Dundalk obstetrician-gynaecologist post
The Deputy pressed for an urgent appointment, citing unsafe gaps in obstetric cover and women travelling to Newry. The Minister described approval and funding obstacles, said he would not sanction appointments without full costings, and agreed to check birth figures; a supplementary also asked why the current surgeon did not perform procedures previously carried out by his predecessor.
asked the Minister for Health if he will sanction the appointment of an obstetrician-gynaecologist at Dundalk County Hospital, County Louth, as a matter of urgency.
Comment on this
The North-Eastern Health Board have sought a meeting with Comhairle na nOspidéal, which have the statutory function of regulating the number and type of consultant medical appointments in hospitals, to discuss the appointment of an obstetrician-gynaecologist to the County Hospital, Dundalk.
The health board has also recently sought funding from my Department for this post. A letter has issued to the board drawing attention to the new procedures to be followed in respect of applications by health agencies for sanctioning of posts falling within the ambit of the Comhairle. The new procedures, which were set out in a letter of 8 March 1983, from my Department to health agencies, involve the completion by the health agency concerned of a form indicating the total costs to which the post will give rise and the extent to which these costs can be met by redeployment of existing resources. When this information is received my Department will indicate the funding possibilities to the health agency and the Department's response should be included in any application to Comhairle na nOspidéal. These new procedures have been arranged to meet difficulties posed by the current financial situation.
The North-Eastern Health Board have also been informed that pending agreement on the funding of the Dundalk post and the approval of Comhairle na nOspidéal no steps should be taken to fill the post.
Comment on this
Is the Minister aware that there is a unique situation in Dundalk County Hospital? The county physician is expected to act as obstetrician-gynaecologist in 1983. He is not qualified to carry out such procedures as caesarian sections, and he is obliged to call on the county surgeon to carry out those procedures for him. The county surgeon who did that down through the years resigned and the new county surgeon does not carry out these procedures. The county physician is in an impossible position, and so are the patients. I am sure the Minister is aware that at Dundalk County Hospital there were 700 deliveries——
Comment on this
Is the Minister aware that there were 700 deliveries in Dundalk County Hospital last year and that a number of women from the town and the surrounding districts are going to Newry?
Comment on this
In view of the serious situation which exists, does the Minister accept that his reply is putting the matter on the long finger?
Comment on this
There are 14 maternity beds in Dundalk County Hospital and obstetrics services are provided by the physician at the hospital as the Deputy indicated. In 1981 the number of births was 500. I have not got the figure readily available for 1982. I will accept the Deputy's figure of 700 and have it checked. An advertisement for a locum obstetrician-gynaecologist in the Dundalk hospital appeared in the Irish Independent of 13 April last. The CEO decided to advertise the post without waiting for Comhairle approval, and without having the Department's agreement on funding.
We had no option but to inform the CEO that the filling of the post should not be proceeded with until Comhairle approval is obtained and until funding is agreed with the Department in accordance with the new procedures. I am not indicating that we will not reach agreement, but I am adamant that the new procedures will have to be adhered to. It is not just a question of appointing a consultant. It is a question of costing the additional back-up staff and all the other arrangements on a revenue basis. When that is available we will make a decision.
Comment on this
Does the Minister accept that the problem is between the Department of Health and the Comhairle and that the CEO recognised the responsibility of the health board when the advertisement for a locum obstetrician-gynaecologist in the interests of the patients in the hospital? Is the Minister aware that the health board received a letter from the Comhairle stating that they were waiting for the Department of Health to decide on the future of the maternity unit in Dundalk before making any recommendation on the matter? Does he also accept that a certain amount of confusion has arisen as a result of his own action in changing the role of the Comhairle?
Comment on this
At the moment I have applications for 79 separate consultant appointments on my desk. We have not got the money. These posts are throughout the country. Each can vary in terms of current revenue from £50,000 to £500,000 per annum. On 28 January last my Department had detailed discussions with representatives of the North-Eastern Health Board on maternity developments in the area. I can assure the Deputy that we are very conscious of the situation in Drogheda and in Navan. I will do my utmost. Our projection of births is around 6,400 per annum. We have done a detailed study on the needs of Dundalk and Navan.
Comment on this
One final supplementary. Will the Minister sanction the appointment of a locum obstetrician-gynaecologist because of the unique situation in Dundalk?
Comment on this
As of now, putting it crudely to the Deputy, I am sanctioning nothing until I have full details of the costings of every single appointment.
Comment on this
I have no wish to intrude on somebody else's question, but has the Minister any information on why the previous surgeon carried out certain work which the current surgeon does not?