Seanad debates
Tuesday, 7 November 2023
Nithe i dtosach suíonna - Commencement Matters
Hospital Facilities
1:00 pm
Robbie Gallagher (Fianna Fail)
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The Minister of State is very welcome to the House this afternoon. Yesterday, the management at Cavan General Hospital issued a statement to local media requesting that non-urgent people would not attend the hospital because of the high volumes they were experiencing. Instead, they asked that patients with non-critical issues to contact their GP or indeed their pharmacy for assistance. This brings into focus again, from our perspective in Monaghan, the role that Monaghan Hospital and, in this instance, the role the injuries unit in Monaghan could provide to help alleviate the pressure on emergency departments, not just in Cavan but in Our Lady of Lourdes Hospital in Drogheda as well.
Thankfully, the injuries unit in Monaghan is now open seven days per week from 8 a.m. to 8 p.m. They treat a wide range of injuries at the hospital. Neither an appointment nor a GP referral is needed to be seen there. I pay tribute to the very professional, caring and dedicated staff who operate there. The place has gone from strength to strength since it has been open seven days a week. Many people are being treated there who would otherwise end up in an accident and emergency department. That is a very positive development.
That is why I was interested in a development that is taking place now in Roscommon University Hospital, whereby some patients are being transferred directly to Roscommon injuries unit by ambulance if they meet the strict criteria, which is a very welcome development. I understand the National Ambulance Service and Roscommon University Hospital have agreed a programme that involves strict clinical and geographical criteria that will see a small cohort of patients, not a large number, with minor injuries being transferred by the National Ambulance Service to the injuries unit for treatment. Opening this new pathway will allow paramedics to bring patients to the most appropriate location and for the most appropriate treatment to be given. That is a very welcome development. It will in turn alleviate the pressure on the likes of the accident and emergency department in that location.
From my perspective, I would like to see a similar development with the injuries unit in Monaghan whereby if it meets the proper criteria as regards geography and clinical need, patients could be transferred directly to Monaghan injuries unit by ambulance to receive their treatment there. As I said, the injuries unit treats many minor injuries. The numbers going through the doors at the moment have been very progressive. It is growing in popularity and strength as people become more and more aware of it.
I very much welcome the development in Roscommon injuries unit and I would like to see a similar arrangement taking place between the National Ambulance Service and the hospital in Monaghan whereby patients appropriately triaged by the paramedic at the scene would be able to be transferred directly to the injuries unit in Monaghan, as opposed to travelling to an accident and emergency department, such as in Cavan or Drogheda, which are under immense pressure already. It is a very common-sense proposal. I commend them on taking this on board. I look forward to a similar arrangement being put in place in Monaghan injuries unit and indeed in other injuries units. I look forward to the Minister of State giving the Minister for Health’s position on that.
Joe O'Brien (Dublin Fingal, Green Party)
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I thank Senator Gallagher for raising the matter of the minor injuries unit at Monaghan Hospital and I welcome the opportunity to update the House on this important service. The minor injuries unit at Monaghan Hospital plays a vital role in providing valuable services to the local community and helping to alleviate pressures on our emergency departments. There are a total of 12 HSE minor injuries units under the governance of HSE acute operations, all operating on a seven day per week basis. This includes the injuries unit service located at Monaghan Hospital which has been open seven days per week since July 2023. It is open to adults for children aged five and older.
The National Ambulance Service has established a medical assessment unit pathway to allow patient referrals by National Ambulance Service paramedics to each of the existing seven model 2 hospital-based medical assessment units.Prior to the development of this pathway only patients referred by GPs or GP out-of-hours services were accepted. Following a successful trial at Wexford General Hospital, the NAS clinical director and the national clinical lead for the acute medicine programme are currently in discussions concerning the feasibility of extending this pathway, which is currently confined to model 2 hospitals and model 3 hospitals including Cavan and Monaghan hospital. This programme ran successfully at Roscommon University Hospital where it was agreed that some patients be transferred directly to Roscommon hospital injury unit if they meet strict criteria. Under this new agreement, the National Ambulance Service paramedics will also transfer patients with minor injuries to the unit.
The pathway will result in patients receiving medical treatment in a hospital closer to their home and will release ambulances more quickly to respond to other emergency calls; 112/999 patients who do not meet these clinical criteria will continue to be transported to emergency departments for assessment and treatment.
Monaghan hospital operates as a single hospital with Cavan General Hospital. Together they share an integrated managerial and clinical governance system, as well as integrated patient care pathways and support functions. The emergency department is located at Cavan General Hospital and provides 24-hour emergency critical care to adults and children, while facilities at Monaghan hospital focus on elective care and the appropriate streaming of patients to the minor injury unit.
Over the past ten years, this injury unit has treated thousands of patients each year, with more than 4,200 attendances in 2020, and nearly 5,400 in 2021. Investment in the minor injury unit in recent years led to the expansion of opening hours in November 2022 and again in July 2023, from 8 a.m. to 8 p.m. seven days a week. This Government is committed to the ongoing development of facilities at injury units across the country.
Robbie Gallagher (Fianna Fail)
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I thank the Minister of State for his reply. As I said earlier, the development in Roscommon is very positive and it makes perfect sense that a similar protocol be put in place in Monaghan. The injuries unit is thankfully now operating seven days a week, as the Minister of State noted. The staff are very dedicated and caring people and provide an excellent service. From my inquiries, I understand this protocol is working very well in Roscommon and I see no reason it would not be introduced and rolled out in Monaghan as soon as possible. I would like to see that happening and I ask the Minister of State to take on board my ambitions for Monaghan hospital to be used to greater capacity to relieve the pressure on the emergency department in Cavan, and indeed Drogeda.
Martin Conway (Fine Gael)
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I thank the Senator for his constant advocacy on behalf of Monaghan hospital, which is duly noted.
Joe O'Brien (Dublin Fingal, Green Party)
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I thank Senator Gallagher for his contribution. Monaghan hospital, serving the people of counties Monaghan and Cavan, has a reputation for the delivery of high quality, innovative and safe care to patients. Over the past ten years, the minor injury unit at Monaghan hospital has treated thousands of patients each year. The National Ambulance Service has established medical assessment pathways to allow patient referrals by National Ambulance Service paramedics to each of the existing seven model 2 hospital-based MAUs. The new programme piloted at Roscommon University Hospital is now being explored for roll-out to other hospitals including Cavan and Monaghan hospital. In summary, the minor injury unit at Monaghan hospital plays a vital role in providing valuable services to the local community and helps to alleviate the pressures on our emergency departments.
Martin Conway (Fine Gael)
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We thank the Minister of State for his time. We appreciate how busy he is and thank him for taking Commencement matters this morning.