our major hospital in Letterkenny. It has also cut home care packages. There are blockages in the entire system. I intend to hold the Minister for Health to account for the key issue in this regard, which is his promise that all 20 beds closed in the short-stay ward would be reopened. I call on him to keep his word and to stand by his promise to the people of Donegal. The recruitment embargo should be lifted to allow the hospital to recruit the necessary nurses to get the beds opened and to try to take the pressure off the entire hospital, particularly the nurses, doctors and staff in the emergency department, who are doing impossible work every day under impossible circumstances.
I thank the Senator. I apologise to him on the basis that this is probably the third time I have been here to deal with the same issue. I acknowledge that he has raised it on a few occasions. I have been reminding the Minister of the situation constantly. I am responding once more today on behalf of Deputy Harris. He acknowledges the distress that overcrowding in emergency departments causes to patients and their families and to front-line staff who work in challenging conditions in hospitals throughout the country. The number of patients attending emergency units continues to increase each year. In the first eight months of 2019, the number of patients attending increased by 2.9% and the number of admissions increased by 1.7% compared with the same period last year. During the same period, attendances at the emergency department in Letterkenny University Hospital increased by 4.5% and admissions increased by 6.1% compared with the same period in 2018. According to provisional TrolleyGAR figures, some 3,025 patients waited on trolleys in the emergency unit in Letterkenny University Hospital between January and the end of September this year. This represented a 32% increase on the same period last year. This is an average of 11 people waiting on trolleys each morning so far in 2019.
The health service capacity review, which was published last year, made it clear that a major investment in additional capacity in hospital and community settings is needed. It also spoke of the need for wide-scale reform of the manner and location of the provision of health services. An additional 267 beds have been opened since 2017. The capacity programme for 2019 provides for increases in capacity, as set out in the 2019 national service plan. Some 75 acute beds and 70 community beds were provided for under the 2018-19 winter plan, including five beds that opened in Letterkenny University Hospital in June 2019 under that plan. Some 47 additional beds, including a 40-bed modular build in South Tipperary General Hospital, three high-dependency unit beds in the Mater Hospital and four high-dependency unit beds in Cork University Hospital, were also provided for. The capacity programme also provides for the preparation of 202 beds during 2019, including 15 in Letterkenny University Hospital, with a view to bringing this additional capacity into operation in the first quarter of 2020. The programme also provides for the commencement of works on a 60-bed modular ward at University Hospital Limerick. In its most recent update to the Department, the HSE advised that ten short-stay ward beds at Letterkenny University Hospital opened in June 2019 and the opening of nine further beds at the hospital is under consideration. To date, no timeline has been provided for the opening of these beds. I will come back to some of the issues raised by the Senator in my concluding remarks.
When one reads the response drafted by departmental officials on behalf of the Minister, one gets to the core of the issue. The response confirms that five beds have been provided. I remind the House that the Ministers for Health and Education and Skills said that all 20 beds would reopen. They said a year ago that they had contacted the manager of the hospital and that the recruitment process had commenced. It has been confirmed in the response that just five beds have been funded. The response also refers to plans for another 15 beds, "with a view" to having them opened in the first quarter of 2020. There is a further reference in the response to the opening of ten beds. The Department is admitting that it funded five beds, but ten beds have been opened. I can inform the Minister of State and the departmental officials that the Saolta University Health Care Group, working with public representatives in Donegal, provided funding to get the number up to ten because of the urgent crisis and the failure of the Government. I am asking the Ministers to keep their promise and their word. The Minister of State has told us that it is "under consideration". That is just not good enough.The Minister for Health is only superseded by the Taoiseach. In recent days, the Taoiseach apologised to all the people in the emergency department. Apologies are no longer any good. People need hope; they need to believe it is going to change. Whatever about the reform of the wider health system, 20 beds were closed and we were promised they would be reopened. It is very simple. The Government was to provide the funding for the nurses and the beds to get it reopened and it has not done so. It broke its promise and its word. I am holding the Government to account. I am not going to go away. We need to see all 20 beds.
I ask that the Minister of State would send the transcript to the Ministers for Education and Skills and Health. I will get the transcript from Highland Radio, if need be, and remind them of the words they uttered. They need to keep their promise and their word, get those beds reopened and give the people of Donegal, and the nurses and doctors in that hospital, some hope. Stop the apologies, give us some hope and give us some solutions.
I acknowledge it is not the first time I have heard the Senator's concerns and anger. I can understand his frustration. It must be acknowledged that attendances at emergency departments are increasing on a yearly basis and the health service capacity review indicates that Ireland has among the highest acute bed occupancy rate in the developed world. Against that backdrop, the HSE capacity review recommended an increase in acute beds to more than 2,600 by 2031 to support the projected increase in demand for the service.
I acknowledge that the Senator has spoken out so strongly regarding the expressions of support from the Ministers for Education and Skills and Health on the additional beds. I assure the Senator I will make it my business, as I always do, to send a transcript to their offices when I receive it later, and I will highlight the concerns that have been raised, not only by the Senator today but by other Senators in the past. Although I cannot speak on behalf of the two Ministers in regard to what they said on radio, I assure the Senator that both of them will receive a copy of the transcript later today. It is up to him after that as to what he wants to do about the local radio interviews. I acknowledge the fact there is much frustration and that beds were promised, as he said. If we are going to promise to do something, I acknowledge that, somewhere along the line, it has to be done. I will convey his concerns to both Ministers.