Lynn Boylan (Sinn Fein)
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I welcome the Minister of State, Deputy Rabbitte.

Tim Lombard (Fine Gael)
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I raise the issue of non-consultant hospital doctor, NCHD, posts in Bantry General Hospital. First, I will give an outline of my argument. Bantry General Hospital is probably one of the most unique and wonderful complexes we have in the State. It services a really rural demographic. It covers a significant rural population that increases during the summertime. There is quite poor infrastructure in regard to the road networks in the area. The next nearest hospital is in Cork city. The latter is approximately 150 km from the peninsulas, which is a significant distance to travel. The hospital also covers seven islands, which work closely with it. The hospital is situated in a unique location.

I acknowledge the amount of work that has been done in Bantry General Hospital, in particular during the past six years. We have seen the refurbishment of the medical assessment unit, costing €1.5 million. St. Joseph's unit was extended to include a theatre and recovery room. This came at a cost €2.5 million. The radiation suite was upgraded at a cost of €500,000. The laboratories and administration buildings were extended. A CT scanner was put into the hospital in 2019, costing €850,000. There is now a massive redevelopment taking place in the building of a new stroke and rehabilitation centre and endoscopy unit, which will cost €17.6 million. There has been significant investment in Bantry. It also has, for the first time ever, six full-time consultants, in addition to 300 members of staff and 17 NCHDs. Due to the success of the hospital and the capital that has gone into it, the number of NCHDs needs to be increased to 21.

Bantry General Hospital is a good-news story. It is an example of what we need to have in rural Ireland: a hospital that is well-invested in, well-maintained and well-run with consultants on the ground. The fact that there are six full-time consultants there - the first time in the history of the State that this has been the case - is a credit to the amount of work that has gone into the hospital. Due to this success and to the amount of work done and capital invested in the hospital over the past six to seven years, we now need to see an increase in the number of NCHDs to 21.

Unfortunately, the political reality is that Bantry General Hospital becomes a political football every time an issue arises, there is an election or someone wants to get media coverage. We need to talk up this hospital, particularly in the context of the management and the staff. The latter are being driven demented because the hospital is being talked down. It covers a huge geographical area, including parts of south Kerry and all of west and north Cork. It really is the focal point for medical services in that entire geographical area. It is also a major financial driver for the area. It is one of the biggest employers there. As already stated, 300 people work at the hospital. The fact that it becomes a political football, particularly at election time, is bizarre. The knock-on impact is that we find it hard to get people to come to this remote location to work. If one were to Google "Bantry General Hospital", one occasionally gets the impression that it is closing. It is anything but closing. In fact, it is going from strength to strength. It is because of the hospital's success and the developments that have taken place there that we need an in the number of NCHDs to 21. We also need to take politics out of it and support the staff and management, who do such a great job. Will a programme be put in place to enable us to increase the number of NCHDs from 17 to 21? This would have a knock-on impact in allowing this good-news story to continue and to become a great-news story.

Anne Rabbitte (Galway East, Fianna Fail)
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I thank the Senator for raising this matter, which I am taking on behalf of the Minister for Health, Deputy Stephen Donnelly. I will stick to the script.

First, I acknowledge the hard work and commitment of all the staff in Bantry General Hospital. The hospital serves a unique, large, rural geographical area, from the peninsulas in the south west, to Clonakilty and Timoleague in the east.Although the hospital serves a population of approximately 60,000 people, during the summer months this figure can increase by 80% to 100%. This also covers the islands, as the Senator has said. Under the reconfiguration of services in Cork and Kerry, Bantry General Hospital has been designated the only model 2R hospital - remote and rural - in the country. This means, that unlike other model 2 hospitals, Bantry General Hospital continues to receive undifferentiated medical presentations 24-7. Services like the medical assessment unit are experiencing a notable increase in demand, up by 7% in 2021 and an additional 13% in 2022. Bantry General Hospital has received a significant level of investment in recent years, with funding increased by 11% since 2020. The hospital's workforce has also grown considerably. As of 2022, the hospital employed 1,165 WTEs, an increase of 10% on the same period in 2020. That sounds to me like a vibrant hospital. The Senator is right to say we should be talking, because all I have ever heard about Bantry General Hospital is negative. The Senator's contributions are therefore welcome this morning. I acknowledge that recruitment of relevant and appropriately skilled staff in rural areas continues to pose a particular challenge to the HSE. Hospitals like Bantry General Hospital are particularly affected by this trend. I have been advised that the hospital is currently relying on short-term and long-term locum non-consultant hospital doctors, NCHD, with differing levels of experience to maintain the very busy twenty-four hour, seven-day per week rota at the hospital. The cost of funding agency spend on NCHDs in Bantry was just under €170,000 for 2022. With the support of these locum doctors the hospital must also meet the 24-hour European working time directive key performance indicator, KPI. Recruitment and retention of healthcare workers generally, including NCHDs, remains a top priority for this Government. As recently as September the Minister announced that he is establishing a national taskforce to focus on the NCHD workforce. The purpose of the taskforce is to put in place sustainable workforce planning strategies and policies to improve the NCHD experience, and support and grow a sustainable NCHD workforce. Central to achieving this will be the promotion of a culture of education and training at clinical site level to support present and future retention of NCHDs in all hospitals, including Bantry General Hospital. Perhaps that will address the Senator's question about expanding the number of NCHDs at that location.

Tim Lombard (Fine Gael)
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I thank the Minister of State for her response. It is about trying to make sure we can get that number from 17 up to 20 or 21. We all realise the geographical issues with Bantry's location. It is about making sure that we talk up the complex, the management and staff, and what they achieve on the ground. If we can tell the good news story, the ability to get the doctors required on the ground will come. It is a global market now. It is not about the Irish national market, or even Europe. This is a global market, so when someone Googles Bantry General Hospital they need to hear the good news story. They need to hear that Bantry is vibrant, and it produces a lot of good work on the ground. It serves a rural community with seven islands, but it does what it does and attains. It actually delivers. We need to make sure that story is out there. I welcome the review. I think it will be positive. Off the back of that we can hopefully get the extra doctors required to ensure we can keep telling the good news story about Bantry General Hospital.

Anne Rabbitte (Galway East, Fianna Fail)
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I would like to reiterate that the Government, along with the Department of Health is committed to addressing workforce challenges across the health services to meet the growing needs of the population. We also need to make sure that sustainability model is in place when we look at rural areas. Since the beginning of the Covid pandemic, this Government has overseen the largest ever expansion of our healthcare workforce. At present, there are almost 18,000 additional whole-time equivalents working in our health service than there were at the beginning of 2020. This is a significant increase of 15%. The number of NCHDs employed has also increased by 18% in the same period. This ongoing growth has supported service delivery and delivered reductions in the overall working time of the NCHDs. It is recognised that in order to make sites like Bantry more attractive, training opportunities need to be enhanced, and the HSE is committed to increasing the overall number of training posts and to providing enhanced training to the NCHDs who are not occupying recognised training posts in sites such as Bantry. The Minister and the Department of Health remain committed to addressing these challenges and delivering the best possible care for the people of the south-west. That is a priority for this Government.