progress report on rosscommon hospital

Tuesday, 8 November 2011 What are written answers?

Department of Health Hospital Services

All Written Answers on 8 Nov 2011 « Previous answer Next answer »

9:00 pm

Denis Naughten (Roscommon-South Leitrim, Fine Gael)

Question 55: To ask the Minister for Health the steps he is taking to provide additional

services at Roscommon County Hospital; and if he will make a statement on the matter.

[32714/11]

James Reilly (Minister, Department of Health; Dublin North, Fine Gael)

An Urgent Care Centre was established in Roscommon County Hospital in July 2011. This

Centre operates from 8am to 8pm, seven days a week and the service is provided by non-

consultant hospital doctors, with clinical governance provided by an emergency medicine

consultant at Galway University Hospital.

An enhanced ambulance service has been put in place. During the day, four ambulances

staffed by paramedics are available, while three are available at night. In addition, there is

a special Rapid Response Vehicle, staffed by advanced paramedics, available on a twenty

four hour, seven day basis. An out of hours GP service is also in operation. A Medical

Assessment Unit is open from 9am to 5pm, Monday to Friday. This is a medical admission

pathway and accepts referrals from a range of sources, including general practitioners.

An outpatient and day surgery plastic surgery service commenced in the last few months.

Furthermore, increased day surgery is due to commence shortly. This will involve taking

suitable patients from Galway University Hospital waiting lists.

Roscommon Hospital has a clear future and will continue to provide key services to the

people of the area. I believe that smaller hospitals can and should provide as wide as

possible a range of services, close to the local community. The key concern is that they are

safe.

Too often we have focused on what we are taking away from rather than what we can add

to, services in smaller hospitals. A framework for the development of smaller hospitals is

being prepared for the Government jointly by the HSE and my Department which will set

out how smaller hospitals will develop to reach their full true potential. This will specify

what services are transferring to them from the larger hospitals.

All of this will be done with full regard to the safety issues highlighted by HIQA, in its

reports on Ennis and Mallow Hospitals. When it is implemented, smaller hospitals will have

vibrant roles, doing more work – not less – and meeting as many as possible of the needs

of their local communities.

QUESTION NO: 493

DÁIL QUESTION addressed to the Minister for Health (Dr. James

Reilly) by Deputy Denis Naughten

for WRITTEN ANSWER on 02/11/2011

* To ask the Minister for Health further to his commitments of 21 July 2011 at the Joint Oireachtas Committee on Health and Children, if he will report on the independent review of the medical research into the recommended treatment times for medical emergencies; when the data referenced regarding cardiac treatment at acute hospitals will be published; and if he will make a statement on the matter. - Denis Naughten REPLY. The issues raised by the Deputy arose from a discussion at the Joint Oireachtas Committee on Health and Children on 21 July 2011 in relation to the emergency service changes at Roscommon Hospital. The HSE plan implementing the changes to the Emergency Department Service at Roscommon County Hospital came into effect in July. The Urgent Care Centre now in place at Roscommon operates from 8am to 8pm seven days a week and is provided by Non Consultant Hospital Doctors (NCHDs) with clinical governance provided by an Emergency Medicine Consultant at Galway. In addition there is a Medical Assessment Unit at the Hospital and an out of hours GP service is in operation. An enhanced ambulance service has been put in place. The changes at Roscommon were necessitated by the serious patient safety concerns of the HSE and of the Health Information and Quality Authority in relation to the accident and emergency service at Roscommon following the publication of the Authority's Report on Mallow Hospital in April 2011. This was compounded because of NCHD recruitment difficulties.

Roscommon County Hospital has a clear future and will continue to provide acute hospital care for the population of the Roscommon area. It will do this as part of a wider network of acute hospitals across the Western area and it will be supported by the other hospitals in the region. While I indicated that I was open to discussing the issue of having evidence such as that referred to by the Deputy reviewed further I was also cognisant, in particular that the independent statutory role of the Health Information and Quality Authority should not be undermined in any way. As Minister I have total confidence in the important work that HIQA performs as an independent statutory authority in the context of ensuring improvements in the quality and safety in health and social care. Although I have doubts about the need for a review I am as I have indicated open to having a discussion with the Deputy in the matter. On the other issue raised by the Deputy I can confirm that the CMO's Office of my Department is finalising a report examining the potential of hospital discharge data in measuring the quality of health care. This includes the measure of recorded 30 day in-hospital mortality rates following heart attack. It is expected that the report will be finalised and published in the near future.

QUESTION NO: 494

DÁIL QUESTION addressed to the Minister for Health (Dr. James Reilly)

by Deputy Denis Naughten for WRITTEN ANSWER on 02/11/2011

* To ask the Minister for Health when the report by the Health Service Executive, on foot of Health Information and Quality Authority guidelines on ambulance response times will be published; the reason for the delay in publishing this data; and if he will make a statement on the matter.

- Denis Naughten

REPLY.

The Health Information and Quality Authority published "Key Performance Indicators for Pre-Hospital Emergency Care Response Times and Quality Standards" on 19 January 2011. The Standards recommended that the National Ambulance Service collate information on response times for different types of emergency calls by different types of resources (i.e. first responder and conveying vehicle), between January 2011 and June 2011 and January and December 2011 respectively. This is with a view to establishing a baseline of performance, to inform the development of targets in those indicators where a target was yet to be set.

HIQA also recommended that response time performance for first responders to Clinical Status 1 (Echo and Delta) calls be published for July onwards, as targets had been published for these standards. The HSE, HIQA and my Department have agreed that this data should be published through the HSE's Performance Monitoring Reporting system and the information has been published on the website: www.hse.ie.

Wednesday, 26 October 2011

What are written answers?

Department of Health Hospital Waiting Lists

All Written Answers on 26 Oct 2011 « Previous answer Next answer »

10:00 pm

Denis Naughten (Roscommon-South Leitrim)

Question 136: To ask the Minister for Health further to his parliamentary reply to a Topical

Issue debate of 29 September 2011, when children will be treated at the urgent care centre

in Roscommon County Hospital; and if he will make a statement on the matter.

[31648/11]


The issue raised by the Deputy is currently being considered by the HSE.





10:00 pm


Question 152: To ask the Minister for Health the timetable of the completion of the project

to allow X-rays taken at Roscommon County Hospital to be read remotely; when a

computerised medical records system will be introduced to allow patient records at

Roscommon to be accessed remotely; and if he will make a statement on the matter.

[31752/11]


As this is a service matter, it has been referred to the Health Service Executive for direct

reply.


What are Dáil debates?

Other Questions Emergency Response Agencies

All Dáil debates on 26 Oct 2011 « Previous debate Next debate »

3:00 pm

Denis Naughten (Roscommon-South Leitrim) Link to this

Question 12: To ask the Minister for Defence if he has satisfied himself with the level of

support available to the Defence Forces to deal with severe weather emergencies; and if he

will make a statement on the matter. [31327/11]

Add your comment

Alan Shatter (Minister, Department of Justice, Equality and Defence; Dublin South, Fine

Gael) Link to this

While the Defence Forces are not a principal response agency, as defined in the framework

for major emergency management, they provide assistance in an Aid to the Civil Authority,

ATCA, role under the multi-agency framework. Representation on the Government task

force, by both my Department and the Defence Forces, ensures the fullest co-ordination and

co-operation with the appropriate lead Department in the event of an emergency. The

Defence Forces are also members of eight regional working groups that have been

established under the framework in order to co-ordinate the work of the principal response

agencies. Furthermore, on an ongoing basis, designated members of the Defence Forces,

based around the country, act as liaison officers to local authorities and I am satisfied that

this arrangement works well locally.

The various procedures that are in place, both nationally and locally, were seen to operate

very effectively last winter as the Defence Forces responded to all requests for assistance

received from the civil authorities during the period of severe weather which ran from 27

November to 26 December 2010. During this period, all assets, resources and capabilities

of the Defence Forces nationally were made available to the task force, and its inter-agency

co-ordination committee, for the purpose of providing assistance where it was not possible

for other agencies and organisations to respond.

The inter-agency co-ordination committee, which met almost daily throughout the

emergency, requested that, strategically, the Defence Forces would concentrate its support

effort on the Health Service Executive, mainly with regard to mobility tasks. Approximately

70% of all ATCA operations conducted by the Defence Forces were in support of the HSE.

This proved to be a very effective approach as transport was provided to HSE staff such as

palliative care and community nurses visiting patients and in the transport of health

workers, particularly doctors and nurses, to their place of work and between hospitals as

the need arose. Assistance was also provided to those involved in the delivery of meals on

wheels while focused ice and snow clearing operations were also carried out throughout the

country, with particular efforts being made to maintain the safety of public infrastructure

and key transport hubs.

A report on the review of the response to the severe weather events of 2009-2010 was

recently published. I believe that the response of the Defence Forces proved to be extremely

effective. Preparations to cope with the possibility of severe weather occurring during this

coming winter are ongoing. Members of the interdepartmental working group on

emergency planning, on which my Department and the Defence Forces are represented, are

currently working to further develop a “whole of Government” approach to preparing for

severe weather. A special meeting of the Government task force on emergency planning is

scheduled for early November, when I will be briefed by Departments and agencies

regarding their winter preparedness measures. Following that meeting, there will be an

information campaign to let the public know what measures have been taken and what

people can do for themselves in order to be better prepared in the event of severe weather

occurring.

Add your comment


I too want to acknowledge the work and the role of the Civil Defence and the Defence Forces,

both recently and over the severe weather crises we have seen over the past number of

years.

I wish to focus on one aspect of this work, the support provided to the HSE. Last winter, the

Defence Forces provided substantial support throughout the country. One of the

recommendations of the working group report is the purchase of key pieces of equipment

that will be required in emergencies in the future. From a value for money perspective, it is

not good value for the type of equipment that is only used in emergencies to be left lying

idle. Would it not be better if strategic equipment, such as field ambulances and high body

six-wheeled vehicles that can access flooded areas were purchased by the Defence Forces

and made available where required?

What is the situation now with regard to the Air Corps and the grounded helicopters in the

context of emergency evacuations that may be required where it is not possible to access a

community in any other way?

Add your comment


Gael) Link to this

As the Deputy will know, the Defence Forces hold a wide range of engineering and transport

plant and equipment for military purposes and all such plant and equipment suitable for use

in emergencies and severe weather situations is made available as the need arises. The

type of plant and equipment suitable for use includes: a 40 tonne crane; a heavy duty fork-

lift; tracked and wheeled excavators; bulldozers; articulated dump trucks; integrated tool

transport carriers; materials; handlers; water purification plants; and a variety of smaller

plant excavators, generators, lighting sets, pumping equipment, water trailers and other

items.

In the context of the snow event that occurred last winter, it was a particularly unusual

event. There is an issue in circumstances where there are limited resources available as to

how to make best use of resources as to what plant and equipment should be purchased

and as to whether it is likely that such plant and equipment will be used or whether it could

end up being stored for many years and not utilised. A broad range of issues arise in

respect of which judgments must be made. I am anxious to ensure any essential

equipment required for regular use is available so people’s safety can be secured when at

risk and so that people can be accessed in snow, flooding or where other climatic issues

that arise. This issue has been under review and the emergency task force will consider it

further at our forthcoming meetings.

Add your comment


Does it not make more sense that the Defence Forces purchases equipment such as field

ambulances and six-wheel vehicles with high bodies to be used in emergencies when they

would be put to good use, rather than local authorities or civil defence teams purchasing

them? We have the potential for serious issues this winter and, in an emergency, if

someone must be transported from an isolated rural community such as those in County

Roscommon to Galway University Hospital, we must consider how we will get them out.

What steps are being taken to ensure the Air Corps has the capability to airlift patients out

when no other vehicle can gain access?

Add your comment


Gael) Link to this

The Air Corps has certain capabilities in that context. Recently, I visited Baldonnel and I

had the opportunity to look at the helicopters that are available and talk to some of those

in the Air Corps who have medical expertise and who engage in air and sea rescues and

who also have the capacity to engage in the activity Deputy Naughten outlined. In an

emergency, they would be available to assist the civil power. As we saw across the country

this week, it is of crucial importance that the Civil Defence, which plays a very particular and

important role, has essential facilities available, such as ambulances and other equipment.

This was deployed with great effect in the events that took place on Monday evening. In

circumstances where limited resources are available, judgments must be made about

where equipment can be best positioned, whether it should be purchased and retained at

local authority level or whether it should be acquired by the Civil Defence or the Defence

Forces. Careful judgements must be made in circumstances of limited financial resources.

I cannot predict what weather we will experience this winter, any more than any other

Member can. The weather events on Monday evening were extremely unusual, as were the

snows of last winter. We do not know if we will have that experience again this winter or if

it will not be repeated for five, ten or 15 years. Judgments must be made about resources

and their location. I am familiar with some of the equipment to which Deputy Naughten

refers, including the six-wheel vehicles, having seen them in use in the United States in

major snow emergencies. They are usually purchased only in states that repeatedly

experience the type of snow we had last winter, often for weeks on end.





7:00 pm


Question 174: To ask the Minister for Health the impact to the provision of acute services in

County Roscommon of the redesignation of up to 20 acute medical beds at Roscommon

County Hospital as step-down rehabilitation beds; the reason other acute hospitals

servicing County Roscommon have failed to transfer back to Roscommon County Hospital

non-critical acute medical patients from the county even after being requested to do so by

local consultants on foot of its accident and emergency department being taken off call;

and if he will make a statement on the matter. [28981/11]


The HSE plan implementing the changes to the Emergency Department Service at

Roscommon County Hospital came into effect in July. The Urgent Care Centre now in place

at Roscommon operates from 8am to 8pm seven days a week and is provided by non-

consultant hospital doctors (NCHDs) with clinical governance provided by an Emergency

Medicine Consultant at Galway. In addition there is a Medical Assessment Unit at the

Hospital and an out of hours GP service is in operation. An enhanced ambulance service has

been put in place.

The changes at Roscommon were necessitated by the serious patient safety concerns of the

HSE and of the Health Information and Quality Authority in relation to the accident and

emergency service at Roscommon following the publication of the Authority’s Report on

Mallow Hospital in April 2011. This was compounded because of NCHD recruitment

difficulties.

Roscommon County Hospital has a clear future and will continue to provide acute hospital

care for the population of the Roscommon area. It will do this as part of a wider network of

acute hospitals across the Western area and it will be supported by the other hospitals in

the region.

I believe that smaller hospitals can and should provide as wide as possible a range of

services, close to the local community. The key concern is that they are safe. A framework

for the development of smaller hospitals is being prepared. The HSE has been asked to

work up detailed draft proposals in this regard which will take account of the results of

consultation with stakeholders.

The framework will specify what services will be transferred to smaller hospitals. Too often

the focus has been on taking away services from smaller hospitals rather than on the

services that they can provide.

I am pleased that services at Roscommon have recently been enhanced with the

establishment of outreach plastic surgical services at the hospital. This is the first of a

number of service enhancements at Roscommon. The issue of locating a satellite service

centre of the National Rehabilitation Hospital at Roscommon is also actively being examined

in the context of enhancing the hospital’s role. I fully support the role of smaller hospitals

like Roscommon in providing for patients whose care no longer requires them to be treated

in larger centres. The transfer of patients back from surrounding hospitals occurs when the

patient’s acute care is complete, and by agreement with the patient, the referring

consultant and the receiving consultant.



Order of Business


A ministerial order is within the terms of the Order of Business.

Regarding No. 82 on the legislative programme, the health (miscellaneous provisions) Bill,

over 50 patients are on hospital trolleys in Galway University Hospital awaiting admission.

At the same time, inpatients at the hospital from County Roscommon will not be

transferred back for treatment to Roscommon County Hospital at which there are vacant

beds.

Add your comment

Seán Barrett (Ceann Comhairle; Dún Laoghaire, Ceann Comhairle) Link to this

Okay, Deputy.

Add your comment


Will the Taoiseach ask the Minister for Health to intervene directly to transfer those

Roscommon patients back to Roscommon hospital and, by doing so, alleviate the

overcrowding in Galway?

Thursday, 29 September 2011


Topical Issue Debate Hospital Services

All Dáil debates on 29 Sep 2011 « Previous debate Next debate »

3:00 pm


Over the last month, Mullingar, Portiuncula and Galway University hospitals have been

taken off call for ambulances due to the chaotic situation in accident and emergency

departments. At the same time, Roscommon accident and emergency operates as a minor

injury clinic for 12 hours a day, seven days a week. I do not care what name is over the

door of the emergency department, what goes on inside is what is important to me and the

people I represent. The reopening of Roscommon is a simple and cost effective way to take

pressure off the other accident and emergency departments and the overstretched

ambulance service.

Within four weeks of the closure of the accident and emergency ward in Roscommon, the

Department of Finance approved the roll-out of a new nationwide telestroke service, which

allows the use of IT for specialists in regional centres to conduct video consultations and

communicate with patients and staff. This is the sort of system hospital campaigners in

Roscommon have always sought because of our unique geographical situation. Safety,

however, was never the issue in Roscommon. Local GPs were told heart attack patients

would be transferred directly to Galway University Hospital for access to the CAT lab. They

now feel they have been lied to as patients are being transferred to Portiuncula hospital, a

hospital with the same facilities as Roscommon; the only difference now is that in some

instances patients are waiting in GPs’ surgeries for up to an hour for the ambulance to

arrive.

Even leaving these issues aside, at this point we have some of the most skilled staff in the

country twiddling their thumbs while chaos reigns in other accident and emergency

departments around the country. Where is the sense in that? There is a need to review the

ambulance and hospital bypass protocols relating to Roscommon. Why does someone who

needs two stitches who was picked up by an ambulance go past the front door of

Roscommon Hospital on the way to an overcrowded accident and emergency department?

Why have 300 children with minor injuries been forced, since the closure of the accident

and emergency department, to travel in pain to other hospitals because staff in

Roscommon have been instructed to turn them away even though Roscommon was well

capable of treating them prior to July this year?

Add your comment

Luke Flanagan (Roscommon-South Leitrim, Independent) Link to this

Before the election, the Minister for Health and his party promised us they would not close

our accident and emergency department. After they closed it, they told us there would not

be any problems with it being closed because we would get extra ambulances and super,

souped-up paramedics. That has not happened either. Last weekend put the tin hat on it

when people were told by the media not to go to the hospital we were told to go to in order

to save lives. As someone who has dedicated his life to saving people’s lives, I wonder how

the Minister for Health can stand over this. It is not unreasonable for us to have some place

to go when we are sick in this area.

Add your comment

4:00 pm

James Reilly (Minister, Department of Health; Dublin North, Fine Gael) Link to this

I thank the Deputies for raising this important issue. The urgent care centre now in place in

Roscommon operates from 8 a.m. to 8 p.m. seven days a week and is provided by non-

consultant hospital doctors with clinical governance provided by the emergency medicine

consultant in Galway. In addition, a medical assessment operates at the hospital and there

is an out-of-hours GP service is in operation.

The changes at Roscommon were necessitated by the serious patient safety concerns of the

HSE and HIQA. The accident and emergency service situation at Roscommon followed the

publication of the authority’s report on Mallow General Hospital in April 2011 and this was

compounded by of NCHD recruitment difficulties. The Deputy knows how many meetings

were held with the various medical, surgical and emergency department experts to see if

there was any way around this. None could be found so my hand was forced, unhappily but

without choice.

Data from the HSE indicate that since the change of Roscommon’s emergency department

to an urgent care centre, the number of patients referred each day to other hospitals has

been very low. The most recent data for ambulance calls in the Roscommon catchment

area show that less than two patients on average per day were brought to Galway and

Portiuncula hospitals.

Even fewer patients were brought by ambulance to Mullingar, Sligo or Mayo hospitals.

While I do not accept that opening the urgent care centre at Roscommon on a 24 hour

basis would address the difficulties experienced from time to time at Galway University

Hospital emergency department, I am committed to ensuring that problems experienced at

emergency departments in Galway and elsewhere are addressed.

In recent months I have established the special delivery unit, SDU, under the leadership of

Dr. Martin Connor. The SDU is working to unblock access to acute services by improving

the flow of patients through the system. It is focusing initially on emergency departments

and will be working to support hospitals in addressing excessive waiting times for admission

to hospital.

I am also committed to the future of Roscommon and to other smaller hospitals. There was

a safety issue. I absolutely concur with the sentiment expressed in the Deputy’s question.

Why does someone needing two sutures need to go to Galway? I ask why someone needing

two sutures needs to go to hospital in the first instance. Why is the GP not suturing? That is

what I was trained to do as a GP.

With regard to media reports, it is my understanding that people were asked to stay away

from Galway University Hospital unless they were acutely or seriously ill. This was because

there was such overcrowding at the hospital. There were 32 people on trolleys on the

Saturday morning. By mid-afternoon the number had reduced to the mid-teens, by 6 p.m.

it was down to ten and by 8 p.m. it was down to five.

There are problems in Galway and Limerick and in other hospitals around the country.

There are difficulties with work practices. Difficulties have arisen because people have not

done what was asked of them. Day surgeries that should have moved from larger to

smaller hospitals, such as Roscommon and Portiuncula, did not do so. That problem is

being addressed.

I understand that a plastic surgery outpatient clinic began last week in Roscommon and

that the first plastic surgery will take place next week, with a new plastic surgeon. I

welcome her return to Roscommon. She is Ms Deirdre Jones and I believe she is from

Roscommon originally.

Add your comment


I ask the Minister to address my questions regarding children and minor injuries which can

be treated in Roscommon.

I bring the case of Mary to the attention of the Minister. Three weeks ago she had a mini-

stroke at 10 p.m. The ambulance arrived within 15 minutes to bring her to the Midland

Regional Hospital in Mullingar. When the ambulance was outside Edgeworthstown, the crew

received a call to say that Mullingar was no longer accepting patients. The ambulance was

turned around and the woman had to be transferred to Sligo General Hospital. She spent

two hours in the ambulance and reached hospital three hours after the time of the stroke.

This is contrary to all the publicity we see regarding fast action in relation to strokes. That

ambulance was tied up for three hours and taken out of the area for which it should have

been providing cover.

Before July, approximately 280 patients per week attended the accident and emergency

department in Roscommon County Hospital. Currently, between 40 and 60 patients per

week attend the department. Where are the other patients? I believe they are afraid to go

to their GPs for fear they will be referred to other hospitals. Many of these people are

elderly and vulnerable.

The Minister gave a commitment to the Joint Committee on Health and Children that he

would have an independent evaluation of the medical evidence regarding the effect on a

critically ill patient of an ambulance transfer in excess of two hours. Has that evaluation

been completed and when will it be published?

Add your comment


The issue of children is of concern. Yesterday, at the request of Deputy Frank Feighan, I

met a group from Roscommon hospital, including some of the surgical staff and

management. This issue was raised and it will be addressed in the next week. There will be

availability for staff to deal with minor injuries and lacerations. I received that undertaking

from a senior clinician at the hospital.

Add your comment


That is a positive development.

Add your comment

Luke Flanagan (Roscommon-South Leitrim, Independent) Link to this

That is only for children.

Add your comment


The Deputy also mentioned other matters.

Add your comment


I also mentioned minor injuries and ambulance transfers.

Add your comment


People should be able to go to the hospital. At yesterday’s meeting, the senior staff

member from Roscommon hospital said he is available to GPs at the end of a telephone. He

will be letting them know that so that they can send people to the hospital. He is on call

and will see people if needs be.

Add your comment


The Minister is missing the point.

Add your comment


I did not interrupt the Deputy. I ask him not to interrupt me. There will be an improved

service in this regard and GPs will be informed of it.

The total number of paramedics in County Roscommon is 26 and the total number of

advanced paramedics is seven. The paramedical service is working very well and has

already had a positive effect on a number of individuals, at least one of whom believes their

life was saved as a consequence of being able to access the paramedical service as rapidly

as they were.

Our commitment to Roscommon remains. The hospital has a bright future. Several other

developments are in hand and will be coming down the track. I will not make a habit of

saying what will come but I will report regularly to the House as to what has come. The

first new development is the new plastic surgery service. There will be other developments

over the next number of months and I will be happy to bring them to the Deputy’s notice.

Wednesday, 28 September 2011

Denis Naughten (Roscommon-South Leitrim, Fine Gael)

Question 36: To ask the Minister for Health his plans for the development of services at

Roscommon County Hospital; and if he will make a statement on the matter. [26148/11]


Question 37: To ask the Minister for Health his plans for the development of services at

Portiuncula Hospital, County Galway; and if he will make a statement on the matter.

[26149/11]


I propose to take Questions Nos. 36 and 37 together.

As these are service issues, they have been referred to the HSE for direct reply.



Topical Issue Matters


3:00 pm

Jack Wall (Kildare South, Labour) Link to this

I wish to advise the House of the following matters in respect of which notice has been

given under Standing Order 27A and the name of the Member in each case: (2) Deputy

Denis Naughten - the need for the Government to reopen Roscommon urgent care centre

on a 24-7 basis and to revise ambulance by-pass protocols in light of the chronic

overcrowding in adjacent accident and emergency departments;


Leas Ceann Comhairle: I wish to advise the House of the following matters in respect of

which notice has been given under Standing Order 27A and the name of the Member in

each case: (5) Deputy Denis Naughten - the need for the Government to reopen

Roscommon urgent care centre on a 24-7 basis and to revise ambulance by-pass protocols

in light of the chronic overcrowding in adjacent accident and emergency departments;



Order of Business

Denis Naughten (Roscommon-South Leitrim, Fine Gael) Link to this

On promised legislation and in light of the disclosure yesterday that the bowel cancer

screening programme is to be postponed for another six months, one of the main issues

that has been raised is the inability of hospitals to do colonoscopies. I understand that

2,500 people are waiting for a colonoscopy. In the context of No. 86, on the licensing of

health care facilities, when will the legislation be introduced? State-of-the-art theatres and

staff are lying idle at Roscommon County Hospital and they could be used to carry out

those procedures, deal with the backlog and take away the fear from people who are

waiting for colonoscopies. Will the Taoiseach intervene to ensure this work takes place in

Roscommon?

Add your comment

A Deputy:

They closed Roscommon hospital.

Add your comment

Enda Kenny (Taoiseach, Department of An Taoiseach; Mayo, Fine Gael) Link to this

Draft heads of a Bill have been submitted to the Minister for consultation. The bowel cancer

screening issue is of concern. I understand the programme was to begin in January and the

Minister is concerned about the delay. As the Deputy knows, the Government’s view is that

small hospitals have a real future.

Add your comment

Micheál Martin (Leader of the Opposition; Cork South Central, Fianna Fail) Link to this

Tell that to the people in Roscommon.

Add your comment

Enda Kenny (Taoiseach, Department of An Taoiseach; Mayo, Fine Gael) Link to this

I am aware this is of concern to Deputy Naughten, Deputy Feighan and others, and in due

course we will make a number of announcements about Roscommon.

Tuesday, 27 September 2011


Topical Issue Matters


5:00 pm

Seán Barrett (Ceann Comhairle; Dún Laoghaire, Ceann Comhairle) Link to this

I wish to advise the House of the following matters in respect of which notice has been

given under Standing Order 27A and the name of the Member in each case: (13) Deputy

Denis Naughten - the need for the Government to reopen Roscommon urgent care centre

on a 24-7 basis and to revise ambulance by-pass protocols in light of the chronic

overcrowding in adjacent accident and emergency departments;



Department of Health Health Services

All Written Answers on 15 Sep 2011 « Previous answer Next answer »

5:00 pm


Question 148: To ask the Minister for Health the number of blue light transfers to the

Dublin hospitals from the Galway, Mayo and Roscommon region in the past available 12-

month period; the break down of the emergency conditions and time of day; and if he will

make a statement on the matter. [24269/11]


Question 149: To ask the Minister for Health the number of number of blue light intra-

hospital transfers in the western region in the past available 12-month period; the break

down of the emergency conditions and time of day; and if he will make a statement on the

matter. [24270/11]


I propose to take Questions Nos. 148 and 149 together.

As these are service matters, they have been referred to the HSE for direct reply.

Does this answer the above question?

Yes! 0 people think so!

No! 1 person thinks not!


Question 150: To ask the Minister for Health the transport service being provided to cancer

patients treated at University Hospital Galway; the cost of this service; if it is available to

all patients; if there is a client contribution; the number of patients availing of this service

in each catchment area and the number of patients who are not availing of this service;

and if he will make a statement on the matter. [24295/11]


The Deputy’s question relates to service delivery matters and accordingly I have asked the

HSE to respond directly to him.

QUESTION NO: 984



* To ask the Minister for Health in view of his commitments to Dáil Éireann on 30 June and 5 July 2011, if he has satisfied himself with the ambulance service provided to the people of County Roscommon; and if he will make a statement on the matter. Denis Naughten T.D. REPLY. The HSE plan implementing the changes to the Emergency Department at Roscommon

County Hospital came into effect on 11 July. This saw the establishment of an Urgent

Care Centre in place of the Emergency Department. People with acute or life threatening

conditions such as heart attacks are being brought by ambulance to larger hospitals, such

as Galway, with higher volumes of patients and better outcomes for such conditions.

The Urgent Care Centre operates from 8am to 8pm, seven days a week and the service is

provided by non-consultant hospital doctors (NCHDs), with clinical governance provided

by an emergency medicine consultant at Galway. As part of the transitional

arrangements, an NCHD was also available at the Urgent Care Centre from 8pm to 8am

for a four week period, supervised by an on call consultant.

An enhanced ambulance service has been put in place. During the day, four ambulances

staffed by paramedics are available, while three are available at night. In addition, there is

a special Rapid Response Vehicle, staffed by advanced paramedics on a twenty four

hour, seven day basis. An out of hours GP service is also in operation. A Medical

Assessment Unit is open from 9am to 5pm, Monday to Friday. This is a medical

admission pathway and accepts referrals from a range of sources, including general

practitioners

I was briefed on the plan by the HSE in advance of its implementation. The plan was

necessitated by the serious patient safety concerns of the HSE and of the Health

Information and Quality Authority in relation to the emergency service at Roscommon,

following the publication of the Authority's Report on Mallow. This was compounded

because of NCHD recruitment difficulties.

Roscommon Hospital has a clear future and will continue to provide key services to the


possible a range of services, close to the local community. The key concern is that they

are safe.

Too often we have focused on what we are taking away rather than what we can add to

services in smaller hospitals. I intend to prepare a framework for the development of

smaller hospitals, which will set out how they will develop to reach their full true

potential. This will specify what services are transferring to them from the larger

hospitals.


reports on Ennis and Mallow Hospitals. When it is implemented, smaller hospitals will

have vibrant roles, doing more work – not less – and meeting as many as possible of the

needs of their local communities.

Thursday, 21 July 2011



All Written Answers on 21 Jul 2011 « Previous answer Next answer »

7:00 pm


Question 624: To ask the Minister for Health if he will publish the baseline figures for the

mortality rates at Roscommon County Hospital; and if he will make a statement on the

matter. [21945/11]

Billy Kelleher (Cork North Central, Fianna Fail)

Question 650: To ask the Minister for Health if he still stands by the mortality figures for

cardiac patients cited by him on 5 July 2011 in relation to Roscommon Hospital the week

prior to the downgrading of services at Roscommon Hospital; and if he will make a

statement on the matter. [22141/11]


Question 651: To ask the Minister for Health the mortality rates for cardiac patients at

Roscommon Hospital cited by him on the 5 July 2011 in Dail Éireann; the way these figures

were compiled; the persons that compiled them; if he will publish figures for all hospitals

around the country; and if he will make a statement on the matter. [22142/11]


Question 652: To ask the Minister for Health the mortality rates for cardiac patients at all

hospitals around the country over the past three years. [22143/11]


Question 653: To ask the Minister for Health the reason figures from the hospital in-patient

inquiry system, compiled for the Health Service Executive by the Economic and Social

Research Institute, show a much lower mortality rate for cardiac patients at Roscommon

Hospital compared to the figures cited by him on the 5 July last; and the figures he will be

applying to other hospitals where patient safety issues have been identified. [22144/11]


I propose to take Questions Nos. 624 and 650 to 653, inclusive, together.

The figures I cited on 5 July referred to 30-day in-hospital mortality rates from Acute

Myocardial Infarction (AMI), otherwise known as heart attack, based on a three year period

from 2008 to 2010. This is an indicator which has been developed by the OECD as part of

its Health Care Quality Indicators (HCQI) project. The data comes from a draft report which

is currently being completed by the Chief Medical Officer’s division within the Department.

This report assesses the potential value of using routinely collected hospital discharge data

derived from the Hospital Inpatient Enquiry (HIPE) system as a means of examining

selected issues on quality of care. It is my intention to publish the report as soon as it has

been finalised.

The reason for the difference in the mortality rates which I referred to and those quoted in

relation to cardiac patients is that they are not measuring the same cohorts of patients. As

indicated, the indicator on AMI in-hospital mortality is an internationally accepted OECD

measure. There is no comparable well-defined indicator of overall mortality from cardiac

conditions. Further, the ESRI, which administers the HIPE system, has not been engaged in

producing hospital-based mortality rates for cardiac patients.

As Minister for Health, I place great value on the use of high quality information in

monitoring the performance of the health system and in informing decision-making. The

HIPE system is our best source of comprehensive, validated data on hospital patients. It

was originally designed to record type and volume of hospital activity, but it is increasingly

important that HIPE be fully and appropriately utilised and enhanced to support robust

quality measurement. The forthcoming report will represent an important contribution to

this objective.

QUESTION NO: 619

DÁIL QUESTION addressed to the Minister for Health (Dr. James

Reilly) by Deputy Denis Naughten

for WRITTEN ANSWER on 21/07/2011

* To ask the Minister for Health the steps which he is taking to fulfill commitments given to the people of Roscommon in Dáil Éireann on 30 June 2011; and if he will make a statement on the matter. - Denis Naughten REPLY. The HSE plan implementing the changes to the Emergency Department at Roscommon

County Hospital came into effect on 11 July. This saw the establishment of an Urgent

Care Centre in place of the Emergency Department. Persons with acute or life threatening

conditions such as heart attacks are being brought by ambulance to larger hospitals, such

as Galway, with higher volumes of patients and better outcomes for such conditions.

The Urgent Care Centre operates from 8am to 8pm seven days a week and is provided by

Non Consultant Hospital Doctors (NCHDs) with clinical governance provided by an

Emergency Medicine Consultant at Galway. As part of the transitional arrangements for a

four week period, an NCHD is also available at the Urgent Care Centre from 8pm to 8am

supervised by an on call consultant.

An enhanced ambulance service has been put in place. During the day four ambulances

staffed by paramedics are available while three are available at night. In addition there is

a special Rapid Response Vehicle, staffed by an Advanced Paramedic on a 24/7 basis. An

out of hours GP service is also in operation. A Medical Assessment Unit is open from

9am to 5pm Monday to Friday. This is a medical admission pathway and accepts

referrals from a range of sources, including General Practioners



Information and Quality Authority in relation to the emergency service at Roscommon

following the publication of the Authority's Report on Mallow. This was compounded

because of NCHD recruitment difficulties.

Roscommon Hospital has a clear future, and will continue to provide key services to the


possible a range of services, close to the local community. The key concern is that they

are safe. I intend to prepare a framework for the development of smaller hospitals, which

will set out how they will develop to reach their full true potential. This will specify what

services are transferring to them, from the larger hospitals. Too often we have focused

on what we are taking away rather than what we can add to services there.


reports on Ennis and Mallow Hospitals. When implemented, smaller hospitals will have

vibrant role, doing more work – not less – and meeting as many as possible of the needs

of their local community.

QUESTION NOS: 297 & 298

DÁIL QUESTIONS addressed to the Minister for Health (Dr. James Reilly)


* To ask the Minister for Health when he approved the Health Service Executive plan for the closure of the accident and emergency department at Roscommon County Hospital; and if he will make a statement on the matter. - Denis Naughten For WRITTEN answer on Wednesday, 20th July, 2011. * To ask the Minister for Health the steps that he is taking to fulfil commitments given to the people of Roscommon in Dáil Éireann on 5 July 2011; and if he will make a statement on the matter. - Denis Naughten For WRITTEN answer on Wednesday, 20th July, 2011. REPLY. The HSE plan implementing the changes to the Accident and Emergency Services at

Roscommon County Hospital came into effect on 11 July. This saw the establishment of

an Urgent Care Centre in place of the Accident and Emergency Department. Persons with

acute or life threatening conditions such as heart attacks are being brought by ambulance

to larger hospitals, such as Galway, with higher volumes of patients and better outcomes

for such conditions.

The Urgent Care Centre operates from 8am to 8pm seven days a week and is provided by

Non Consultant Hospital Doctors (NCHDs) with clinical governance provided by an

Emergency Medicine Consultant at Galway. As part of the transitional arrangements for a

four week period, an NCHD is also available at the Urgent Care Centre from 8pm to 8am

supervised by an on call consultant.

An enhanced ambulance service has been put in place. During the day four ambulances

staffed by paramedics are available while three are available at night. In addition there is

a special Rapid Response Vehicle, staffed by an Advanced Paramedic on a 24/7 basis. An

out of hours GP service is also in operation. A Medical Assessment Unit is open from

9am to 5pm Monday to Friday. This is a medical admission pathway and accepts

referrals from a range of sources, including General Practioners



Information and Quality Authority in relation to the accident and emergency service at

Roscommon following the publication of the Authority's Report on Mallow. This was

compounded because of NCHD recruitment difficulties.

Roscommon Hospital has a clear future, and will continue to provide key services to the

people of the area. I am committed to the expansion of appropriate services like

diagnostics at the hospital. I have asked the HSE to develop proposals in this regard as

quickly as possible.

New ambulance base in Tuam exposes need for West Roscommon

Local TD Denis Naughten has called for immediate action to address the lack of proper ambulance cover in West Roscommon, pointing out that it is now the only area in the West of Ireland which is an ambulance blackspot.

While welcoming the commencement of construction of the ambulance base in Tuam, which will service areas of west Roscommon like Cloonfad and Granlahan as well as North East Galway, Denis Naughten said: “It now exposes the fact that West Roscommon is still without a basic service.

“The new ambulance base in Tuam will form part of the network of ambulance bases in the HSE West region and will have a catchment area broadly within a 15 mile/25 minute radius of Tuam.

“In 2001, as a member of the old Western Health Board, I succeeded in getting the development of an ambulance base in West Roscommon adopted as board policy. However, ten years on little has been done to progress this issue.

“The other two ambulance blackspots identified 10 years ago were Achill and North Galway. While steps have now been put in place to deal with these areas West Roscommon/East Mayo has been put on the long finger.

“Some of the country’s major roads traverse West Roscommon, an area which remains a blackspot for ambulance coverage. It is unbelievable that the N17 route from Sligo to Galway, one of the busiest roads in the HSE western region and just outside West Roscommon, does not have an ambulance station within 20 miles of it.

“Neither Knock Airport on the edges of West Roscommon nor the N5 which runs through the county, have adequate rapidly accessible ambulance cover. This situation cannot and must not continue.

“I understand that proposals are being put forward by the communities in both Ballaghaderreen and Castlerea to facilitate the location of an ambulance base in the area and it is now imperative that immediate action is taken to address this life and death issue. An ambulance base in West Roscommon is essential to improve the response times in emergencies and to provide better geographic coverage. It is an issue that can no longer be ignored,” concluded Denis Naughten.

Speech by Denis Naughten on Topical Issue Motion regarding Roscommon Hospital.

Topical Issue Motion

The need for the Government to reopen Roscommon Urgent Care Centre on a 24/7 basis and to revise ambulance by-pass protocols in light of the chronic overcrowding in adjacent A&E departments.

Speech by Denis Naughten TD on Topical Issue Motion in Dail Eireann re.

Roscommon County Hospital Emergency Department

(check against delivery)

The latest INMO trolley watch figures show that there are 46 patients on trolleys in GUH, 11 in Portiuncula & 9 in Mullingar.

Over the last month all three hospitals have been taken off call for ambulances due to the chaotic situation within their A& E departments.

At the same time Roscommon A&E is operating only as a minor injury clinic on a 12/7 basis.

I want to state categorically that I don’t care what name is over the door of our emergency department; what goes on inside is what is important to me and the people who I represent.

The reopening of Roscommon is one very simple cost effective way to take pressure off the A&Es in Mullingar, Portiuncula & Galway and the over stretched ambulance service.

In practical terms this has a serious impact on patient safety, as was the case with Mary who 3 weeks ago had a mini stroke at 10 o’clock at night. The ambulance was there within 15min and she was brought to Mullingar Hospital. When the ambulance was in Edgeworthstown the paramedic was told that Mullingar was not accepting any more patients and as a result they diverted to Sligo. So after spending 2 hrs in the ambulance, they arrive 3 hours after the stroke in Sligo.

So much for acting “FAST” as the advert advises.

This also tied up an ambulance for at least 3 hours.

Patients such as this lady could be treated safely in Roscommon Hospital with proper protocols put in place.

It is a fact that within just 4 weeks of the closure of Roscommon A&E being deemed “unsafe” due to the lack of adequate medical “supervision”, the Department of Finance approved the roll out of a new nationwide telestroke network service because specialists are keen to improve thrombolysis rates across the country.

This process involves the use of specially designed IT systems that allow specialists, from a remote location, to conduct video consultations and communicate with patients and staff. Evidence shows that such systems improve access to thrombolysis and raise standards in stroke care.

This is the type of system that hospital campaigners in Roscommon have always been looking for, because of our unique geographical situation. A system that would allow patients who have suffered a stroke to attend at our local hospital.

But the reality is safety was never the issue.

Local GPs were told that their heart attack patients would be transferred directly to GUH for access to the CAT lab. They now feel they were lied to as patients are being transferred to Portiuncula Hospital – a hospital which has the same facilities as Roscommon. The only difference is that now, in some instances, patients are waiting in GP surgeries for up to an hour for an ambulance.

Even leaving these specific issues aside, at this point in time we have some of the most highly skilled staff in the country twiddling their thumbs, while chaos reigns in other A&E departments. Where is the sense? There is a need to review ambulance and hospital by pass protocols.

For example, why does someone who requires 2 stitches, and who is picked up by an ambulance, have to pass the front door of Roscommon hospital and travel 40 min up the road & in all likelihood wait for hours instead of being dropped at Roscommon Emergency Department?

Why have over 300 children with minor injuries been forced to travel in pain for an additional hour, because staff have been instructed to turn them away at the door; even though, with the exact same staffing, they could be safely treated just a few months ago?

While we can dispute whether 4% of patients who were treated at Roscommon A&E could get better care somewhere else; can you not let common sense prevail and allow the other 96% of patients who were attending to continue to be safely treated at Roscommon Hospital and not have to risk the Russian roulette of our so called regional “centre of excellence”?

Topical Issue Motion

Bowel cancer screening programme for Roscommon postponed – Naughten

The bowel cancer screening programme due to commence next January and which included Roscommon County Hospital as a centre for the service has been postponed for at least six months, local TD Denis Naughten has stated.

“Last July when the Government closed our A&E we were promised that Roscommon County Hospital would become a centre of excellence for bowel cancer screening. The service was to be developed ‘within weeks’ and would be fully operational by the beginning of 2012. However, the screening programme has now been delayed by at least six months,” said Deputy Naughten.

“In the interim there are nearly 2,500 people waiting on colonoscopies in hospitals around the country, while at the same time Roscommon County Hospital has theatres and surgeons with virtually nothing to do.

“To compound the problem for Roscommon Hospital it is facing a budget cut of €1.5m between now and the end of the year, which will effectively see existing services wound down.

“This is just not good enough. The Health Minister said that he could not deliver on pre-election commitments because of HIQA. Now, promises that were made as recently as last July are also being reneged upon.

“We need to see investment at Roscommon Hospital and we need it now in order to retain the existing staff and their valuable skills. If they are lost to Roscommon, they will be very difficult to replace,” concluded Denis Naughten.

One additional paramedic not good enough – Naughten

The disclosure by the HSE that only one additional advanced paramedic has been appointed to the ambulance service following the closure of the A&E department at Roscommon County Hospital has been described as totally unacceptable by Denis Naughten TD.

“At the time of the closure of Roscommon County Hospital both the HSE and Department of Health gave clear commitments to provide a first class ambulance service with a rapid response vehicle with fully trained paramedics who could treat people at the scene of an accident.

“We now find that this is not the case as the rapid response vehicle is only manned by an advanced paramedic on occasions, depending on availability.

“The current situation runs contrary to the statements given by Health Minister James Reilly, whose survival rates for road accidents were based on having advanced paramedics at the scene of an accident as soon as possible.

“The fact remains that the people of Roscommon want their 24/7 emergency services at Roscommon Hospital reinstated but that does not mean that the HSE can get away with putting in half an ambulance service instead of the one that was promised,” concluded Denis Naughten.

Government must provide clear timetable on Hospital investment– Naughten

25th July 2011

Local TD, Denis Naughten is calling on the Government to provide a clear timetable for their proposed investment at Roscommon County Hospital.

Responding to questions from Deputy Naughten at the Dáil Health Committee last week, Minister James Reilly said “The future of Roscommon is a priority for me and this Government and I want it to be an exemplar of what can be achieved”.

Responding to the Health Ministers comments, Denis Naughten said “if the future of the hospital itself is to be protected then the people of Roscommon need to see HIQA approved services begin to move from Galway to Roscommon at the same speed the HSE moved to close our A & E”.

“Within the last month, as part of my negotiations with the HSE & Department of Health, Minister Reilly gave me a number of commitments on his plans for investment of in excess of €2m at Roscommon Hospital”.

“If the Government is serious about investing in the hospital, then we need to see the detailed plans for additional diagnostics and screening, including colorectal cancer screening, including the necessary capital investment”.

“Such a proposal must be published immediately with a detailed timetable of when each phase will be implemented, if the plan is to have any credibility”

“It is important to point out that while the proposed capital investment, would be warmly welcomed and will be of direct benefit to the staff & the local economy , is not a replacement for the removal of a 24/7 emergency service” concluded Denis Naughten

QUESTION NO: 177



* To ask the Minister for Health further to Parliamentary Question No. 484 of 20 September 2011, if he will furnish an accurate table clearly indicating the location of APs; if he is satisfied with the fact that the west has the lowest level of APs to qualify in the next two years; and if he will make a statement on the matter. - Denis Naughten REPLY. The number of advanced paramedics (APs) who have completed their training and the numbers due to qualify in January 2012 and July 2012 are as outlined to the Deputy in reply to his previous Parliamentary Question. Candidates entering the advanced paramedic programme agree to work anywhere within an operational area. In order to ensure maximum flexibility in their deployment, on successful completion of the two year course candidates are not permanently assigned to specific ambulance stations, but are assigned to wherever they are required at a particular time. The average cost of training an AP is €127,000 and the skill level that they attain makes them extremely valuable resources in pre-hospital emergency care. Accordingly, it is essential to have the most flexible use possible through dynamic deployment, to ensure maximum availability to patients. Roscommon is a prime example, with a number of APs have been deployed to the greater area to operate a Rapid Response Vehicle twenty four hours a day. Given the investment involved, it is essential that suitable candidates are nominated for what is a very onerous course, hence the need for a robust selection process. The National Ambulance Service assures me that it makes every effort to distribute course places across the country based on service needs and available candidates. However, there is more interest among staff in some areas of the country than in others to compete for a place in the national selection process. In September 2011, for the first time in a number of years the National Ambulance Service was able to fill all 44 available places on the two courses per year.

QUESTION NO: 484



* To ask the Minister for Health the number of advanced paramedics who completed their training course in August 2011; the locations to which they were deployed; the numbers due to qualify in January 2012 and July 2012 ; the number enrolled in the course that has just commenced; the numbers that qualified from the last four courses; the locations to which they were deployed; and if he will make a statement on the matter. Denis Naughten T.D. REPLY. Nineteen advanced paramedics (APs) completed their training course in July 2011,

including three students from previous courses who sat the undergraduate internship and

assessment. These APs have been deployed to the following locations.

• 1 to the South East

• 6 to the South

• 1 to the West

• 3 to the North West

• 3 to Dublin ire Brigade

• 2 to the East

• 1 to the Midlands

• 2 to the North East

A further 42 APs are due to qualify in January and July next year

The attached table details the numbers and locations of APs who have qualified in the

past and students who are currently training in the National Ambulance Service College.

It is important to note that candidates who successfully complete the first year of the course and exams are then required to undergo a post graduate internship of one year before being fully qualified as APs.

QUESTION NOS: 71, 59, 45, 85 & 46

DÁIL QUESTIONS addressed to the Minister for Health (Dr. James Reilly)

by Deputies for ORAL ANSWER on 08/11/2011

45. To ask the Minister for Health if he will put in place an emergency plan for hospitals to accommodate the predictable surge in activity that occurs every winter; and if he will make a statement on the matter. - Caoimhghín Ó Caoláin For ORAL answer on Tuesday, 8th November, 2011. 46. To ask the Minister for Health when the recommendations of the special delivery unit in the accident and emergency department in the Midwestern Regional Hospital, Limerick, will be implemented; and if he will make a statement on the matter. - Willie O'Dea For ORAL answer on Tuesday, 8th November, 2011. 59. To ask the Minister for Health the steps he is taking to address the overcrowding crisis at Galway University Hospital; and if he will make a statement on the matter. - Denis Naughten For ORAL answer on Tuesday, 8th November, 2011. 71. To ask the Minister for Health if his attention has been drawn to the overcrowding which occurred at the accident and emergency department of National University of Ireland Galway Hospital on the 24 September; if his further attention has been drawn to the fact that the hospital was forced to appeal to the public, via local radio stations' news bulletins, not to bring emergency cases to the accident and emergency department of NUIG hospital on 24 of September; his views that this overcrowding is unacceptable and a danger to health and that the extra burden placed on the accident and emergency at NUIG hospital is in part due to its vastly increased catchment area due to the closure of Roscommon County Hospital accident and emergency ward; and if he will make a statement on the matter. - Luke 'Ming' Flanagan

For ORAL answer on Tuesday, 8th November, 2011. Details Supplied: at one point there were 34 people awaiting admission via the A&E dept. and the hospital appealed to the public to bring their casualty cases to their GPs instead 85. To ask the Minister for Health if he will urgently address the critical situation in hospitals in the North-East region, including record numbers of patients on trolleys in Our Lady of Lourdes Hospital, Drogheda, this autumn; and if he will make a statement on the matter. - Gerry Adams For ORAL answer on Tuesday, 8th November, 2011. REPLY. I have said very clearly on many occasions that the situation in our hospital emergency

departments where people must wait for unacceptably long periods on trolleys will not

be allowed to continue. For this reason, as I have already outlined to the House today,

one of my first actions as Minister for Health was to set about establishing the Special

Delivery Unit.

The problems in our emergency departments are complex and they did not arise

overnight. The particular issues vary from hospital to hospital and some of the solutions

will depend on local factors. Delayed discharge, for example, is an issue in some parts of

the country but not others. However, a common factor is the need for reliable real time

information, agreed standards for safe care and relentless performance management

against those standards.

Following considerable analysis of the problems in individual hospitals, I recently

approved an initiative whereby funding will be made available to ease pressures in

certain emergency departments. The supports being funded are dependent on certain

conditions and the money will be released based on specific performance. The supports

may involve providing funding for smaller hospitals in the group to ease pressures on the

major centre. As I have frequently said, I want to ensure that as many services as

possible can be provided safely in smaller, local hospitals.

In the case of Our Lady Of Lourdes Drogheda, the hospital has requested a range of

supports and the SDU has agreed to a set of proposals which will cost over €700,000

between now and the end of this year. Over €300,000 is being made available to Galway

University Hospital. The SDU has indicated to me that considerable improvements can

be made at Limerick hospital within existing budgets and I have requested the HSE to

implement these changes. These include some reallocation of existing staffing resources,

a better bed management system and the shifting of day case capacity to other hospitals

in the group. The issue of further support for Limerick is under consideration by the

SDU.

The HSE has indicated that the impact of the ED changes introduced at Roscommon

County Hospital in July 2011 has been marginal. The figures for the three month period

to end of October indicate an increase of 127 patients at Galway during this period which

is equivalent to 10 additional patients per week (or less than two a day).

Peaks and troughs are a feature of attendances at emergency departments. The SDU is

working with hospitals to use the data on attendance patterns to plan for the variations

which will inevitably occur. At my behest, the SDU is driving this approach to radically

reduce the overcrowding in our emergency departments which has been tolerated for far

too long.

PQ No: 33397/11 QUESTION NO: 394

To ask the Minister for Defence further to Parliamentary Question No. 372 of 2 November, the base for each of the three field ambulances in the Western Brigade; the number of standard ambulances available to the Defence Forces; the location of each; his plans to purchase additional standard vehicles; and if he will make a statement on the matter.

DEPUTY DENIS NAUGHTEN

FOR WRITTEN ANSWER ON TUESDAY, 8th NOVEMBER, 2011.

REPLY

Minister for Defence (Mr. Alan Shatter, T.D.): The three field ambulances in the Western

Brigade are located as follows:

Finner Camp, County Donegal 1 x Ambulance

Custume Barracks, Athlone, Co. Westmeath 2 x Ambulances

In addition to the fleet of eleven field ambulances, eleven standard ambulances are

currently in service with the Defence Forces.

The standard ambulances are located in the following Barracks/Bases:

Location Standard

Ambulances

St. Bricins Hospital, Dublin 2

Defence Forces Training Centre, Curragh Camp, County Kildare

2

12th Infantry Battalion, Sarsfield Barracks, Limerick

1

3rd Infantry Battalion, Stephens Barracks, Kilkenny

1

Training Installation, Kilworth Camp, County Cork

1

Medical Company, Collins Barracks, Cork

1

Medical Company, Custume Barracks, Athlone, County Westmeath

1

Air Corps, Baldonnel, County Dublin

1

Naval Base, Haulbowline, County Cork

1

Total 11

There are no plans at this time to purchase any additional standard ambulances.

progress report on rosscommon hospital

Documents

roscommon hospital

acute hospitals

mallow hospitals

larger hospitals

roscommon county hospital

range of services

key services

galway university hospital