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Cuts at Monaghan General Hospital will be resisted – Ó Caoláin

22 April, 2008


Speaking in the Dáil this evening on a private members motion on neurology services Sinn Féin Health Spokesperson Caoimhghín Ó Caoláin TD described the plan strip Monaghan Hospital of acute inpatient care as a death threat and warned that it will be resisted.

Deputy Ó Caoláin said, "I fully support this motion and welcome its identification of the devastating effects of current HSE cutbacks and its focus in particular on the massive gaps in the provision of neurology services in this State.

"The motion speaks at the outset of the impact of cuts and staff shortages on patients in general. Before coming to the main substance of the motion I have to put on record here the outrage that is growing daily throughout the country at the cutbacks being imposed by the HSE and at their policy of destroying the services provided at local hospitals.

"Yesterday I revealed the internal HSE plan to impose a sentence of death on Monaghan General Hospital and a sentence of hard labour on Cavan General Hospital. Under this Taoiseach and this Minister for Health the HSE plans to close 50 acute inpatient beds and 6 critical care beds in Monaghan by the end of November. In one fell stroke Monaghan will be denied the ability to care for 3,000 acute inpatient admissions per annum. Those admissions will have to be dealt with by Cavan which already has 5,000 inpatient admissions per annum and 160% bed occupancy. And this is to be done without one single extra bed being provided in Cavan.

"The HSE's plan is fraudulent in the extreme. It claims that the net loss of 56 hospital beds in Cavan and Monaghan and the North East region will be compensated for by greater provision of non-acute care, rehab, step-down beds, respite care and so on. But these are the very services that are being slashed by the HSE in its current wave of cutbacks. It is closing a 12-bed respite unit in St. Oliver's Hospital in Dundalk. That is replicated across the country, notably the 12 respite beds being cut in Cherry Orchard Hospital in Dublin.

"I warn the Minister and her colleagues that the death threat to Monaghan General Hospital will be resisted. We will not allow a hospital that has served our community for generations to be destroyed by this Government. You can be sure that this is not the last you will be hearing of this." ENDS

Full text of Deputy Ó Caoláin's speech follows:

I fully support this motion and welcome its identification of the devastating effects of current HSE cutbacks and its focus in particular on the massive gaps in the provision of neurology services in this State.

The motion speaks at the outset of the impact of cuts and staff shortages on patients in general. Before coming to the main substance of the motion I have to put on record here the outrage that is growing daily throughout the country at the cutbacks being imposed by the HSE and at their policy of destroying the services provided at local hospitals.

Yesterday I revealed the internal HSE plan to impose a sentence of death on Monaghan General Hospital and a sentence of hard labour on Cavan General Hospital. Under this Taoiseach and this Minister for Health the HSE plans to close 50 acute inpatient beds and 6 critical care beds in Monaghan by the end of November. In one fell stroke Monaghan will be denied the ability to care for 3,000 acute inpatient admissions per annum. Those admissions will have to be dealt with by Cavan which already has 5,000 inpatient admissions per annum and 160% bed occupancy. And this is to be done without one single extra bed being provided in Cavan.

The HSE's plan is fraudulent in the extreme. It claims that the net loss of 56 hospital beds in Cavan and Monaghan and the North East region will be compensated for by greater provision of non-acute care, rehab, step-down beds, respite care and so on. But these are the very services that are being slashed by the HSE in its current wave of cutbacks. It is closing a 12-bed respite unit in St. Oliver's Hospital in Dundalk. That is replicated across the country, notably the 12 respite beds being cut in Cherry Orchard Hospital in Dublin.

I warn the Minister and her colleagues that the death threat to Monaghan General Hospital will be resisted. We will not allow a hospital that has served our community for generations to be destroyed by this Government. You can be sure that this is not the last you will be hearing of this.

Turning to the main substance of the motion I commend the Labour deputies for highlighting neurological needs.

The huge gaps in the provision of Neurological services in Ireland were identified by an expert panel, together with the Neurological Association of Ireland, in three Standards of Care documents, published between 1999 and 2002 and a series of far reaching recommendations were generated.

These identified a number of problems in relation to Neurological services including:

- Long waiting times for initial diagnosis and follow up due to a chronic shortage of neurologists

-Lack of resources for provision of multidisciplinary care needed by those with Neurological conditions, palliative and respite care and co-ordinated follow-up in the community

- Problems in accessing transport, healthcare, employment and information about their condition for those with Neurological conditions

The documents make a series of recommendations which focus on changes in the health sector to meet the needs of those with Neurological conditions, as well as the wider issues of access to information, support, employment, and transport.

As the motion makes clear the progress on these vital recommendations has been minimal.

In January 2006 after an inquest on a woman who died during an operation in Beaumont Hospital's neurosurgery centre, Prof Ciarán Bolger, head of research and development in neurosurgery at Beaumont and head of clinical neurosurgery at the Royal College of Surgeons in Dublin, spoke out. He said there were about 200 patients throughout the country are on an urgent waiting list for a bed at the national neurosurgery centre in Beaumont.

The condition of 10 of those patients was life-threatening, said. He said the computer guide system in the operating theatre had broken down during five of the last six neurosurgery procedures which he had carried out in Beaumont. While this made the operations more difficult, the procedures had to continue.

"Various other machines used in the clinic also regularly break down," said Prof Bolger. There has been no increase in the number of neurosurgeons working in the health service in 25 years, despite a dramatic increase in the population. Fewer neurosurgery operating slots are available nowadays than 25 years ago.

In 2006 there were 1,000 non-urgent patients are on a waiting list for a bed at the neurosurgery centre.

Cork University Hospital is the only other hospital in the State with a neurosurgery department, but it is limited by staffing and medical equipment in what it can do.

"The national neurosurgery service is a mess," Prof Bolger said. "We have nine neurosurgeon consultants in Ireland, six in Beaumont and three in Cork.

"For our population we should have 16, in line with the UK, which has the lowest in Europe. By US and continental Europe standards, we should have 20 to 30."

Repeated promises to improve neurosurgery services have been broken. Meanwhile what is happening at Beaumont itself? Priority is being given to making space for one of this Government's precious private for-profit hospitals. The long-promised psychiatric unit at Beaumont is again to be deferred because the private hospital is going on the site earmarked for this vital facility.

This motion identifies one area of pressing need in healthcare. The real pain and hardship caused by this Government's failures in health are again exposed. I say shame on them and I join in the demand for justice for patients requiring neurological services in this State.

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