Tuesday, 30 March 2004
Department of Health and Children
Question 392: To ask the Minister for Health and Children when a person (details supplied) in Dublin 11 will have their condition diagnosed by a neurologist; if he has satisfied himself that there is a sufficient number of neurologists at Beaumont Hospital to cater for such demands on its services; if he has further satisfied himself that there is a sufficient number of hours devoted to public patients among the neurologists who work in Beaumont Hospital; and if he will make a statement on the matter. [9842/04]
Responsibility for the provision of services to residents of counties Dublin, Kildare and Wicklow rests with the Eastern Regional Health Authority, and services at Beaumont Hospital are provided under an arrangement with the authority. My Department has, therefore, asked the regional chief executive of the authority to investigate the matter raised by the Deputy and to reply to her directly.
Question 393: To ask the Minister for Health and Children the way in which he will ensure that the services for tuberculosis patients are fully maintained in view of the pending closure of the tuberculosis unit at Peamount Hospital; the rehabilitation and geriatric services which will be provided and when; if the ERHA were fully informed on the proposed closure; the ERHA policy in this regard; if he has satisfied himself with the approach adopted by the hospital board in making a hospital consultant redundant; and if he will make a statement on the matter. [9845/04]
Question 398: To ask the Minister for Health and Children the plans in place to deal with and treat TB om Dublin and nationally; and if he will outline the future for Peamount Hospital in view of the reduction in TB treatment services at this hospital. [9936/04]
I propose to take Questions Nos. 693 and 698 together.
In July 2000, Comhairle na nOspidÃ©al made a number of recommendations on the future organisation and delivery of respiratory and tuberculosis services. Comhairle recognised the valuable role which Peamount Hospital has played for many years. However, in line with major advances in medical treatment, it recommended that the optimal in-patient care of patients with respiratory diseases, including tuberculosis, is more appropriate to acute general hospitals, staffed by consultant respiratory physicians and other consultants supported by an array of investigative facilities.
Peamount Hospital was not regarded by Comhairle na nOspidÃ©al as an appropriate location for the treatment of TB patients, especially those requiring ventilation and specialised treatment for other symptoms, such as heart disease, HIV, etc., who may present with TB. Comhairle na nOspidÃ©al subsequently appointed a committee to advance the implementation of the 2000 report. The report of this committee, which endorsed the recommendations in the earlier report, was adopted by Comhairle in April 2003. Specifically it recommended that Peamount Hospital should play an active role in the provision of a range of non-acute support services, including pulmonary rehabilitation, within the South Western Area Health Board. It also recommended that patients who have been treated in St. James's Hospital and other major acute hospitals, and who require on-going rehabilitative care, could be transferred to Peamount Hospital for completion of their care.
I understand that in addition to the Comhairle advices on this issue, the board of Peamount Hospital has developed a strategic plan for the next five years. The hospital employed external support to assist them in this process and to advise of developments in the wider health care environment. The strategy adopted by the board proposes considerable enhancement of existing services and development of new services in the areas of rehabilitation and continuing care of older people, persons with intellectual disabilities and adults with neurological or pulmonary illness. The hospital will now develop a transitional plan to transfer acute services in a planned way, and following consultation, to an appropriate location in an acute general hospital.
Services in the hospital such as phlebotomy and X-ray will continue to be available to the local community; indeed much of the discussion to date has related to how Peamount can more effectively meet the primary care needs of the local population. After discussion with local GPs, it is clear that key concerns are in relation to the management of older people with chest infections and respiratory difficulties. The Eastern Regional Health Authority is in continuing discussion with Peamount in regard to how these services will be maintained. This will be supported by the appointment of a consultant geriatrician to Tallaght Hospital, with two sessions per week specifically committed to Peamount.
The authority is also working with Peamount to ensure that rehabilitation facilities will continue to be available for people with TB who have chronic lifestyles and are at risk of being unable to maintain their treatment programme without supervision. A joint consultant post in rehabilitation medicine is also being established between the National Rehabilitation Hospital and Peamount.
Existing day and residential services for older people, people with intellectual and physical disabilities will continue to be provided. I would like to assure the Deputy that the direction which Peamount is now taking will see it developing its overall role and its support for acute hospitals, general practitioners and the community of the surrounding area and is in line with its commitment to the provision of the highest quality of care to existing and future patients. The implications for the acute respiratory services currently provided at the hospital are being assessed, following which it is understood there will be further consultation with a range of relevant parties. The authority will participate fully in this process to ensure that the interests of, and potential benefits to, patients of the region are fully realised. The industrial relations issue referred to by the Deputy is a matter for the board of Peamount Hospital and, accordingly, I do not propose to comment on the matter.
Question 394: To ask the Minister for Health and Children his proposals to provide the appropriate level of dialysis services at Waterford Regional Hospital, bearing in mind the present highly unsatisfactory level of dialysis service at WRH; and if he will make a statement on the matter. [9846/04]
The provision of hospital services at Waterford Regional Hospital is, in the first instance, a matter for the South Eastern Health Board. My Department has, therefore, asked the chief executive officer of the South Eastern Health Board to investigate the matter and reply directly to the Deputy.
Question 395: To ask the Minister for Health and Children when a person (details supplied) in Dublin 11 will receive an appointment to see an orthopaedic surgeon in Beaumont Hospital; and if he will make a statement on the matter. [9847/04]
Responsibility for the provision of services to residents of counties Dublin, Kildare and Wicklow rests with the Eastern Regional Health Authority. My Department has, therefore, asked the regional chief executive of the authority to investigate the matter raised by the Deputy and to reply to him directly.
Question 396: To ask the Minister for Health and Children if the Mid-Western Health Board has provided a site to the Mid-Western Hospital Trust for the purpose of building a radiotherapy unit; if the planned radiotherapy unit will treat public and private patients; the way this planned radiotherapy unit will fit in with the Minister's plans for the development of radiation oncology services in Ireland; and if he will make a statement on the matter. [9855/04]
I have met with both the Mid-Western Hospitals Development Trust and the Mid-Western Health Board in respect of their proposal for the development of a radiation oncology unit on the campus of the Mid-Western Regional Hospital Limerick. The proposal is for a facility to be constructed on a site to be made available by the Mid-Western Health Board and to be operated by a private hospital, with funds provided by the Mid-Western Hospitals Development Trust. I have been assured that the development will not require revenue or capital resources from my Department. My understanding is that it is intended to treat public and private patients at this facility.
I have advised the representatives of the Mid-Western Health Board of the establishment of a national radiation oncology co-ordinating group which will advise inter alia on the national co-ordination and delivery of existing and planned radiation oncology services, including agreeing quality assurance protocols and guidelines for the referral of public patients to private facilities.
My plan for the development of radiotherapy services is that the supra-regional centres in Dublin, Cork and Galway will provide comprehensive radiation oncology services to patients regardless of their place of residence. Specifically, these supra-regional centres will provide significant sessional commitments to patients in the mid-west. I expect proposals in that regard to be finalised shortly for submission to Comhairle na nOspidÃ©al, involving the Mid-Western, Western and Southern Health Boards, in order to expedite the recruitment of consultant radiation oncologists at Cork University Hospital and at University College Hospital, Galway.
The implementation of the report on the development of radiation oncology services in Ireland is the single most important priority in cancer services in the acute hospital setting. The immediate developments in the southern and western regions will result in the provision of an additional five linear accelerators. This represents an increase of approximately 50% in linear accelerator capacity. We will also provide for the appointment of an additional five consultant radiation oncologists. We currently have ten consultant radiation oncologists nationally. This will result in a significant increase in the numbers of patients receiving radiation oncology in the short term. These appointments are specifically designed to offer patients in areas such as the mid-west equity of access to radiation oncology services that are in line with best international practice.