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Adjournment Debate. - Navan (Meath) Orthopaedic Services.

Wednesday, 8 May 1996

Dáil Éireann Debate
Vol. 465 No. 1

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[319]Mr. Hilliard: Information on Colm M. Hilliard Zoom on Colm M. Hilliard I thank the Minister for his attendance. For more than 20 years Our Lady's Hospital, Navan, County Meath has been recognised as the orthopaedic services centre for the North Eastern Health Board area. The Minister is aware that its record of service is second to none. It appears that there has been a change of policy, however, as the hospital has been waiting a year or more for the appointment of an orthopaedic surgeon to replace a retired person. It also appears that there is an embargo against such an appointment. Will the Minister immediately investigate this urgent matter? Four new consultants, including one orthopaedic surgeon, have been or are being appointed to Our Lady of Lourdes Hospital, Drogheda. One must assume that this represents a clear U-turn in policy as it means a division of services and a possible future winding down of the orthopaedic service at Navan hospital.

The orthopaedic service at Our Lady's Hospital, Navan is well below its quota of surgical personnel at consultant level. I am pleased with the new capital development in recent years at the hospital. Regrettably, however, this has not been matched by increased orthopaedic surgical consultant personnel and staff. It is obvious that there is concern among the existing professional staff with regard to the future policy for the development of the orthopaedic service at Navan hospital. It appears that the North Eastern Health Board has not been fully advised in this regard. The Minister should clarify this matter as soon as possible.

In 1992, the then Minister for Health, former Deputy O'Connell, informed me that the important orthopaedic role played by Our Lady's Hospital, Navan was greatly appreciated. He assured me there was no question of weakening the hospital's services, particularly the orthopaedic service. I appeal to the current Minister to give the same assurance to the consultants, staff and patients of the orthopaedic unit at Our Lady's [320] Hospital, Navan, that these services will remain as the sole orthopaedic service for the region.

The advantages of having one unit based at Navan hospital include the fact that an experienced staff is already in place. Six surgeons would work together on one site and a pooling of expertise, consultation and cross-referral would occur as a result. The existence of one unit would also mean better value for money as there would be fewer consultant travelling expenses, etc., and it would be more cost effective to have one set of staff — consultants, nursing and junior doctors — on one site. Another advantage would be having one consultant on emergency call for the region, with a one in six rota meaning that no locum would be required. Other advantages include the fact that orthopaedic theatres and dedicated nursing staff are already in place and qualified junior staff would be attracted to one site. Finally, more acute orthopaedic beds would be required in Navan hospital and hand/foot surgery could be encouraged at that centre. This would lead to a strengthening of general surgery and medical back-up.

In conclusion, I recommend that the Minister keep the acute orthopaedic unit in Navan hospital with six consultants to lead the service. The expertise of existing staff should be built upon.

Mr. Noonan: Information on Michael Noonan Zoom on Michael Noonan (Limerick East): I thank Deputy Hilliard for giving me the opportunity to clarify the position with regard to the provision of orthopaedic services in the North Eastern Health Board region.

In 1993 the North Eastern Health Board adopted the policy outlined in the report A New Direction for Acute Hospital Services. Under this policy, hospitals in the area no longer act as individual units but have become component parts of a regional service. In line with this policy, the board established two hospital groupings, the Cavan/Monaghan group and the Louth/Meath group. Our Lady's [321] Hospital, Navan forms part of the Louth/Meath group.

The question of the provision and development of services at individual hospitals is a matter for the health board in the first instance. However, I am aware that the board is in the process of developing a comprehensive policy on orthopaedic and trauma services for the region. The regional elective orthopaedic unit for the north east is based at Our Lady's Hospital, Navan. The majority of elective orthopaedic patients within the region are treated at this unit and it provides a high quality service to the people of the north east. There are currently four orthopaedic surgeons working from the unit, one of whom is retired but continues to provide a service at the hospital. In recent weeks my Department approved this replacement post and it is now a matter for the board to make an application for this post to Comhairle na nOspidéal, the statutory body charged with responsibility for the regulation of consultant appointments. Applications for additional consultant orthopaedic posts have also been received in my Department from the board and they are being examined in the context of the board's overall policy for acute hospital service development.

The Deputy will wish to know that in the past three years, the board has been successful in participating in an orthopaedic waiting list initiative which has significantly reduced the waiting list time for in-patient care. A further initiative is planned for this year.

I reiterate my Department's support for the board's policy for the development of acute hospital services. Over the past two years my Department has made substantial capital and revenue funding available for this purpose. In all, a total of 21 new and replacement consultant posts have been approved for the region, ten of whom are in respect of the Louth-Meath hospital group. I am satisfied that this substantial investment by my Department will enable each of the board's hospitals to continue [322] to play a key role in the delivery of acute hospital services within the region.

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