Waiting Lists – Statement in the Dáil 09 February 2017
Seamus Healy TD:
The recent “RTE Investigates” programme told us what we have all known for many years. The nation was rightly shocked. It put the human face of pain and suffering on the figures. The public has been misled. The term “alternative facts” comes to mind. The public is entitled to, must be told and know the truth. The long waiting lists are the result of cuts to services by successive governments, for example, 2,000 beds have been taken out of the system, there is overcrowding in accident and emergency departments, posts are not filled and there is a moratorium on posts. I have been raising these issues for some time.
I recently raised the issue of the urology waiting list at University Hospital Waterford. A letter received by one of my constituents puts the case very plainly:
We are writing to inform you that you have been placed on … waiting list. We will forward you an appointment in due course.
You have been prioritised as: URGENT.
You should expect to be seen within 48+ months.
If you have any queries please do not hesitate to contact us.
The constituent must wait more than four years. The reply from the HSE and the Minister, which I received only yesterday, confirms that there is a major problem at University Hospital Waterford. It states, “The clinical risk for the Urology Services is on the Corporate Risk Register and is rated high risk.” The management at the hospital has applied for additional resources, two consultant urologists, support staff and funding to provide a proper service to the hospital. Those resources have not been provided. Will the Minister provide those resources not just for University Hospital Waterford but for all those from the south east, including Tipperary, using the services at the hospital?
In view of the fact that the urology outpatient waiting list at Waterford University Hospital is now 48-plus months, I asked Minister for Health Simon Harris what proposals he has to rectify the situation. He has referred my question to the HSE for reply. I will continue to follow up and keep you updated.
I welcome the opportunity to speak to and support the motion. A Vision for Change, published in 2006, is a template for a community-based progressive and modern mental health system. The policy emphasises provision of a mental health system based on community services and supports provided by community-based multi-disciplinary teams with a significantly reduced need for inpatient services. Ten years later, there is a crisis in our mental health services arising from and compounded by the abject failure to fund, resource, staff and implement the A Vision for Change policy. The Government failed in budget 2017 to address the resource issues needed for mental health services. In July of this year, the Department of Health stated that €35.4 million per year over the next five years was needed to implement A Vision for Change. Despite that, only €15 million was provided; a shortfall, therefore, of €20 million.
The mental health services in my own constituency of Tipperary are a good example of the malaise in which the services are at both a local and national level. Despite the best efforts of staff, the service is dysfunctional. In 2010, then Fianna Fáil Minister of State, John Moloney, decided to close the county’s inpatient services at St. Michael’s unit in Clonmel. His successor, then Labour Party Minister of State, Kathleen Lynch, implemented that closure, despite the opposition of service users, carers, doctors, nursing staff and the public generally. South Tipperary inpatients were sent to Kilkenny and north Tipperary inpatients were sent to Ennis. That was done in 2012. The Minister of State sold the closure on the basis of a promise, quid pro quo, of a Rolls-Royce community-based service.
Three years later, we have the worst of all worlds. We have no inpatient service, community services are under-staffed, under-resourced and under-funded, and community-based teams are struggling to provide a safe service. They are deficient of staff across all categories of nursing, medical and paramedic staff. We have no 24-7 service. The new crisis house promised has not materialised. Patients are assessed in wholly unsuitable, busy and overcrowded accident and emergency departments with no privacy or confidentiality. The inpatient services in Kilkenny and Ennis are regularly overcrowded, there is difficulty in gaining admission and very often inappropriate early discharge. There is the proposed closure of the unit at Mount Sion in Tipperary town. The situation is wholly unacceptable. I call on the Minister of State to immediately implement A Vision for Change in Tipperary, including the provision of 24-7 services, the recruiting of additional nursing, medical and paramedic staff for our multi-disciplinary teams, the re-opening of the inpatient unit at St. Michael’s in Clonmel and a commitment to keep the Mount Sion unit open.
I acknowledge the excellent work being done by various voluntary organisations in the area of mental health locally.
I acknowledge organisations such as the consumer mental health panels, C-SAW suicide awareness group, the River Suir Suicide Patrol, Taxi Watch, the Wellness Recovery Action Plan support group and the Carrick-on-Suir River Rescue organisation among many others. I call on the Minister of State, Deputy McEntee, as a matter of urgency, to meet with a deputation from County Tipperary about the mental health services in the county.
I appeal to the Minister of State and the HSE to continue the funding of the five steps to living well with dementia project in south Tipperary. In 2012, south Tipperary received funding to develop a new and innovative dementia project for a three-year period. The project was jointly funded by Atlantic Philanthropies and the HSE through the Genio trust. It is time to put the funding for the project and services on a permanent basis. A core principle of the project and the services in south Tipperary is to provide flexible, person-centred care in the home and allow people to remain at home for as long as possible. The project has been a great success. It has already transformed the life experience of many people with dementia and their families in south Tipperary and is an ideal template for the national dementia strategy. Crucially, the development of the services included dementia sufferers, their carers, the Alzheimer Society of Ireland, the Carers Association, Muintir na Tíre, the South Tipperary Community and Voluntary Forum, GPs and representatives of the HSE. I acknowledge the vital input of people such as Dr. Caitríona Crowe, consultant in the psychiatry of old age, and Professor Eamon O’Shea of NUI Galway.
It is a five step programme, the key elements of which include a media campaign. The campaign was to raise awareness among the public about dementia, dispel myths and reduce stigma. There was buy-in to the programme by all the local media such as local radio stations, including Tipp FM, Tipp Mid West Radio and the print media. A community connector was appointed to liaise with organisations across the county and raise awareness in general about dementia and in particular about the services and supports available. Volunteers were largely provided by the Carers Association.
The single most important element of the programme was establishing a single point of contact to ensure people could access the information, supports and services they needed. The appointment of dementia support workers was also important. These people support people with dementia in their homes and ensure they can live at home for as long as possible and delay the need for long-term care. A further development at South Tipperary General Hospital is the memory technology library which provides a large range of assistive technology products to support people with memory loss. The programme in south Tipperary has been significant and successful and I compliment all those involved. I again ask the Minister of State to put permanent funding in place to continue it.
Speaking in the Dáil regarding Mental Health Services
I welcome the opportunity to speak on this motion and to indicate my support for it. A Vision for Change, launched in 2006, was a template for a community-based, progressive and modern mental health care system. Today, ten years later, there is a crisis in our mental health services arising from, and compounded by, the failure to implement the policy set out in A Vision for Change.
The mental health services in my constituency of Tipperary are a case in point and highlight the malaise in the service currently, both locally and nationally. Despite the best efforts of staff, the service is dysfunctional. The Minister of State’s predecessor, the former Labour Party Minister of State, Kathleen Lynch, closed the inpatient unit at South Tipperary General Hospital, St. Michael’s unit, and transferred south Tipperary patients to Kilkenny and north Tipperary patients to Ennis. That was in 2012. She sold that closure on the basis of a promised quid pro quo that we would have a Rolls-Royce community-based service.
Three years later we have the worst of all worlds. We have no inpatient service, a issue to which I will return, and our community services are understaffed, under-resourced and underfunded. Our community-based teams, multidisciplinary teams supposedly, are struggling to provide a safe service. They are deficient in terms of staff numbers across all categories – nursing, medical and paramedical staff members. The promised provision of a crisis house has not materialised. The inpatient service has been transferred to Kilkenny for people from south Tipperary and to Ennis for people from north Tipperary. That means assessments of patients have to take place in a busy overcrowded accident and emergency department with no privacy or confidentiality. The unit in Kilkenny is overcrowded regularly, there is difficulty gaining admission, and if one gains admission, there is the practice of early discharge. The situation is completely unacceptable.
I call on the Minister of State to implement A Vision for Change immediately, including the 24/7 services, to recruit additional nursing, medical and paramedical staff for the multidisciplinary teams and to reopen St. Michael’s unit in Tipperary. I acknowledge the work done by the various voluntary organisations in this area, the community consumer mental health panels, the C-Saw suicide awareness group and others, and thank them for it.
South Tipperary General Hospital
Statement by Seamus Healy TD 087-2802199 Chairperson Save Our Acute Hospital Services Committee
The decision by the Minister for Health to approve the commencement of the procurement process for additional beds at South Tipperary General Hospital is another success for the Save Our Acute Hospital Services Committee.
The Committee, embracing all stakeholders, has been pursuing this project for some time. It is a decision which was expected and one that is very welcome.
As chairperson of the Committee, I want to thank all those who worked together on this issue, including the general public, hospital patients and their families, hospital staff and their representatives, the media, especially the Nationalist newspaper and Tipp FM radio, hospital management and local and national Public Representatives
These hotel type beds are, of course, only an interim and partial solution to the continuing crisis at the hospital. The delivery of these beds and the crucial future development of permanent beds, new wards and upgraded facilities will require a continued united effort to deliver for the people of the County.
The Hospital Committee policy over the last 8 years of inclusivity and united effort of the public, patients, staff, hospital management the media and people of all political persuasions and none has been particularly successful.
I want to appeal to all concerned to put aside any personal or political differences and to continue to work together for the future of hospital services in County Tipperary.
The early delivery of the additional beds will require a hugely concentrated effort and commitment and the dovetailing of a number of processes including procurement, planning, building, fitting-out and staffing. It is vital that this be done with the greatest possible haste.
Other measures are also necessary to address the overcrowding crisis at the hospital.
· Full time Community Intervention Teams
· Additional Home Care Packages
· Reversal of the cuts to Home Help hours
· Additional Step-down Beds
The Save our Acute Hospital Services Committee sees the commencement of the promised Phase 2 development at the hospital as both urgent and vitally important. It has raised this issue on an ongoing basis with HSE officials and previous Ministers for Health including Minister Varadkar.
Minister Harris must now instruct the HSE to complete a Development Control Plan for the Hospital and commit Capital Funds to the hospital in Budget 2017.
The Development Control Plan should detail Phase 2 developments at the hospital, including new medical, maternity, paediatric and acute psychiatry inpatient wards, together with support facilities and services.
The closure of St Michael’s Unit and the transfer of acute in-patient psychiatric beds to Kilkenny and Ennis has been nothing short of disastrous and these beds must be returned to South Tipp General Hospital in the short term.
The Committee will be raising these issues directly with the minister on his visit to the hospital on the 1st of October next
Seamus Healy TD
Chairperson of the Save our Acute Hospital Services Committee 087-2802199