Irish hospitals 1956-1971

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Authors Hospitals' Trust (1940) Ltd

Publisher Hospitals' Trust (1940) Ltd

Download date 07/10/2021 04:20:23

Link to Item http://hdl.handle.net/10147/316723

Find this and similar works at - http://www.lenus.ie/hse SLIGO COUNTY HOSPITAL (Photograph by Brian Leech) Irish Hospitals 1956 ·1971

Irish Hospitals 1956 - 1971

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Hospitals' Trust (1940) Lid:,.t ~allsbridge, Dublin 4. It is very difficult to do justice in a few words to the multi·various achievements of a man of the calibre and ability of the late Joseph McGrath.

A Dublin man, in the best traditions of Dublin men, his name is popularly associated with the Irish Hospitals' Sweepstakes. His enterprise in helping to start them, the effort he put into administering them, and to raising them to their present pinnacle of achievement are widely known outside as well as in Ireland. It is a simple fact that without his efforts the medical and hospital scene in Ireland would be infinitely poorer in quality and scope and far less prestigious internationally.

The Irish Hospitals' Sweepstakes were only one facet of his activities. Mr. McGrath was a revolutionary who endured personal risk, privation and prison in his country's cause. Member of Parliament, Cabinet Minister, successful industrialist and business man (he it was who revived the craft of Waterford Glass), doyen of the Irish horse breeding, training and racing industry-there is material for a volume for any writer in each of these aspects of his life. Mr. McGrath was very much part of the rebirth of this nalion and he contributed in no small measure to its growth and development. If I were to try in one brief comment to appraise his worth to Ireland I think I would do so in the terms that all he set out to do he did with the best interests, in practical terms, of the Irish people in his kindly and generous heart.

Erskine Childers, T.D. Tanaiste and Minister for Health Joseph McGrath. First Chairman and Managing Director FOREWORD

In 1956, in a publication entitled "Irish Hospitals 1930-1955", an account was given 01 the development 01 hospitals in Ireland, with particular emphasis on the allocation 01 the funds raised by Hospitals' Trust (1940) Ltd. We leel that the time has come to give a lurther account 01 the application of Hospitals' Trust grants and the improvement and growth of Irish hospitals during the intervening years.

Up to 1956, Hospitals' Trust contributed over thirty·five and a half million pounds to the building and maintenance of Irish hospitals. Since then it has added a further fifty·six million pounds-a total of ninety·one million pounds. It is due In no small way to Sweep­ stakes grants that modern medical facilities and up·ta-date hospitals have been made available which otherwise the country could not afford. The following pages will give some picture of the vast benefits which these contributions have helped to make possible.

Hospitals' Trust has won a place for itself in the everyday life of the Irish people. It is one of the largest employers of female labour and earners of foreign currency. It has helped to spread the name of Ireland to some countries where it was scarcely heard of before.

To be concerned with an undertaking such as Hospitals' Trust and, more so, the people who have made it possible by their daily contribution to the success of this wonderful work is indeed a privilege. We look forward to its continuation and further success.

CHAIRMAN AND MANAGING DIRECTOR, HOSPITALS' TRUST (1940) LTD. Patrick W. McGrath, Chairman and Managing Director of Hospitals' Trust (1940) Ltd., Member of co-ordinating and executive committees of the Irish Sweeps Derby. I .,i;'~ ~.- , eee ;.: .f- e, e,. if.

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R. J. Duggan, Capt. Spencer Freeman, C.B.E., Original Director. Original Director. , , REAMHRA

1956, I bhfollseachan dar teldeal "Irish Hospitals 1930·1955", tugadh cuntas ar fhorbalrt na nospldeal In ~Irlnn, agus go hBlrlthe ar dhallhi an alrgld a chrulnnlgh lontaobhas na nOspldeal (1940) Teo. Measalmld go bhfuil se In am a thullleadh eolals a thabhalrt ar an gcuma Inar balneadh usald as deontals 6 lontaobhas na nOspldeaf agus ar fheabhsu agus fas ospldeal na h~lreann I ~caltheamh na trelmhse 6n am sin I lelth.

Suas go dtf 1956, thug lontaobhas na nOspldeal breis agus trfocha dig go lelth mllllun punt le haghaldh t6gail agus cothabhail ospldeal na h~lreann. On am sin I lelth ta caoga a se milllun punt eile tugtha alge-sln n6cha a haon mllliun punt ar fad. Is do dheontals crannchuir ata m6ran dB bhulochas ag dui go bhfull saoraidl lIachta nua-almslre agus ospldell urnua curtha ar fall nach mbeadh se d'acmhalnn ag an tlr a sholathar da n·ulreasa. Gheotar Jeargas eJgin sna leathanalgh seD leanas ar na sochalr 0llmh6ra ata curtha ar lall le cabhalr na ndeontas alrgld sin.

Ta cilt agus tabhacht saothralthe ag lontaobhas na nOspldeal d6 rein I ngnathshaol mhulntlr na h~ireann. Ta se ar cheann de na gn6thais Is m6 a Ihostalonn mna agus Is m6 a thullleann alrgead coigrfche. Chabhralgh se le hainm na h~ireann a chur I gceln, flu go tlortha nar alrlodh tracht ulrthl roimhe sin ach ar elgln.

Is prlbhJeld go delmhln bhelth I mbalnt le gn6thas mar lontaobhas na nOspldeal agus, thalris sin, lels na daolne a rlnne a gclon laethuil oibre lonas gur thcilnlg barr agus toradh ar an saothar lantairbheach seo. Gura fada buan e faol bhua agus rath.

CATHAOIRLEACH AGUS STIORTHOIR-BHAINISTEOIR, IONTAOBHAS NA nOSPID~AL (1940) TTA,

9 OUR LADY OF LOURDES HOSPITAL, DROGHEDA. This up-to-date hospital Is run by the Medical Missionaries of Mary and has special training facilities for the treatment of tropical diseases.

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THE SUCCESS OF THE IRISH HOSPITALS' SWEEPSTAKES

Were it not for the launching 01 the Irish Hospitals' Sweepstakes In the year 1930, It Is certaJn that many of the voluntary hospitals In Ireland would have been forced through lack of funds to curtail their activities or face extinction. It Is also true that the vast capital Improvements carried out In both the voluntary and local authority hospitals over the past forty years could not have been carried out to the extent achieved without the aid of the funds derived from the Sweepstakes.

Here In Ireland, as In other countries, the voluntary hospitals faced unprecedented financial difficulties in the years following World War I (1914·1918) when sources of Income by way of charitable donations, benefit functions and bequests had greatly diminished, while at the same time maintenance costs had been progressively rising. The annual deficits of the voluntary hospitals had, Indeed, reached such alarming proportions that many of them were 'aclng bankruptcy. In that period, too, bOth the voluntary and the local authority hospital systems were In serious need of modernisation alter long years of financial stringency.

The Immediacy of their deficit position led six of the Dublin voluntary hospitals to combine In the year 1930 for the purpose o. running a Sweepstake to raJse money to clear their debts. The organising work was entrusted to Hospitals' Trust Limited. The Initial venture proved a remarkable success and an additional seventeen hospitals Joined In sponsorIng the second Sweepstake. Then a further eleven hospitals {making 34 In all} Joined In promoting the third Sweepstake. Inside one year these three Sweepstakes had resulted In the distribution of over one and a quarter million pounds among the participating voluntary hospitals. Not only were the hospitals saved from the prospect of bankruptcy, but they could look forward with confidence to the completion of sorely·needed structural Improvements and the purchase o. up-tCHiate equipment and appliances.

In 1931 the Government passed legislation which decreed that the proceeds of future Sweepstakes should be divided as to two-thirds .or the voluntary hospitals and one-third for the local authority hospitals. The allocation of grants to the voluntary hospitals was entrusted to a Committee of Reference appointed for the purpose while the distribution of I grants to the local authority hospitals was left to the MInister for Health. Very many of these I ~ latter hospitals had, prIor to the establishment of the State, sufl·ered from long years of neglect. In 1933 another Public Hosplta.ls Act was passed under which the available surpluses of ensuIng Sweepstakes would be payable Into the Hospitals Trust Fund under the control of Trustees and the Hospitals CommIssion was set up to report to the Minister 'or Health on applications for grants from the Fund. That system Is stili operating. I 11 :.1"I !I ,11 I'il! q ;1/':1,

:i'." I! For the next five years the Irish Hospitals Sweepstakes continued to command widespread and Increasing support not only In Ireland but In many other countries, especially In those lands where members 01 our lar·flung race had settled. However, during World War " (1939·1945) the limitations Imposed on the distribution of tickets naturally caused a diminution 01 the proceeds. Despite these difficulties the Sweepstake scheme maintaJned a fair measure of support and the hospitals benefited accordingly. It Is worthy 01 mention here that during the war years Hospitals' Trust Ltd. also organised ten Sweepstakes for the benefit of the Red Cross and out 01 their proceeds help was given to deserving causes In 98 countries through the medium of the Irish Red Cross Society and Its International associates.

When the war ended In 1945, the Irish Hospitals' Sweepstakes were able to advance again on a wider basis. They obtained renewed support In many countries Inaccessible during the hostilities and were thus enabled to resume Increased aid to the hospitals. The need lor this aid was, Indeed, greate·r than ever before because of the enormous increase (more than twenty·lold) In the annual maintenance deficits of the voluntary hospitals and because of the general rfse In the costs of building construction and equipment. The tables given on pages 66·76 show how widely distributed among hospitals and other Institutions were the grants from the Hospitals' Trust Fund. The magnitude of the grants Is Indicated In the amount of the grand total of £85,000,000 for the period 1930 to 1969.

Until the year 1970, It had been the practice to organise three Sweepstakes each year but because 01 the Increasing demand on .the resources of the Hospitals' Trust Fund it was decided to run a fourth Hospitals' Sweepstake In 1970 and to aim at continuing to do so In succeeding years. The Initial venture proved successlul. In 1971 a further Incentive to participants In the Sweepstakes was Introduced when, In addition to the usual aHractlve prizes, a special one 01 £200,000 for the lirst ticket drawn from the drum was offered. The winning of the first of these special prizes by a ticket holder In Canada was given widespread publicity. The Indications are that so generous an extra prize will be a popular attraction for all future participants in the Sweepstakes.

There Is general recognition of the enormous benefits derived from the Sweepstakes by the hospitals, as well as by other such activities as Medical Research, Hospital Libraries, District Nursing Service, etc. It Is not so widely appreciated that the organisation controlled by Hospitals' Trust Ltd. gives employment to a large staff many of whom through widowhood, physical Infirmity or advancing years would otherwise have found It extremely difficult to obtain work.

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The drawing of the counterfoils from the Drum Is open to the public and to the press. It Is under the supervision of the Commissioner of Police and a Superintendent of that force is always In attendance. Winning counterfoils drawn by a panel of nurses from Dublin hospitals are handed to the Superintendent who hands them to the Public Auditors and the winning numbers are called out. Lucky winners are notified by telegram at once.

In his foreword to "Ireland's Hospitals: 1930·1955", the late Joseph McGrath, Managing Director, Hospitals' Trust Ltd., wrote: "We claim to have faithfully executed the task entrusted to us." It was a simple claim, modestly expressed, but no truer tribute could be paid to Joseph McGrath's memory. His was the decisive leadership, his the ceaseless efficiency and his the prescience In the selection and control of staff who helped him to . execute the task of organising the Irish Hospitals' Sweepstakes so that their success In providing funds for the Irish hospitals Is now universally acknowledged and acclaimed.

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13 THE DEVELOPMENT OF HOSPITAL SERVICES IN DUBLIN By T. Fagan, Senior Executive Officer, Eastern Health Board

At the date of the last Census (1966), the population of Dublin City and County had risen to 795,047, I.e. an addition of 70,000 In the decade from 1956. There are proposals to hold another Census thIs year and the Interim signs IndIcate a growth In population to well over 800,000. As thIs figure represents over one-third of the total population of the State, It follows that (apart from hIstoric reasons) Dublin must of necessity provIde comprehensive medIcal and hospital services on a broad basIs to cater for so large a populatIon. HIstorIc reasons also call for faCilities In the hospital field to servIce quite a proportion of the rest of the country, where In some areas hospital beds are at a premium and specialist services non­ existent.

In this context of providing In-patient and out-patient services, an examination of the last "Return of Statistics of ParticIpating Voluntary Hospitals" Issued by the Hospitals Commission shows that of a total of 7,520 beds there were 5,640 beds or 75% provided In the Dublin Voluntary Hospitals. The same Return shows aHendances at out-patient clinIcs to have been 2,105,666, of whIch Dublin accounted for 1,659,417, or over 78%. It should, of course, be : noted that to these services should be added another 7,000 available beds (IncludIng -,I psychiatric) and over 47,000 aHendances at specIalist clinics In hospitals administered by the Dublin Health Authority. '

ORIGIN OF THE DUBLIN VOLUNTARY HOSPITALS

Historically In Ireland (as In Great BritaIn), It was the religIous houses which mainly provided care for the sick. The suppresson of the monasteries {n the reign of King Henry VIII (1509- 1547) put an end to that situation and only haphazard provision for the housIng and care of the sick was made in the succeeding years. It was not until the end of the 17th century and the beginning of the 18th that some practical aHentlon was given to the plight Of. the sick poor who up to then had literally nowhere to go. In 1703 legislation was enacted seHlng up the present St. Kevin's Hospital In James's Street, Dublin, as a Foundling Hospital and Workhouse. Succeeding years saw some further central government Interest In hospital­ ising the sick poor but basically IIHle more than shelter and maintenance were provided by the County Infirmaries which were set up In addition to Workhouses. It was not until 1923 that the terms Workhouses and County Infirmaries were replaced by those of County Hospitals, District Hospitals and County Homes under the control of local authorities.

Reverting to the position In Dublin In the early part of the 17th century, It Is of Interest to recall that this was the period which saw the establishment of Voluntary Hospitals as we

14 know them today; except, of course, that in those early days no State funds were made avail· able to them. Jervls Street Hospital was opened In 1718, Dr. Steevens' Hospital In 1733 and Mercer's Hospital In 1734. A number of other city hospitals were opened later In that century. Perhaps the most notable of these was St. Patrlck's Mental Hospital founded In 1746 with the aid of moneys left by Dean Swift who had earlier wrlHen In a poem relating to his own death the following IInes:- "He gave the IiHle wealth he had To build a house for fools and mad, And showed by one satiric touch No nation wanted It so much." In 1745 the world· renowned Rotunda Maternity Hospital was founded, to be followed in , I 1753 by the Meath Hospital which now occupies a site which was formerly Dean Swift's I garden. Arthur Guinness, founder of the brewery firm, was the first Treasurer of the Meath Hospital. SWEEPSTAKE LEGISLATION Whereas the County Infirmaries and Workhouses were financed by taxation (State and local), the Voluntary Hospitals had to depend on donations and legacies received from charitably· disposed private Individuals and on fund raising activities of various klnds--concerts, dances, etc. The political and economic upheavals of the following centuries materially reduced the flow of such moneys with the result that the Voluntary Hospitals were always functioning In 3 state of financial stringency. They were hard pressed to meet running costs which perforce had to be kept at a bare minimum and even then some of them were bordering on bank· ruptcy. Funds were urgentiy needed If they were to remain open for the admission and treat· ment of patients. The question of obtaining money for capital purposes (structural develop· ment and new appliances and equipment) was not even considered as the possibility of receiving It appeared to be too remote. At this Juncture of grave financial crisis for the Voluntary Hospitals' came the proposal to establish the Irish Hospital Sweepstakes which were legalised under the terms of the Public Charitable Hospitals (temporary Provisions) Act, 1930. Subsequent legislation broadened the spheres of activity of the Sweepstakes Scheme. In all, the phenomenal total of over £90 million was collected by Hospitals Trust for Irish hospitals In the period 1930·1970. OTHER FINANCIAL AID FOR HOSPITALS Despite the enormous help given by the Sweepstake Funds to the hospitals, expenditure on the running costs of hospitals Increased so largely that other measures of financial aid had to be Introduced If the hospital service was to keep abreast of modern diagnostic techniques, the employment of paramedical aides, Improvement In the remuneration of staffs, etc. The Health Services (Financial Provisions) Act of 1947 and the Health Act of 1953 both In their respectlveilpheres helped the voluntary and local authority hospitals.

15 The effect of the 1947 Act was that 50% of the health expenditure of local authorities was met out of central government funds and since then certain other supplementary grants have been added. The 1953 Act, insofar as the voluntary hospitals were concerned, .authorlsed a sub­ stantial increase in the daily capitation rate payable by health authorities on behalf of eligible Health Act patients treated In voluntary hospitals. This daily capitation rate has been pro­ gressively Increased since 1953 to the current rate of 85/- per day (£4.05 In the new decimal currency) for patients In the Teaching Hospitals and somewhat less for those In other hospi­ pltals. By this measure, the acute situation In regard to the maintenance deficits of the voluntary hospitals has been considerably relieved. The current 1971/1972 estimates of the Dublin Health Authority for payments in respect of eligible patients in the voluntary hospitals amount to over £4 million. Further legislation In 1957 also helped the hospitals financially when In that year the Volu?tary Health Insurance Board was set up and gave persons (espe­ cially those in the middle Income group) the opportunity of insuring against In-patient and specialist services expenses. This insurance scheme has proven of inestimable value not alone to hospital finances but also to the 15% of our population not eligible for services under the terms of the 1953 Act.

CAPITAL WORKS IN VOLUNTARY HOSPITALS As an indication of the tangible benefits (apart from deficit grants) derived by the Dublin voluntary hospitals from the distribution of Sweepstake Funds between the years 1956 and 1969, the following capital works either carried out or In the course of completion may be cited. The Royal City of Dublin Hospital, Baggot Street, got a new Cardio-Pulmonary Unit; Sir Patrick Dun's Hospital a new Pathology Laboratoryj a new magnificent 455 bed Teaching Hospital has been opened at Elm Park, replacing the old St. Vincent's Hospital at St. Stephen's Green. The famous Coombe Maternity Hospital was re-sited and now has 144 maternity, 58 gynaecological and 51 paediatric beds. Jervis Street Hospital got a new Operat­ ing Theatre Suite and a Drug Addiction Unit. Of major Importance in Jervis Street is the work done on renal dialysis. The former T.B. hospital of Our Lady of Lourdes, Dun Laoghaire, was adapted and extended to provide a National Rehabilitation and Limb-fitting Centre, whilst a new Central Remedial Clinic was opened In Clontarf. The specialist Cancer Hospital of St. Luke's received grants to enable Cobalt and Isotope Units to be provided. A 50 bed extension has been added to the National Maternity Hospital In Holies Street. This hospital, founded In 1894, was replaced in 1936 on its original site by an all-electric hospital and was the first new hospital built In Dublin since 1904 to that date. Many other additions and renovations, as well as Installations of appliances and equipment, have been made with the aid of Sweepstake Funds in the Dublin voluntary hospitals but are too numerous to mention In detail.

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CAPITAL WORKS IN LOCAL AUTHORITY HOSPITALS

It must not be overlooked that the local authority hospitals in Dublin also benefited substan­ t
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y from Sweepstake Funds. The old workhouse look has disappeared completely from SI. Kevln's Hospital and It Is now a modern general hospital of over 1,200 beds. Many major capital works were completed at St. Kevin's In recent years, e.g. a new Paediatric Unit costing over £17,000; a new boiler house supplying steam, hot water and heat to the hospital and laundry, completed at a cost of £140,000; and very recently a magnificent staH restaurant together with an elaborate new kitchen, opened In 1970. An Important Innovation at SI. Kevln's was the opening there In 1967 of a Nurses' Training School which now caters for I approximately 144 student nurses. Current capital works In the same hospital comprise a new , i Day Hospital, a new Psychiatric Unit and an extension to the Maternity Department. In the : I I I old St. Brendan's Mental Hospital, structural and building operations have given the hospital a modern look In consonance with the recognised importance of environment in psychiatric 11 treatment. In this hospital new Teaching and Assessment Units have been built at a cost of over £60,000 whilst a new 78 bed unit for geriatric patients has been provided at a cost of over £115,000. At SI. Ita's Mental Hospital In Portrane a new Female Nurses' Home was built whilst St. Loman's Hospital at Palmerstown (formerly a T.B. Hospital) has been adapted and renovated to cater for female psychiatric patients and severely emotionally disturbed children.

SPECIALIST CENTRES

As mentioned earlier, Dublin houses most of the specialist centres providing a national service. To those already listed can be added SI. Laurence's Hospital for neuro-surgery, the Meath Hospital for genito-urinary disorders and the Mater Hospital for heart surgery. There are also, apart from Our Lady of Lourdes Hospital, Dun Laoghaire, rehabilitation centres at SI. Anthony's, Herbert Avenue and at SI. Joseph's Unit of Our Lady's Hospice, Harold's Cross. The headquarters of many national associations are also In Dublin, e.g. The Mass Radio­ graphy Board, The National Blood Transfusion Board, The Joint Hospital Services Board, The Medlco-Soclal Research Board, etc. There are over 20 Teaching Hospitals In Dublin and with Medical Schools attached to the two Dublin Universities and the College of Surgeons, the city may be said to provide ample facilities for the pursuit of the academic and practical careers of Its doctors and nurses. In the field of medical research, many of the more Impor­ tant units are sited In Dublin hosDltals.

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TRAINING OF PARA-MEDICAL PERSONNEL

Dublin provides the national centres for the training and qualification of para· medical person. nel. Courses for Physiotherapists are organised by the Dublin School of Physiotherapy, Hume Street and by the Mater Misericordlae Hospital In conjunction with the two Dublin Universl· ties. A specialised course of training for Radiographers Is directed In association with the Radiography Department of St. Vincent's Hospital. At the National Rehabilitation Centre, our Lady of Lourdes Hospital, Dun Laoghaire, there has been established In recent years a train· Ing school for Occupational Therapists. Degree Courses in Social Science In the two Dublin Universities qualify those who subsequently take up posts as Almoners In the hospitals. Catering Officers and Dieticians receive their training at the College of Domestic Economy, Cathal Brugha Street. Laboratory Technicians obtain the necessary academic and practl· cal education In our Vocational Colleges and after in· hospital training qualify In this field. The Institute of Hospital Administrators, founded In 1945, runs diploma courses in association with the College of Management, Rathmines, for the training of hospital administrators and most of our city hospital secretaries and administrative personnel are members of the Institute.

GROUPING OF HOSPITALS AND REGIONALlSATION

Investigation of our hospital services and recommendations for their progressive Improvement are being continuously pursued. Perhaps the two most noteworthy documents to have resul· ted from such Investigations are the Fitzgerald Report on the Outline of the Future Hospital Services and the Health Act, 1970. The Fitzgerald Report recommends for Dublin the estab· lishment of two major hospital groups having at least 1,000 beds each with a comprehensive range of medicine and surgery for a community service. The highly specialised and complex work for Dublin and its region Is to be concentrated In these centres together with certain national services. Each of the two major groups will have associated with It at least one general hospital of 300/500 beds. Other Dublin hospitals Including the Special Hospitals will have associations with the major groups. In the field of local authority administration, the 1970 Health Act will from the first day of April, 1971, divide the country Into eight Health Regions, each In charge of a Chief Executive Officer who will be assisted by a team of Programme Managers and Functional Officers in co·ordlnating the health services of the areas. Three Regional Hospital Boards are being set up and will be charged with "the General organisation. and development of hospital services In an efficient and satisfactory manner In the hospitals administered by the Health Boards and other bodies in its functional area which are engaged In the provision of services under the Act." The Dublin Regional

18 Hospital Board, comprising the Eastern Health Board, the Midland Health Board, the North. Eastern Health Board and the South· Eastern Health Board, will cater for an estimated popu­ lation of 1,650,000

It may, with confidence, be claimed that the existing Dublin hospital services Clln compare favourably with the best available In other cities and that they are conUnuing to develop In line with modern thought and procedures. The cost involved In their progressive develop. ment will naturally put an increasing strain on the available finances and will, therefore, require the continued financial assistance from the Hospital Sweepstake Scheme which has been so effectively provided over the past forty years. That the hospital services In Dublin today are so effiCiently organised and financed, must in great measure be aHrlbuted to the vision and ability of the founders of the Hospitals' Sweepstakes.

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DR. STEEVENS' HOSPITAL. Founded In 1733 by Grlzel, the sister of Dr. Richard Steevens with money from his estate and built around a graceful courtyard. This is the oldest public hospital in Ireland.

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RECENT HOSPITAL DEVELOPMENTS IN IRELAND by Joseph A. Robins

Hospital Development 1941·1965 The shortage of essential materials caused by the advent of the Second World War, had by 1941, put an end to further large scale hospital development. Many proJects then under way were completed with difficulty; others which were yet In the planning stage were abandoned or pigeon -holed until the world returned to peace. In the meantime the Department of Local Government and Public Health undertook the planning of three large-scale regional sanatoria which, In the light of the mortality rate for tuberculosis, were then regarded as the major priority. In 1947 the setting up of a separate Department of Health added Impetus to the plans for extending accommodation for the tubercular and led to the preparation of a short­ term programme of hospital development generally. It was an ambitious and far-reaching programme which aimed to provide over 1.2,000 new hospital beds of various categories representing a net addition to existing beds of over 9,000. It marked, too, the advent of a new principle Into the Irish hospital system, namely the provision of regional hospitals, catering for patients from more than one county and generally providing services of a more specialised or expensive nature than the existing county Institutions. .

By 1960 about two thirds of the projects Included In the programme had been completed at J ( \'Jl.) ~f;~t(\ a cost to the sweepstakes funds of about £25,000,000. Not all the projects originally planned ) '!{ ~ ''', t f I had materialised, for the Inflationary trend of the post-war years led to sharply Increasing J~f ()+... ~ building costs which quickly absorbed the large amount of sweepstake funds accumulated f during the Inactive war years. The Government found It necessary to support the sweepstakes fI-o"'f I ~A"""''-Y' fund with grants-In-aid from the Exchequer and during the 1960s It was possible to .resume C:1-l.-~iL ~ Iq$) {l- the planning of various projects which had earlier been postponed. Many of these projects _ p' , have now been completed together with new works, particularly those In relation to mental ~

hospitals, mental handicap Institutions and homes for the aged and Infirm, which had been 11 added to the Department's earlier building programme. Altogether the amount spent between 1948 and 1970 In capital works on hospitals and Institutions was £50 million of which £27.5 million came from the Hospitals Trust Fund, £12 million from Exchequer grantS-In-aid and the rest from borrowing.

Developments In Hospital Policy since 1965 The year 1965 may be taken as roughly marking the beginning of a period of hospital develop­ ment In Ireland. Many of the projects which have come to fruition since then had their origins In the previous period, among the most noteworthy being the new 455-bed St. Vincent's

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I I Hospital at Elm Park, Dublin and the new 265 -bed Coombe Maternity Hospital also in Dublin. Rapidly advancing medical technology and new approaches towards the care of some categories of patients have made It necessary to look critically at long established arrange­ ments for caring for the Ill. During the last five years a series of reports by specially constitu­ ted bodies have made recommendations which have, In general, been accepted by the Government and policy in relation to the future development of hospitals and Institutions Is based on the views of these expert bodies.

General Hospital Services The general hospital services are by far the most expensive element of the health services and their cost has been rapidly Increasing. In November, 1967, the Minister for Health established a consultative council of eighteen prominent doctors, all actively associated with these services to advise him on how the general hospital system might be most effectively re-organised.

Re-organisation of Hospital System The Council recommended the re-organisation of the hospital system into three regions based on the medical teaching centres Dublin, Cork and Galway. There would be two kinds of acute care hospital (a) the Regional Hospital and (b) the General Hospital. Associated '..' with these would be a system of Community Health Centres and District Nursing Homes which would provide a limited range of In-patient services not requiring the supervision of a specialist as well as a fairly wide range of out-patient clinics. Two Regional Hospitals were proposed for Dublin and one each for Cork and Galway. Depending on the population to be served it was recommended that these regional hospitals should have a minimum of 600 beds and, as well as providing the usual range of general hospital services for their Imme­ diate area, they would provide certain highly specialised services for the region. The Council proposed twelve General Hospitals located at centres which would ensure reasonable acces· sibility to their services for all parts of the country.

The basic services of these hospitals would be general medicine, general surgery, obstetrics, gynaecology, pathology and radiology. Some other speclalties might be InCluded In a number of them. Minimum consultant staffing In these hospitals would be two pathologists, two radiologists, three physicians, three surgeons, two obstet­ rician-gynaecologists and three anaesthetists.

The recommendations of the Council have been accepted In prinCiple by the Government and the future development of the general hospital system will, in general, be based on them. The Regional Hospital proposed for Cork, which was already being planned by a special

22 body set up some years ago for the purpose, by the Minister for Health, will be put to tender next year. In Galway a Regional Hospital of the dimensions recommended by the report will be achieved by the amalgamation of the two existing regional Institutions In that city. In Dublin, talks are proceeding with the various hospital interests about the suggested develop· ments there. The full Implementation of all these proposals will, however, require a substantial amount of capital funds which means that the realisation of the new system must be a long term 'undertaking.

Institutions for the Mentally III and Mentally Handicapped The needs of the mentally III and the mentally handicapped have been the subject of a very searching examination by two special commissions which have reported to the Minister for Health.

In 1966 the Commission of Inquiry on Mental Illness made a very comprehensive report on all aspects of the care of mentally III persons. Some of its main recommendations related to the future development of hospital care for these patients. Emphasising the need to Integrate closely psychiatry with general medicine, the Commission recommended the provision of short·term residential treatment in specially organised units at general hospitals or In close association with them. It also recommended improved services for mentally III persons needing care In the existing long·term mental hospitals.

While It was satisfied that Increased emphasis on active treatment and on community care would lead to a very significant decline In accommodation for persons receiving In·patlent care In long·term hospitals, the Commission recommended substantial Improvements to these Institutions to provide facilities of up·to·date standard. The establishment of special units was also proposed. Some of these will be Industrial therapy units and sheltered workshops to provide a means of helping patients to return to their normal livelihood. Others will provide for psychiatric children, for disturbed adolescents, for alcoholics and for drug addicts and psychopaths.

The Implementation of the recommendations of the Commission began a few years ago and will continue to be developed In the coming years. The tables In the appendix to this book give an indication of the substantial amounts which have been provided from sweepstake funds towards Improvements In the mental hospitals throughout the country. Noteworthy features of the projects which have been completed are the new short·term admission units at Clonmel, CastJebar and SI. Brendan's Hospital, Dublin. Plans are well advanced for new units to be associated with the major general hospitals in Cork, Limerick and Galway.

23 I ','

Mentally Handicapped The needs of the mentally handicapped have also been the object of special attention In recent years. A special commission which reported to the Minister for Health In 1965 made comprehensive proposals In relation to the early diagnosis and subsequent treatment of mental handicap. It also found a need for further accommodation for handicapped persons In addition to that already provided or planned. Schemes nOw in progress or In planning will provide 1,500 additional places and bring total accommodation up to 5,600 places. Further schemes during the next ten years will include special units such as sheltered workshops, accommodation for delinquent boys who are mentally handicapped and hostels for adults living In community. Existing residential homes will be upgraded and staff accommodation Improved.

Homes for the Aged In 1951 the Government undertook to make grants available to local authorities by way of contribution to loan charges on monies borrowed for the purpose of carrying out renovations at homes for the aged and Infirm. In the Intervening years Improvement schemes have been completed or have been undertaken at various Institutions throughout the country at an esti­ mated expenditure of well over £4,000,000. In the meantime a special Inter-departmental committee has reported (1968) to the Minister for Health on all aspects of the problem of the care of the aged. While the Committee based Its recommendations on the belief that It Is more desirable to help the aged to live In the communJty than to provide for them In hospitals or homes, It accepted as unavoidable the need to provide for some of them In Institutions. Its proposals envisaged a comprehensiVe assessment of the needs and Infirmities of every old person seeking Institutional care. He would then be admitted to either (1) a general hospital or (2) a short-term assessment and rehabilitation unit or (3) a long-stay hospital unit or (4) a welfare home. These recommendations are now being implemented and the building of the first group of welfare homes Is about to commence at Bray, Carlow, Dungarvan, Mldleton, Monaghan, Nenagh and Roscrea. They will be small Institutions, providing 30 or 40 places In a homely atmosphere under the care of a matron with nursing qualifications. The welfare homes In the course of planning or about to commence and further proJected Improvements at homes for the old and Infirm will cost altogether about £3,5QO,000.

Centralised Hospital Services In 1965 the Minister for Health established a special corporate body to organIse and operate on a national basis a centralised service of sterile goods for use In hospitals. Later the new body, the Hospitals Joint Services Board, had Its terms of reference broadened and It was requested by the Minister also to undertake the provision of a laundrj' and linen sel'Ylce for hospitals In the Dublin area.

24 The Board initiated Its sterile goods service In November, 1966, based on premises at the Dublin Industrial Estate at Finglas Road, Dublin. Plans for the extension of the premises to allow the expansion of the sterile goods service and the establishment of a laundry had to be shelved when planning permission was refused. Subsequently the Board obtained a site at Holylands, Rathfarnham and the building of a new sterile centre and laundry has Just been completed there. The cost of building and equipping the premises will be close to £1 million and will be met from the Hospitals Trust Fund.

Changes In Health Administration Recently Important changes have taken place In the administration of the health service In Ireland which will help to facilitate the developments In the hospital system referred to earlier. As from 1 April, 1971, responsibility for the operation of the health services has been taken over from the twenty· seven health authorities and seven Joint mental health boards by eight health boards each responsible for a group of counties. The boards consist of rep­ resentatives of the local authorities In their areas; of the medical, nursing, pharmaceutical and dental professions, and of a number of Ministerial nominees In each instance. The boards will be responsible for the provision of all local health services, and hospitals and other Institutions owned by the former health authorities have been transferred to them, and their day-to-day administration has been entrusted 0 them.

Health Act 1970 The Health Act, 1970, which empowered the seHlng up of the health boards also provided for the establishment of three regional hospital boards and of a central body, Comhalrle na nOspldeal (the Hospitals Council). The regional hospital boards would have responsibility for the general organisation and development (but not the administration) of hospital services In their areas whilst the central body would control the number and type of speCialist appoint­ ments In all hospitals, both health board and voluntary. The statutory provision for these bodies arises from recommendations made In the report of the Consultative Council on the General Hospital Services to which earlier reference has been made. The underlying aim of these bodies will be to bring about an Integrated and efficient hospital system and to avoid the unnecessary duplication of specialist services. At the time of writing discussions were being held with Interested authorities about the detailed functions and composition of the proposed bodies.

25 DEVELOPMENT OF HOSPITAL SERVICES IN RURAL IRELAND

By E. Hannan, Chlel executive Officer, Western Health Board

The many social, economic and medical changes which have occurred In Ireland In the past quarter 01 a century, especially In the rural areas, have led to a reappraisal 01 the hospitalisation needs and 01 the services required to meet them. The preventive measures which resulted largely In lhe eradication 01 levers and tuberculosis made possible the conversion 01 Fever Hospitals Into District Hospitals. Sanatoria In the main are now lunctlonlng as general acute hospitals or as Institutions lor the care 01 geriatric or psychiatric patients. The drllt Irom the land to urban employment, common In most countries, had worse ellects In rural Ireland owing to the limited opportunities lor work In Industry and the consequent widespread emigration to Britain and the United States 01 America.

REFORM OF HOSPITAL SERVICES There were other lactors which contributed to the lormulatlon 01 plans to reform the health and hospital services, apart Irom the lact that the big reduction In the density 01 population In rural Ireland made obvious the anomaly 01 ha~lng such a multiplicity 01 hospitals serving a population 01 less than three millions. Dealing with acute medical and surgical cases and maternity patients there were 169 hospitals alone. It could not be possible to provide the up-to-date expensive diagnostic, operative and treatment equipment, which the modern hospital service demands, In all those hospitals 01 varying sizes. Neither could the specialist medical and nursing stalls, as well as the laboratory, radiographic and physio­ therapy, etc., stalls be recruited on so large and diverse a scale. On the other hand, ambulance lacllltles (Including helicopters In cases 01 emergency) can now ensure the rapid transport 01 patients requiring speCialist treatment to the main hospital centres. The time had therelore arrived lor a more rational organisation 01 the hospital services as a whole.

THE HEALTH ACT" The enabling legislation lor the reglonallsatlon 01 the country's health services, operative as Irom 1st April, 1971, Is the 1970 Health Act. Its prinCipal provisions provide lor the replacement 01 twenty-seven Health Authorities by eight Health Boards. The membership 01 these Boards comprises elected members selected by County CouncilS, representatives 01 the medical, nursing and para-medical prolesslons and three nominees 01 the Minister 101

26 Health on each Board, the laHin being persons experienced In some aspect of community· social services or public administration. A number 01 the representatives 01 prolesslons on the Boards are employees 01 the Boards, which Is a leature Introduced In Ireland lor the IIrst time. The total membership 01 Health Boards varies Irom 28 to 35 and they are responsible lor overall pollcy·makIng decisions and budgetary control. On the execu­ tive side, the emphasis Is on teamwork, maximum delegation 01 lunctlons to stall, co­ ordinated under the leadership 01 a prolesslonal administrator, called the Chlel Executive Olllcer.

To Indicate the areas and extent 01 the Regional Health Boards, the lollowlng statistical Inlormatlon Is glven:-

EXPENDITURE TITLE GROUPING POPULATION AREA IN 1970/71 SQ. MILES £m. Eastern Dublin City and County, Kildare, Wicklow 921,000 1,800 19 Midland Laols, Longlord, Ollaly, West· meath 178,000 2,520 4 MId·Western Clare, Limerick City and County, Tipperary (N.R.) 265,000 3,040 6 North·Eastern Cavan, Louth, Meath, Monaghan 237,000 1,950 5 North·Western Donegal, Leitrim, Sligo 191,000 2,600 4 South·Eastern Carlow, Kilkenny, TIpperary (S.R.), Wexlord, Waterford CIty and County 319,000 3,630 7 Southern Cork City and County, Kerry 452,000 4,700 11 Western Galway, Mayo, Roscommon 320,000 5,020 8

It Is also provided In the legislation that In eaCh 01 the three teaching hospitals centres (Dublin, Cork and Galway) there will be established a Regional Hospital Board to advise on the co-ordination 01 hospital services and other lunctlons. 'In addition, there Is to be aet up In each county a Local CommlHee, advisory In nature, whose members approxi­ mately thirty In number, will be drawn Irom the elected Councils, the professions and others Interested In social and community wellare.

REGIONALlSATION OF HOSPITALS The proposed reglonalIsatlon programme has been widely welcomed. It Is appreciated that If we are to provide the best possible patient cure at the lowest possible cost, there must

27 01 necessity, be rationalisation In the number and use 01 the many small hospitals now lunctlonlng. The obvious remedy Is to concentrate the speclaltles In the larger centres 01 population while maintaInIng (~nd perhaps developIng In some cases) the small hospItals on the periphery as community care centres where the local General Practitioner will be In charge. He will be supported by diagnostic lacllltles, dIstrict nurses and other ancillary stall as required and. with -regular clinics conducted by Consultants Irom the larger hospitals on a visiting basIs. This will ensure that whenever leasible, Investigations and treatments are carried out at out· patient level, that nursing care Is available In the patIent's home and that the hospital admission rate, which Increases by 4 % annually, will be kept In check.

It is hoped, under the new health administration, that when the "choice 01 doctor" service Is Introduced there will be a noticeable reduction In the number 01 patients seekIng admission to hospital, with a corresponding abatement 01 hospital costs.

In this connection, It is relevant to recall the statement made by the Minister lor Health In An D611 on 30th March, 1971, that" the present rate 01 Inflation continued the total cost 01 the health services, and In particular the hospital servIces, would be doubled within the next eight years: labour requiring 71 % 01 the total budget, without any Increase or Improvement In the volume of servIces.

INCREASE IN COST OF HEALTH SERVICES The enormous Increase In the cost of the Health ServIces has strengthened the arguments 01 those who have been long contending that local rates are not an appropriate means for levying taxation to IInance those services. Consideration has been given to the employ­ ment of other ways and means and one suggestion has apparently received approval. The indications are that legIslation will be Introduced to provide for contributions by persons in the middle Income group, e.g. persons who are not entitled to free services but whose Income Is less than £1,200 per annum or the rateable valuation of whose farms is less than £60. TheIr contributions would go towards the cost of the health services available, such as child health, maternity and hospItal servIces. It Is Intended that the contributions will replace the present hospital charges on the mIddle Income group which may range In the scale to a maximum of ten shillings (SOp) per day In a public ward.

AVERAGE COST The alarmIngly high cost 01 hospitalisation Is Illustrated In the statistics available lor the year ended 31st December, 1969 (the latest available at the time 01 writing), which show

28 that the average cost 01 treating a patient In a County Hospital was £53 (lull stay) or an average cost 01 £34 per week. The costs In the major teaching hospitals would be con· slderably higher. Those Ilgures Indicate the need lor constant vigilance towards ensuring 1~ that all hospitals are operated with maximum elllclency consistent with good medical and 1 nursing practice.

" They also highlight the desirability 01 having ellicient out· patient and home nursing services to help to reduce the number 01 admissions to the acute hospitals now totalling over 300,000 patients per annum. This number' represents more than one In ten 01 our population and does not Include patients sulferlng Irom psychiatric Illness.

All the foregoing factors will command the active attention of the new Regional Health Boards and their stalfs In their task of providing elllclent services at the most reasonable cost. Preventive medicine, early diagnostic processes and domiciliary nursing care should reduce the number of Intern patients and as lar as possible when hospitalisation Is necessary It will be provided In the patient's own area. When specialised treatment Is decided on, the patient will have an elllclent ambulance service at his disposal and alter short-stay treatment In a central hospital he could be taken back to a small hospital near his home lor lurther recuperative care or convalescence. The members 01 the rural communities In Ireland, ther,elore, may confidently look forward to a competent and con· slderate hospital service In the future.

I

, I~ r li

I1 i

29

) THE MEATH HOSPITAL. Opened In 1753 in the Coombe. In the first seven months It treated twelve In-patients and 4,095 out-patients, II:nd the four surgeons attended daily without remuneration. The hospital moved five times before settling In Heytesbury Street In 182.2, where It now has 300 beds.

30

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! I

SPECIALISED MEDICAL PROGRESS IN IRELAND , 1 Since the time of Moss, Stokes and Corrigan Irish medicine has always' made Its contribution to the advance and application of medical knowledge and continues to do so.

On the following pages we give a brief account of some of the modern specialised departments of medicine in Ireland to-day. All these articles have been contributed by the leading specialists in their respective fields. The work and research carried on In these hospitals and centres have been helped financially by funds made available by Hospitals' Trust.

31 -

·THE UROLOGICAL DEPARTMENT, MEATH HOSPITAL, DUBLIN

The Urological Department, Meath Hospital, Is one of the largest of its kind in the world and probably unique In the fact that It was designed· specifically as a Urologlcal Centre attached to the Meath Hospital, which Itself Is one of the oldest Voluntary Hospitals In Dublin and the biggest of the Federated Dublin Voluntary Hospitals. ) The building financed out of Sweepstake Funds was completed and opened In 1955. It consists of 78 beds and these include accommodation for women and children. It Is asso­ c
ated with St. Kevin's Hospital where a further 50 urological beds are available and It has attached to It 20 short-stay beds at an annexe at St. Catherine's, Ringsend. It has Its own Out-patient Department and an unusual operating theatre situated on the ground floor which Is specially equipped for urologlcal surgery.

It provides urologlcal services for the National Medical Rehabilitation Centre (Paraplegic Unit), the Rotunda Hospital, the National Children'S Hospital, Harcourt Street and for the other Hospitals In the Federated Dublin Voluntary Group. The work of the Department is exclusively urologlcal and patients are accepted not only from Dublin but from all over the Republic of Ireland.

Since its opening In 1955, the Department has dealt with a steadily increasing number of patients_ In Its first year of functioning 5,925 out-patients were seen and 1,328 were admitted. In the year 1970 there were 13,999 patients seen in the Out-patients Department and there were 3,343 admissions_

The wor~ done Is largely surgical but nephrology cases are also admitted for diagnosis and treatment. It has an active clinical research programme and contributions to world literature have been made on Prostatectomy (over 300 a year are done in the Department, mostly by the transurethral method~, Tuberculosis, Neurogenic Bladder and other urological subjects.

The Department Is attached to the School of Physlc, Trinity College, Dublin, and participates in undergraduate teaching. It also carries out postgraduate teaching for the Royal College of Surgeons In Ireland.

As it is recognised as a training centre for Urologists by the British Association of Urologlcal Surgeons It has trained or Is training surgeons from Egypt, The Middle East, India, Thailand and Australia.

32 : I

NEUROSURGICAL DEPARTMENT, ST. LAURENCE'S HOSPITAL ~ 1I The neurosurgical department of Sl. Laurence's (Richmond) Hospital was founded by i Professor Adams McConnell over forty years ago following the acceptance of neurosurgery ,I as a definite speciality.

The Richmond Hospital has a long neurosurgical tradition, and Professor McConnell has detailed notes of an operatlon-a posterior fossa craniotomy which he performed on 19th i• September, 1912. Since Its foundation in 1926, the Society of British Neurological Surgeons has visited Dublin no less than five times, and Professor McConnell was President of the Society-the parliament of neurosurgery In these Islands-from 1936 to 1938.

At the present time the Richmond Neurosurgical Department is staffed by three neuro­ surgeons, two neurologists, two neuroradlologlsts, a neuropathologist, and a neuro - ophthalmologist. The consultant staff Is supported by specialist anaesthetists, aural surgeons, theatre and ward sisters, and by an augmented physiotherapy department.

The Department of Neurosurgery is concerned with the treatment of brain and spinal cord tumours, Intra cranial aneurysms, the surgical treatment of strokes, Intra cranial suppuration, : i and the management of the problems associated with the treatment of hydrocephalus and spina bifida. It is also concerned with the treatment of neurotrauma, and at any given time there are between twenty and thirty patients with head injury undergoing treatment.

The work and scope of this speciality Is Increasing yearly and the department of neuro­ radiology alone handled 3,047 cases during 1970. 934 patients had cerebral angiography carried out, and 206 patients had other diagnostic procedures such as ventriculography etc. performed.

Plans are well advanced to extend this busy department which is supported by monies made available out of Sweepstake Funds with the approval of the Minister for Health.

33 THE IRISH HEART FOUNDATION

The Irish Heart Foundation was established In the spring of 1966. It represents a co·operative effort on the part of the medical profession and lay people from all walks of life. The Found­ ation Is specifically dedicated to the conquest of heart and blood vessel diseases through research, education and community service.

A sum of nearly £350,000 has already been subscribed or promised to the Foundation for its work. The Irish Hospitals Trust was one of the first and certainly the largest subscriber to the initial founding fund.

The services of the Foundation can be divided into educational, research and public service. A nationwide educational campaign has been launched on the prevention of heart disease and stroke, and this educational programme Is mostly linked with the fund-raising activities of the organisation. The educational programme also Includes numerous meetings and sym· posla for the medical, nursing and paramedical professions. Of particular importance has been the courses for nurses and ambulance crews on the treatment of acute heart attacks and of other cardiorespiratory emergencies.

On the service side the Foundation has been extremely active. The MEDISCAN programme is a population risk factor screening programme which it Is hoped will eventually be made available to every citizen In the country. It Is a unique and pioneering practical effort to tackle the present high incidence of coronary heart disease and stroke in a realistic manner. The Foundation has also organised the mobile coronary service in Dublin. This service Is also unique In that the ambulance personnel is fully trained to carry out life·saving resus­ citative measures.

On the research side the Foundation has already allocated a sum of more than £102,000 towards research. Some of the monies have been designated for specific research projects by the donors but most of the money is awarded for projects which are approved by the Scien· tific Committee of the Foundation.

The Foundation is also extremely active In the International Cardiology Federation and in the International sphere In general.

34 \

THE CANCER ASSOCIATION OF IRELAND

This body was established originally in 1950 as Comhlachas Allse na h-Elreann (The Cancer Association of Ireland), a Company Limited by Guarantee. In 1964 it became a Corporate Body under the provisions of the Health (Corporate Bodies) Act, 1961, with the title "Saint Luke's Hospital". Saint Luke's Hospital, Rathgar, Dublin, built in the early 1950s is Ireland's principal Radio­ therapy Centre. It has 147 beds, Is equipped with two Radio-active Cobalt Units and four Deep X-Ray Therapy Apparatus and provides a wide range of treatment and diagnostic services for malignant diseases. The Cobalt Units are available to the other Cancer Hospitals for the treatment of their patients, and the services of a Nuclear Medicine Department are at the disposal of hospitals and consultants generally.

Saint Agatha's Radiotherapy Clinic in Cork, conducted by Saint Luke's, is also equipped with Radio-Active Cobalt and Deep X-Ray Therapy Apparatus and has a Radlo·Active Isotopes Laboratory. There are twenty beds available In Saint Finbarr's Hospital for the accommodation of patients receiving treatment at the Clinic, and It Is accordingly possible to provide for the needs of Cork and adjoining areas as regards diagnosis and treatment In this field of Medicine. With the co-operation of the Local Authorities the Consultant Staff of Saint Luke's Hospital provides Diagnostic Clinics at the following centres:- DONEGAL (Letterkenny and Donegal Town), GALWAY, KERRY (Tralee), LIMERICK, MAYO (Castlebar), SLIGO, TIPPERARY (Cashel), WATERFORD, WESTMEATH (Athlone and Mulllngar).

The National Radiation Monitoring Service Is conducted by Saint Luke's Hospital, providing a continuous check on the Radiation doses received by persons operating X·Ray Apparatus. This service Is used by the great majority of hospitals in the country, and hospitals and other Institutions also avail themselves of special surveys of X·Ray and similar apparatus which are carried out by the hospital Scientists.

Saint Luke's Cancer Research Fund Is maintained by the Hospital Board for the purpose of receiving donations and assisting research projects. The principal project at present assisted from the Fund Is the research work In the Cancer Research Laboratories at Saint Luke's Hospital under the direction of Professor R. A. Q. O'Meara, who Is Professor of Experimental Medicine In Trinity College and also holds the position of Pathologist to the Hospital and Director of Research in the Hospital.

Saint Luke's Hospital, Dublin, and Saint Agatha's Clinic, Cork, were built and equipped out of Sweepstake Funds and the annual revenue deficits are recouped from the same source.

35 MEDICAL RESEARCH COUNCIL OF IRELAND

The most notable development in the policy of the Medical Research Council during the last 15 years has been the Increasing support of research in the clinical sections of the medical schoolS. It had not been possible earlier because of lack of suitable facilities. Dublin was the first centre to be involved but both Cork and Galway have now been Included. Active clinical research programmes have now been established In each of the medical schools in these centres. The support which the research requires has been made possible by Increased funds provided by the Minister for Health from the Hospitals Trust Fund.

Of the other research activities summarised in "Ireland's Hospitals, 1930·1955" the Chemo­ therapy Unit under the direction of Dr. V. C. Barry, has continued Its combined chemical and biological aHack, which was originally concentrated on tuberculosis, and has extended Its range to Include leprosy and cancer. One of the compounds developed In the Unit, B. 663, has been found to be the most effective agent against certain forms 01 leprosy and is now being extensively used. The search for substances active against one or other of the various types 01 cancer continues.

Research work on cancer, supported by the Council, is also carried out by Professor O'Meara in St. Luke's Hospital, Dublin.

With the death 01 Professor E. J. Conway in 1969 the work on cell membrane permeability carried out in the Cell Metabolism Unit under his direction came to an end.

During the last 15 years the Medical Research Council has carried out special surveys, at the request of the Minister for Health, on perinatal mortality, dental caries and gastro· enteritis In infants, in addition to the general research programmes which it supports in the laboratory departments of medical schoolS.

36 I

NATIONAL MEDICAL REHABILITATION CENTRE

This centre which is under the auspices of the Sisters of Mercy was opened In 1961. A joint committee of the National Rehabilitation Board and representatives of the Sisters of Mercy advise on the scope of the services to be provided and the selection of specialist staff. The Centre has residential accommodation for 120 persons and operates within the Health Services on the same basis as a voluntary hospital. The Medical Director of the National Rehabilitation Board Is also Medical Director of the Centre.

Facilities in the Centre include the National Llmb·Fitting Services, the National Spinal Injuries Unit and medical rehabilitation facilities for a variety of disabilities including neuro· logical, orthopaedic and rheumatic conditions.

There are departments of physiotherapy, hydrotherapy, occupational therapy, speech therapy and social services.

National Spinal Injuries Unit This provides a service for the care of the acute spinal injury with spinal cord involvement (paraplegia) and the later follow up throughout life of these cases. All ambulance men receive training here in the movement of possible spinal cases from the scene of the acci· dent. A flying squad of doctor and nurse is on call to travel to any part of the country to bring In these cases. They should be brought into the Centre within hours of injury If possible. The Defence Forces keep a 'rescue' helicopter at the ready. On notification of such a case the helicopter flies to the Centre, picks up the doctor and nurse. This team brings in the spinal case without any risk of further injury. About 40 such cases are admitted annually. Each case left with permanent paralysis Is admitted every six months for review throughout life. Every nurse In the public health service is trained here for one week in the care of such patients as part of her course.

Unit for Spina Bifida Children

Early operation in Spina Bifida has resulted in the majority of cases surviving to school going age. Between 100·140 such Infants have immediate surgery annually In Ireland. r About half of the survivors have little or no disability. About half are Incomplete or complete I paraplegics and will require the follow up service of the paraplegic unit throughout life. The early surgery is performed In the paediatric and neurosurgical centres. The unit in this Centre co.operates In providing the services of the paraplegic unit at a later age.

37 National Limb Fitting Service

A 11mb flHlng and manufacturing service which Is being developed on a national basis Is in operation at the Centre. At present about 160 new limbs are manufactured at the Centre which Is about half the immediate requirements. Clinics and repair workshops operated by the staff of the Centre are being established In Galway and Cork. The manufacture and fitting of artificial limbs are carried out by our expert team under medical guidance. Certain other appliances such as braces for spina bifida children are also manufactured In the unit.

Vocational Assessment

In addition to the disabled persons undergoing treatment in the Centre, problem cases are referred here for vocational assessment. This Includes medical evaluation, psychological testing, work sample testing and a period of pre·vocational training in the workshop.

Assessment for Aids and Advisory Service

The Centre provides advisory services for the health boards In the selection of aids, wheel· chairs and motorised transport.

SI. Joseph's College of Occupational Therapy

This College for the training of occupational therapists Is operated by the National Rehabili· tation Board. It Is placed in the Rehabilitation Centre.

38 THE ARTIFICIAL KIDNEY UNIT JERVIS ST. HOSPITAL

The Artificial Kidney Unit was Inaugurated In 1958 when members of the Visiting Staff, at the Instigation of Dr. A. P. Barry, purchased a kidney machine and presented It to the hospital. In the early years the work of the Unit was devoted entirely to the treatment of acute renal failure I.e. the replacement of kidney function by dialysis In situations of temporary failure following accidents, operations and some medical Illnesses. This remains the most Important function of the department and there are approximately 150 such admissions annually.

The Increasing incidence of acute drug Intoxication and poisoning (accidental and Inten­ tional) has posed a difficult problem for the department. In view of the facilities for dialysis available such patients are admitted to a renal unit.

In the last 4 y,ears the Unit has been engaged In a programme of Regular Dialysis Treatment combined with Renal Transplantation for suitable patients with permanent and terminal failure of kidney function. Filty five transplants have been carried out to date. Two years , I ago, following the training of medical and nursing personnel In Jervls Street Hospital the dialysIs programme was extended to unIts In St. Finbarr's Hospital In Cork and Merlyn Park Hospital In Galway. The three centres work In the closest co-operation and In fact form part of a planned single programme which Is at present providing Regular Hospital Dialysis Treatment for over 50 paUents. They attend twice weekly for treatment. In October 1970, a Home Dialysis Training Programme was commenced In Jervis Street Hospital. Patients and their spouses a:re trained In a special area for 6·8 weeks and then sent home to continue on their own. Each patient has a machine with the necessary accessories Installed. ThIs Is a more economic and efficIent way of dealing with long term dialysis even though It Involves the capital expenditure of a separate machIne for each patient. The work of the Artificial Kidney Unit and Renal Department Involves the closet possIble co-operation with the Urological Department, and needless to say, without the help of the Pathology and BiochemIstry Departments the development of the Renal Department would not have been possible. In the field 01 transplantation the Tissue Typing Department In St. Laurence's Hospital Is providing a totally essential service.

Apart from the management of renal failure the Department Is actively engaged In the diagnosIs and treatment of kidney disease In general and Indeed thIs field Is becoming IncreasIngly Important and Involves a considerable amount of research. One such

39 project at present is a multi centre trial of treatment under the auspices of the Medical Research Council of Great Britain and is associated with 24 centres throughout Great Britain and Ireland.

In the matter of tissue typing and the transfer of kidneys to the most suitable recipient the Unit Is part of the London Hospital "Pool" In conjunction with 21 transplant centres In Great Britain.

The Department will be extending Its facilities In the near future In co-operation with the Dublin Health Authority which Is providing a Unit In St. Mary's Hospital for the Investigation and management of patients with kidney disease, together with a separate area to which It Is proposed to transfer the Home Dialysis Training Programme.

The Headquarters of the European Dialysis and Transplant Association under the Secretary· Treasurer is currently situated In this hospital following Its transfer from Amsterdam 2 years ago.

40 SIR PATRICK DUN'S. Opened in Artichoke Road in 1809 with thirty patients. During the epidemics of 1826-28 and 1846-48 over 10,000 cases of fever were treated. At present is one of the principal hospitals in Dublin.

41 1. St. Vincent's Hospital, Elm Park, Dublin 2. St. Vincent's Hospital, Elm Park. Dublin 3. Our Lady of Lourdes International Missionary Training Hospital, Drogheda 4. Our Lady of Lourdes International Missionary Training Hospital, Drogheda

43 ..,"

., ,. ,.. t, ,

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1. Mater Misericordiae Hospital, Dublin 2. Mater Misericordiae Hospital, Dublin 3. Adelaide Hospital, Dublin 4. I,delaide Hospital, Dublin

45 1. Galway Regional Hospital 2. Galway Regional Hospital 3. Barrington's Hospital, Limerick 4. Barrington's Hospital, Limerick 1. Sligo County Hospital 2. Sligo County Hospital 3. Sligo County Hospital 4. St. Agatha's Radiotherapy Clinic, Cork

49 1. Louth County Hospital, Dundalk 2. Louth County Hospital, Dundalk 3. District Hospital, Dungloe, Co. Donegal 4. County Hospital, Letterkenny, Co. Donegal 1. SI. Mary's Auxiliary Orthopaedic Hospital, Ba~dovle. Co. Dublin 2. Cork Spastic School and Clinic 3. Cork Spastic School and Clinic

52 53 1. National Medical Rehabilitation Centre. Our Lady of Lourdes Hospital, Dun LaoQhaire 2. National Medical Rehabilitation Centre, Our Lady of Lourdes Hospital, Dun LaoQhaire 3. Central Remedial Clinic, Dublin 4. Central Remedial Clinic, Dublin THE ROTUNDA HOSPITAL. The first lying-in hospital in Ireland or Britain, founded by Bartholomew Mosse in 1757. The medical school attracts students and post- graduates from all parts of the world.

[, r r:i j, H L\ 1 r:ti 2 II I:

1 1. Central Remedial Clinic. Dublin 1 2. Central Remedial Clinic. Dublin

56 57 1 14 -- 215 -- 31 6

1. National Maternity Hospital, Dublin 2. National Maternity Hospital, Dublin 3. Coombe Hospital, Dublin 4. Rotunda Hospital, Dublin 5. SI. Vincent's Hospital, Athy, Co. Kildare 6. Rotunda Hospital, Dublin

59 1. Coombe Hospital, Dublin 2. County Hospital, Castlebar, Co. Mayo 3. St. Mary of the Angels, Beaufort, Co. Kerry 4. St. Luke's Hospital, Clonmel, Co. Tipperary

60 r.~

1 12 1. Portrane Hospital, Co. Dublin 2. St. Mary's, Delvin, Co. Westmeath

~

62 63 1 1. Peamount Hospital, Co. Dublin 2 2. SI. Paul's Hospital, Beaumont, Dublin

64 SAINT BRENDAN'S HOSPITAL. Opened In 1815 with a parliamentary grant from the Lord Lieutenant. In accordance with modem practice it has recently removed its walls to reveal Its pleasant lawns and gardens.

65 ~~~oVo= oo_~~ ______--' ______

Payments to Hospitals and Health Agencies from Sweepstake Funds from 1930 to 1969 inclusive

Funds received Hospital or Health Agency from 1st six Maintenance Capital Totals Sweepstakes Payments Grants

£ s. d. £ s. d. £ s. d. £ s. d. Auxiliary Orthopaedic Hospital, Baldoyle, Co Dublin. 134,867 0 0 59,121 5 0 193,988 5 0 Auxiliary Sanatorium, Kilkenny•... 3,547 o 11 3,547 o 11 Ardkeen Chest Hospital, Waterford. 1,176,876 12 1 1,176,876 12 1 An Bord Altranals 5,367 0 0 5,367 0 0 Adrigole District Nursing Association 460 0 0 460 0 0 Adelaide Hospital, Dublin 788,337 17 4 96,126 10 0 884,464 7 4

Beaumont Convalescent Home, Dublin. 20,139 16 5 7,060 0 0 102,015 7 1 1.29,215 3 6 Barrington's Hospital, Limerick 55,398 9 6 490,651 0 0 164,703 12 6 710,753 2 0 «It c» Bedford Row Lying-in Hospital, Limerick 33,326 14 4 18,251 0 0 36 18 2 51,614 12 6 Ballyowen Sanatorium, Co. Dublin 512,661 10 1 512,661 10 1 Bray Maternity and Child Welfare Clinic, Co. Wicklow 487 5 0 487 5 0

Cobh General Hospital, Co. Cork. 3,555 0 0 21,590 13 11 25,145 13 11 Cancer Association of Ireland (SI. Agatha's 72,638 17 11 72,638 17 11 Radiotherapy Clinic at Cork) Central Remedial Clinic, Clontarf 100,000 0 0 100,000 0 0 Cllflon Convalescent Home, Cork 16,747 18 2 27,417 0 0 44,164 18 2 County & City of Cork Lying-In Hospital, Erlnvllle, Cork 35,960 9 8 358,360 2 1 .236,499 o 11 630,819 12 8 Cheeverstown Convalescent Home, Co. Dublin 14,357 6 2 49,008 0 0 6,204 17 10 69,570 4 0 Children'S Sunshine Home, Stillorgan, Co. Dublin 2,000 0 0 21,500 0 0 23,500 0 0 Catholic Institute for Deaf and Dumb, Cabra, Dublin 8,529 0 0 132,706 11 1 141,235 11 1 Charitable Infirmary, Jervls Street, Dublin 121,851 16 8 1,651,412 19 6 351,283 5 11 2,124,548 2 1 Children'S Hospital, Temple Street, Dublin 103,966 5 4 559,249 16 9 95,704 0 2 758,920 2 3 Child Guidance Clinic, Rathgar, Dublin. 31,332 14 0 31,332 14 0 City of Dublin Lying-In Hospital (Coombe), Dublin 119,245 10 6 1,352,571 0 0 902,254 11 4 2,374,071 1 10 City of Dublin Skin and Cancer Hospital, Dublin 510,877 18 6 59,234 10 0 570,112 8 6 Cork Street Fever Hospital, Dublin 58,298 7 3 6,108 0 0 60,263 9 10 124,669 17 1 County Infirmary, Kildare 237 0 0 237 0 0 County Infirmary, Limerick 38,785 8 9 118,550 0 0 157,335 8 9 County Infirmary, Louth 45,205 7 9 45,205 7 9 County Infirmary, Meath 24,862 6 2 8,103 15 10 32,966 2 0 County and City Infirmary, Waterford 71,020 17 10 250,232 2 1 321,252 19 11 Countess of Wicklow Memorial Hospital, Wicklow 19,002 4 1 40,711 0 0 20,807 4 1 80,520 8 2 County Hospital, Carlow 30,738 16 10 30,738 16 10 County Clinic, Cavan 13,638 18 3 13,638 18 3 County Hospital, Cavan 3,374 0 1 3,374 0 1 County Surgical Hospital, Cavan 1,484 1 0 1,484 1 0 County Clinic, Ennls, Co. Clare 15,685 10 5 15,685 10 5 County Hospital, Ennls, Co. Clare 85,531 8 1 85,531 8 1 Central Hospital, Santry, Co. Cork 222,195 15 0 222,195 15 0 County Hospital, Mallow, Co. Cork 57,780 0 4 57,780 0 4 County SanatoriUm, Heatherslde, Co. Cork 72,585 3 8 72,585 3 8 County Clinic, Letterkenny, Co. Donegal 1,700 0 0 1,700 0 0 County Hospital, Letterkenny, Co. Donegal 327,163 11 8 3:27,163 11 8 Charles Street Dispensary, Dublin .22,704 12 1 22,704 12 1 Crooksllng Sanatorium, Co. Dublin 33,220 2 5 33,220 2 5 Crumlln Health Centre, Dublin 20,000 0 0 20,000 0 0 Crumlln Health Clinic, Dublin 51,579 17 10 51,579 17 10 County Clinic, Galway 22,804 5 7 22,804 5 7 .....en County Clinic, Tralee, Co. Kerry 14,510 0 0 14,510 0 0 County Hospital, Tralee, Co Kerry 33,013 3 10 33,013 3 10 New County Hospltal,Tralee, Co. Kerry 14,000 0 0 14,000 0 0 Central Laundry for Dublin Corporation Hospitals 991 16 0 991 16 0 (proposed) County Clinic, Naas 22,920 0 0 22,920 0 0 County Hospital, Kilkenny 147,653 3 3 147,653 3 3 County Hospital, Naas 2,411 14 0 2,411 14 0 County Clinic, Kilkenny 18,049 4 6 18,049 4 6 County Hospital, Portlaoise 86,726 2 4 86,726 2 4 County Fever Hospital, Abbeylelx 41,347 19 :2 41,347 19 .2 County Clinic, Portlaoise 13,380 18 6 13,380 18 6 County Hospital, Manorhamllton, Co. Leitrim 211,165 4 3 211,165 4 3 Orthopaedic Hospital, Croom, Co. Limerick 5,788 0 0 5,788 0 0 City Home and Hospital, Limerick 229,480 16 1 229,480 16 1 County Clinic, Longford 15,615 12 7 15,615 12 7 County Hospital, Longford 31,157 0 0 31,157 0 0 County Hospital, Dundalk 341,031 15 7 341,031 15 7 County Hospital, Castlebar, Co Mayo 135,258 17 3 135,258 17 3 County Clinic, CastJebar, Co. Mayo 11,406 9 1 11,406 9 1 County Hospital, Navan, Co. Meath 84,730 19 10 84,730 19 10 Funds received Maintenance Capital Hospital or Health Agency from 1st six Payments Grants Totals Sweepstakes

County Clinic, Navan 10,364 0 0 10,364 0 0 County Hospital, Monaghan 99,630 0 0 99,630 0 0 County Clinic, Monaghan 1,560 0 0 1,560 0 0 County Hospital, Tullamore, Co. Offaly 84,885 3 7 84,885 3 7 County Clinic, Tullamore, Co. Offaly 14,439 10 7 14,439 10 7 Castierea Sanatorium, Roscommon 227,241 16 6 227,241 16 6 County Hospital, Roscommon 156,243 7 0 156,243 7 0 County Clinic, Roscommon 10,570 12 7 10,570 12 7 County Hospital, Sligo 418,878 6 8 418,878 6 8 County Hospital, Nenagh, Co. Tipperary 39,078 5 6 39,078 5 6 County Clinic, Nenagh, Co. Tipperary. 11,002 6 3 11,002 6 3 County SanatoriUm, Roscrea, Co. Tipperary 2,150 1 6 2,150 1 6 County Hospital, Cashel, Co. Tipperary 77,901 11 1 77,901 11 1 County Clinic, Clonmel, Co. Tipperary 12,843 3 4 12,843 3 4 County Clinic, Waterford 5,186 18 8 5,186 18 8 0) County Hospital, Waterford 5,364 18 4 5,364 18 4 co County and City Infirmary, Waterford 71,020 17 10 71,020 17 10 County Home and Fever Hospital, Co. Westmeath 500 0 0 500 0 0 County Hospital, Mulllngar, Co. Westmeath 69,557 5 6 69,557 5 6 County Clinic, Wexford 13,904 6 11 13,904 6 11 County Hospital, Wexford 35,115 .2 0 35,115 2 0 New County Hospital, Wexford 615 0 0 615 0 0 District Hospital, Wicklow 17,287 5 10 17,.287 5 10 County Clinic, Mulllngar, Co. Westmeath 18,355 18 7 18,355 18 7

Dental Hospital, Cork 15,204 19 4 7.2,735 0 0 87,939 19 4 Dr. Steevens' Hospital, Dublin. 927,162 12 4 267,086 14 7 1,194,249 6 11 Drumcondra Hospital, Dublin 1,750 18 4 75 12 0 1,826 10 4 Dublin Fever Hospital, Clondalkln, Dublin 1,067,376 14 2 1,067,376 14 2 Drogheda Memorial Hospital, Kildare 7,769 7 4 42,452 0 0 50,221 7 4 Drogheda Cottage Hospital, Co. Louth 12,593 1.2 3 280,165 12 1 47,439 19 9 340,199 4 1 District Hospital, Tullow, Co. Carlow 4,404 2 9 4,404 2 9 Dispensary Buildings In Co. Cavan 9,600 0 0 9,600 0 0 Dispensary Buildings In Co. Clare 4,800 0 0 4,800 0 0 Dispensary Buildings In Co. Cork 7,098 5 0 7,098 5 0 Dispensary Buildings In Co. Donegal 16,800 0 0 16,800 0 0 Dispensary Buildings In Dublin 24,821 5 11 24,821 5 11 Dispensary and Clinic, Blackrock, Co. Dublin 10,830 11 2 10,830 11 2 Dispensary Buildings In County Galway 15,600 0 0 15,600 0 0 Dispensary Buildings, Carlow 3,600 0 0 3,600 0 0 Dispensary Buildings In Co. Kerry 2,400 0 0 2,400 0 0 Dispensary Buildings In Co. Kildare 4,800 0 0 4,800 0 0 Dispensary Buildings in Co. Kilkenny 13,200 0 0 13,200 0 0 Dispensary Buildings In Co. Laols 6,600 0 0 6,600 0 0 Dispensary Buildings In Co. Limerick 9,600 0 0 9,600 0 0 Dispensary Buildings In Co. Leitrim 1,200 0 0 1,200 0 0 Dispensary Buildings In Co. Longford 5.400 0 0 5,400 0 0 Dispensary Buildings, Co. Louth 1,200 0 0 1,200 0 0 Dispensary Buildings In Co. Mayo 5,766 0 0 5,766 0 0 Dispensary Buildings In Co. Monaghan 2,400 0 0 2,400 0 0 Dispensary Buildings In Co. Meath 4,800 0 0 4,800 0 0 Dispensary Buildings In Co. Offaly 2,400 0 0 2,400 0 0 Dispensary Buildings In Co. Roscommon 7,800 0 0 7,800 0 0 Dispensary Buildings In Co. Sligo 2,400 0 0 ~,400 0 0 Dispensary Buildings In Co. Tipperary N.R. 6,600 0 0 6,600 0 0 Dispensary Buildings In Co. Tipperary S.R. 2,800 0 0 2,800 0 0 GI Dispensary Buildings In Co. Waterford 4,200 0 0 4,200 0 0 CD Dispensary Buildings In Co. Westmeath 2,400 0 0 2,400 0 0 Dispensary Buildings In Co. Wexford 4,800 0 0 4,800 0 0 Dispensary Buildings In Co. Wicklow 3,600 0 0 3,600 0 0 District Hospital, Ennlstymon, Co. Clare 6,650 0 0 6,650 0 0 District Hospital, Kllrush, Co. Clare 4,250 0 0 4,250 0 0 District Hospital, Scarlff, Co. Clare 9,327 6 6 9,327 6 6 District Home, Mldleton, Co. Cork 400 0 0 400 0 0 District Hospital, Bandon, Co. Cork 2,087 10 0 2,087 10 0 District Hospital, Castletownbere, Co. Cork 22,159 15 10 22,159 15 10 District Hospital, Clonakllty, Co. Cork 17 17 0 17 17 0 District Hospital, Dunmanway, Co. Cork 271 0 0 271 0 0 District Hospital, Fermoy, Co. Cork 1,083 7 0 1,083 7 0 District Hospital, Klnsa:e, Co. Cork 238 4 10 238 4 10 District Hospital, Mldleton, Co. Cork 11,611 16 7 11,611 16 7 District Hospital, Mlllstreet, Co. Cork 7,332 0 0 7,332 0 0 District Hospital, Rathlulrc, Co. Cork 600 0 0 600 0 0 District Hospital, Schull, Co. Cork 6,329 13 2 6,329 13 2 District Hospital, Sklbbereen, Co. Cork 130 2 4 130 2 4 District Hospital, Youghal, Co. Cork 20,993 10 7 20,993 10 7 Funds received Maintenance Capital Hospital or Health Agency from 1st six Payments Grants Totals Sweepstakes

District Hospital, Carndonagh, Co. Donegal 79,800 0 0 79,800 0 0 District Hospital, Dungloe, Co. Donegal 91,931 14 3 91,931 14 3 District Hospital, CIUden, Co. Galway 13,378 6 8 13,378 6 8 District Hospital, Caherclveen, Co. Kerry 52,180 0 2 52,180 0 2 District Hospital, Dlngle, Co. Kerry 10,650 0 0 10,650 0 0 District Hospital, Kenmare, Co. Kerry 10,880 6 9 10,880 6 9 District Hospital, Klllarney, Co. Kerry 22,300 0 0 22,300 0 0 District Hospital, Llstowel, Co. Kerry 15,101 4 2 15,101 4 2 District Hospital, Athy, Co. Kildare 1,905 18 3 1,905 18 3 District Hospital, Mohlll, Co. Leitrim 775 7 8 775 7 8 District Hospital, Longford 3,995 7 1 3,995 7 1 District Hospital, Dundalk, Co. Louth 754 10 4 754 10 4 District Hospital, Birr, Co. Offaly 1,197 10 0 1,197 10 0 District Hospital, Edenderry, Co. Offaly 1,465 0 0 1,465 0 0 ..... District Hospital, Boyle, Co. Roscommon 7,544 7,544 0 1 0 0 1 District Hospital, Roscrea, Co. Tipperary N.R. 480 0 0 480 0 0 District Hospital, Thurles, Co. Tipperary N.R. 16,612 13 9 16.612 13 9 District Hospital, Clonmel, Co. Tipperary S.R. 14,107 19 8 14,107 19 8 District Hospital, Dungarvan, Co. Waterford 1,623 1 3 1,623 1 3 District Hospital, Llsmore, Co. Waterford 1,327 0 0 1,327 0 0 District Hospital, Athlone, Co. Westmeath 37,219 19 4 37,219 19 4 DIstrict Hospital, Gorey, Co. Wexford 21,545 11 6 21,545 11 6 District Hospital, New Ross, Co. Wexford 24,723 18 11 24,723 18 11 District Hospital, Baltinglass, Co. Wicklow 69,881 7 7 69,881 7 7 District and Fever Hospital, Balllna, Co. Mayo 61,340 18 8 61,340 18 8 District and Fever Hospital, Belmullet, Co. Mayo 28,615 10 5 28,615 10 5 District Hospital, Swinford, Co. Mayo 25,726 6 9 25,726 6 9 Drumbeg Home for Mentally Handicapped 10,000 0 0 10,000 0 0

Eye, Ear and Throat Hospital, Cork 6,484 8 6 160,260 0 0 39,842 8 9 206,586 17 3

Fever Hospital, Cork 67,970 2 8 42,061 0 0 4,128 16 5 114,159 19 1 Fever Hospital, Cavan 156 5 0 156 5 0 fever Hospital, Ennls, Co. Clare 8,273 14 3 8,273 14 3 Fever Hospital, Carndonagh, Co. Donegal 12,150 0 0 12,150 0 0 Fever Hospital, Dingle, Co. Kerry 680 0 0 680 0 0 -'---~------

Fever Hospital, L1stowel, Co. Kerry 1,543 5 8 1,543 5 8 Fever Hospital, Klllarney, Co. Kerry 24,388 17 10 24,388 17 10 Fever Hospital, Naas, Co. Kildare 25,950 0 0 25,950 0 0 Fever Hospital, Longford 12,710 10 4 12,710 10 4 Fever Hospital, Dundalk, Co. Louth 42,054 2 11 42,054 2 11 Fever Hospital, Roscrea, Co. Tipperary N.R. 1,731 10 0 1,731 10 0 Fever Hospital, New Ross, Co. Wexford 34,789 8 6 34,789 8 6 Fever Hospital, Wexford 1,128 0 0 1,128 0 0

Galway Association for Mentally Handicapped 5,000 0 0 5,000 0 0 Gascolgne Home 2,195 17 8 2,195 17 8 General Hospital, Cork 20,019 9 9 20,019 9 9 Grianan an Chlalr, Co. Clare 11,070 18 7 11,070 18 7 Grianan Padralg Naomhtha, Sligo 33,646 18 5 33,646 18 5 Grlanan Charmain, Wexford 51,549 3 9 51,549 3 9

House of the Holy Angels, Glenmaroon, Dublin 89,003 15 0 89,003 15 0 Home for Epileptic Women, Moore Abbey, 179,158 4 1 179,158 4 1 Monasterevan, Co. Kildare Hospitals Commission 598,581 0 0 598,581 0 0 ...... Hospitals Library CounCil, Dublin 117,277 0 0 117,277 0 0 Hospitals Joint Services Board 15,084 0 0 314,716 0 0 329,800 0 0

Incorporated Dental Hospital of Ireland, Dublin 42,158 19 1 382,571 0 0 7,034 1 3 431,764 0 4 Incorporated OrthopaediC Hospital, Dublin 175,177 0 0 58,758 10 1 233,935 10 1

Joint T.B. Clinic, Cork 216 13 4 216 13 4

Kllcreene Orthopaedic Hospital, Kilkenny 310,733 8 6 310,733 8 6

Lady Lane M.D. InstitUtion, Waterford 1,450 0 0 1,450 0 0 L1nden Convalescent Home, Dublin 64,146 17 9 240,656 0 0 39,210 0 4 344,012 18 1 La Sagesse Mental Defective Institute, Sligo 257,979 18 0 257,979 18 0 Lady Dudley Nursing Scheme 27,232 10 0 27,232 10 0

Mary Immaculate School for Deaf Boys, Stlllorgan 5,395 4 0 5,395 4 0 Mass Mobile Radiological Unit, Cork 171 10 3 171 10 3 Maternity Hospital, Carlow 3,466 14 2 3,466 14 2 Mercy Hospital, Cork ' 15,119 17 8 143,875 8 7 150,689 10 1 309,684 16 4 Monkstown Hospital, Dublin 5,619 16 9 205,028 12 4 29,946 13 1 240,595 2 2 Funds received Maintenance Capital Hospital or Health Agency from 1st six Payments Grants Totals Sweepstakes

Mater Mlserlcordlae Hospital, Dublin 113,179 7 8 1,855,865 10 4 435,936 18 1 2,404,981 16 1 Meath Hospital and County Dublin Infirmary (Including Meath Hospital Convalescent Home) Dublin 128,426 16 11 1,948,189 0 0 325,206 7 8 2,401,822 4 7 Mercer's Hospital, Dublin 23,423 17 0 849,295 19 8 112,649 18 4 985,369 15 0 Martin Hospital, Portlaw, Co. Waterford 8,511 2 0 30 0 0 8,541 2 0 Mental Hospital, Carlow 76,376 12 7 76,376 12 7 Mental Hospital, Ennls, Co. Clare 190,051 7 0 190,051 7 0 Mallow Chest Hospital, Co. Cork 52,751 6 9 52,751 6 9 Mental Hospital, Cork 134,771 16 9 134,771 16 9 Mental Hospital, Letterkenny, Co. Donegal 52,401 5 6 52,401 5 6 Mental Hospital, Grangegorman, Dublin 451,570 19 2 451,570 19 2 Maternity Home, Tuam, Co. Galway 3,830 15 4 3,830 15 4 Mental Hospital, Balllnasloe, Co. Galway 250,211 17 2 250,211 17 2 Mental Hospital, Klllamey, Co. Kerry 104,164 1 4 104,164 1 4 Mental Hospital, Kilkenny 37,661 16 10 37,661 16 10 .... Mental Hospital, Portlaoise, Co. Laois 113,634 6 7 113,634 6 7 N Mental Hospital, Limerick 58,575 17 2 58,575 17 2 Mental Hospital, Ardee, Co. Louth 7.2,293 17 3 72,293 17 3 Mental Hospital, castlebar, Co. Mayo 128,097 8 2 128,097 8 2 Mental Hospital, Monaghan 156,665 18 0 156,665 18 0 Mental Hospital, Castlerea, Co. Roscommon 180,235 4 3 180,235 4 3 Mental Hospital, Sligo 127,189 11 5 127,189 11 5 Mental Hospital, Clonmel, Co. Tipperary ~~0,382 1 9_ 120,382 1 9 Mental Hospital, Waterford 73,611 17 5 73,611 17 5 Mental Hospital, Mulllngar, Co. Westmeath 256,601 19 5 256,601 19 5 Mental Hospital, Ennlscorthy, Co. Wexford 229,442 11 6 229,442 11 6 Medical Research Council 1,210,994 16 2 1,210,994 16 2

National Association for Cerebral Palsy, Ballintemple, Cork 5,000 0 0 5,000 0 0 Nazareth House, Mallow, Co. Cork 31,600 0 0 31,600 0 0 North Charitable Infirmary, Cork 75,746 6 9 394,219 12 4 38,262 18 7 508,228 17 8 National Children'S Hospital, Dublin 74,067 7 1 881,784 10 4 104,405 17 7 1,060,257 15 0 National Maternity Hospital, Dublin 162,986 1 11 1,582,621 2 1 308,985 6 4 2,054,592 10 4 Nurses' Home, Kanturk, Co. Cork 750 0 0 750 0 0 Nurses' Home and Fever Hospital, Tralee, Co. Kerry 2,011 17 7 2,011 17 7 56,361 1 1 National Organisation for Rehabilitation, Dublin 56,361 1 1 181,600 0 0 National B.C.G. CommlHee 181,600 0 0 0 Nurses' Convalescent Home, Inc. 2,066 0 0 19,134 4 0 21,200 4

Orthopaedic Hospital, Gurranebraher, Cork 652,695 13 7 652,695 13 7 Our Lady of Good Counsel, Lota, Cork 3,500 0 0 236,500 0 0 240,000 0 0 Our Lady of Lourdes Hospital, Dun Laoghaire 36,843 3 7 617,366 2 1 264,796 6 8 919,005 12 4 418,636 8 Our Lady's Hospice, Dublin 333,593 0 0 85,043 9 8 9 Our Lady's Hospital for Sick Children, Crumlin, Dublin 1,046,949 0 0 1,402,643 4 1 2,449,592 4 1 Our Lady of Lourdes Hospital, Drogheda 833,256 0 0 315,447 2 7 1,148,703 2 7 Our Lady's and st. Teresa's Tuberculosis Hospital, Edenburn, Co. Kerry 48,353 2 8 48,353 :l 8

Peamount Sanatorium, Newcastle, Co. Dublin 28,612 17 3 1,121,655 10 4 519,664 3 8 1,669,932 11 3 Pelletstown Auxiliary Hospital, Dublin 43,385 4 9 43,385 4 9 Pigeon House Sanatorium, Dublin 1,849 12 6 1,849 12 6 Provisional Cancer Council 1,500 0 0 1,500 0 0 Public Health Centre, Mallow, Cork 6,882 19 0 6,882 19 0 Public Health Clinic, City Hall, Cork 1,689 5 0 1,689 5 0 c:t Public Health Clinic, Dun Laoghalre, Co. Dublin 11,834 19 11 11,834 19 11 Public Health Clinic, Limerick 3,639 4 0 3,639 4 0 Public Health Clinic, Balllna, Mayo 126 15 0 126 15 0 PubliC Health CliniC, Ballybay, Monaghan 3,400 0 0 3,400 0 0 Public Health Clinic, Carrlckmacross, Monaghan 4,646 5 2 4,646 5 2 Public Health Clinic, Castleblayney, Monaghan 3,964 5 8 3,964 5 8 public Health Clinic, Clones, Monaghan 4,746 1 4 4,746 1 4 Public Health CliniC, Monaghan 461 3 9 461 3 9 Portluncula Hospital, Balllnasloe, Galway 507,188 0 0 270,970 11 8 778,158 11 8

Queen's Institute of District Nursing 46,310 11 11 46,310 11 11

Regional Polio Service 17,325 4 10 17,325 4 10 Reglna Coell Hostel, Dublin 10,830 0 0 10,830 0 0 Regional Hospital, Cork 95,874 13 7 95,874 13 7 Regional Hospital, Galway 2,640,683 14 2 2,640,683 14 2 Regional Hospital, Limerick 1,393,855 19 11 1,393,855 19 11 Regional Maternity Hospital, Limerick 433,737 6 8 433,737 6 8 Regional Sanatorium, Cork 1,695,685 3 9 1,695,685 3 9 Regional Sanatorium, Dublin 1,944,660 16 8 1,944,660 16 8 Regional Sanatorium, Galway 1,955,407 8 6 1,955,407 8 6

------~------Funds received Maintenance Capital Hospital or Health Agency from 1st six Payments Grants Totals Sweepstakes

Rheumatism Clinic, Association, Dublin 12_6,224 4 11 18,059 5 11 144,283 10 10 Rlalto Hospital, Dublin .200,902 11 3 200,902 11 3 Rotunda Hospital, Dublin 36,252 4 0 2,229,263 3 1 451,439 4 11 2,716,954 12 0 Royal City of Dublin Hospital, Dublin 91,293 2 11 1,480,729 8 8 90,119 0 7 1,662,141 12 2 Royal Hospital, Dublin .238,000 0 0 36,969 15 11 274,969 18 11 Rochfort Wade Hostel for Blind Women, Dublin 567 9 10 567 9 10 Royal Victoria Eye and Ear Hospital, Dublin 18,9.27 4 11 888,038 0 0 45,560 11 10 952,525 16 9 Royal National Hospital for Consumption, Newcastle, Co. WICklow 709,554 0 0 386,982 5 5 1,096,536 5 5

Sacred Heart Home, Bessboro, Co. Cork 23,605 0 0 23,605 0 0 Sir Patrlck Dun's Hospital, Dublin 176,581 13 11 1,475,253 14 10 117,938 16 4 1,769,774 5 1 Shell Hospital, BaUyshannon, Co. Donegal 18,505 12 11 88,819 0 0 28,388 14 4 135,713 7 3 South Charitable Infirmary, Cork 60,667 5 2 296,888 0 0 12,530 11 1 370,095 16 3 SI. Anne's Skin and Cancer Hospital and SI. Brlgld's Auxiliary Hospital, Dublin 61,113 3 6 252,039 15 9 42,826 19 11 355,979 19 2 ~ St. Augustine's Home for Mental Defectlves, Dublin 64,825 9 1 64,825 9 1 SI. Brendan's Hospital, Mlllstreet, Cork 5,679 2 9 5,679 2 9 St. Brlgld's Sanatorium, Laols 22,887 6 3 22,887 6 3 SI. Colman'S Hospital, Macroom, Cork 2,298 9 4 2,298 9 4 SI. Columba's, Killybegs, Donegal 70,395 8 9 70,395 8 9 St. Columcllle's Hospital, Loughllnstown, Co. Dublin 191,232 1 5 191,232 1 5 SI. Clare's Hospital, Dublin 7.2,517 10 5 7.2,517 10 5 SI. Conleth's Sanatorium, Co. Kildare 1,798 19 9 1,798 19 9 SI. Carthage's, Lismore, Co. Waterford 7,528· 1 5 7,528 1 5 St. Colman's, Rathdrum, Co. Wicklow 1,800 0 0 1,800 0 0 Cork Polio and General After-Care Association 74,608 3 7 74,608 3 7 st. Fachtna's Hospital, Sklbbereen, Cork 2,433 12 0 2,433 12 0 St. Fellm's Hospital, Co. Cavan 1,505 7 0 1,505 7 0 St. Flnbarr's Hospital, Cork 173,031 9 2 173,031 9 2 St. John's Hospital, Limerick 22,330 11 9 206,558 0 0 80,717 2 7 309,605 14 4 SI. Joseph's Hospital, Mount Desert, Co. Cork 80,344 14 1 80,344 14 1 SI. Joseph's Home, Clonsllla, Co. Dublin 281,056 16 0 281,056 16 0 SI. Joseph's Asylum for Male Blind, Dublin 34,665 5 10 34,665 5 10 St. Joseph's, Kllcornan House, Co. Galway 99,349 17 1 99,349 17 1 SI. Joseph's Orthopaedic Hospital, Coo le, Co. Westmeath 39,771 2 11 8,848 0 0 110,850 3 5 159,469 6 4 ------'------

St. Anthony's Hospital, Herbert Avenue, Merrlon, Dublin 17,329 19 1 17,329 19 1 SI. Joseph's Hospital, L1stowel, Co. Kerry 1,543 5 8 1,543 5 8 SI. Patrlck's Hospital and County Home, Carrlck-on- Shannon, Co. Leitrim. 27,998 1 11 27,998 1 11 St. Kevln's Hospital, Dublin 827,906 12 3 827,90612 3 st. Loman's Mental Hospital, Dublin 431 15 0 431 15 0 St. Laurence's Hospital (existing), Dublin 163,802 10 1 3,148,513 7 4 154,280 16 3 3,466,596 13 8 SI. Laurence's Hospital (new), Dublin 98,733 2 6 98,733 2 6 SI. Laurence's Home, Lota Park, Cork (Cheshire Foundation) 426 13 2 426 13 2 St. Luke's Hospital and Hostel, Dublin 1,282,961 7 2 931,641 7 4 2,214,60.2 14 6 st. Mary's Open-Air Hospital, Cappagh, Co. Dublin 48,946 7 9 569,585 0 0 163,589 .2 2 782,120 9 1l St. Mary's Asylum for the Blind, Dublin 66,429 19 0 66,429 19 0 St. Mary's, Drumcar, Co. Louth 461,415 0 5 461,415 0 5 SI. Mary's Convent, South Hili, Delvln, Co. westmeath 226,306 5 11 226,306 5 11 St. Mary's Chest Hospital, Dublin 820,282 11 7 820,282 11 7 St. Margaret of Cortona, Dublin 2,500 0 0 2,500 0 0 St. Mlchael's Hospital, Dun Laoghalre, Co. Dublin 49,777 8 2 415,697 0 0 207,673 12 3 873,148 0 5 St. Mlchael's, Lota, Glanmlre, Co. Cork 13,490 12 4 13,490 12 4 St. Michael's Hospital, Beleek, Co. Mayo 18,533 0 0 18,533 0 0 ut St. Patrlck's, Belmont Park, Waterford 1,551 18 4 1,551 18 4 St. Gabrlel's School for Handicapped Children (Day Clinic for Cerebral Palsy cases) 2,000 0 0 2,000 0 0 St. Patrlck's Incurable Hospital, Cork 17,093 9 10 199,251 0 0 26,007 14 1 24:Z,352 3 11 St. Patrlck's Infant Hospital, Temple Hili, Co. Dublin 216,323 0 0 11,292 1 0 227,615 1 0 st. Patrlck's Guild, Dublin 31,274 18 10 8,338 0 0 39,612 18 10 St. Patrlck's, Kilkenny 12,615 0 0 12,615 0 0 St. Peter's Maternity Home, Castlepollard, Co. Westmeath 7.2,501 0 2 72,501 0 2 st. Raphael's, Oakley Park, Celbrldge, Kildare 249,44.4 3 10 249,444 3 10 St. Senan's Hospital, Foynes, Co. Limerick 72,320 9 5 72,320 9 5 St. Theresa's SanatoriUm, Co. Mayo 1,465 10 0 1,465 10 0 SI. Vincent's School and Home, Cab ra, Dublin 50,908 16 2 50,908 16 2 SI. Vincent's Hospital, Dublin 94,443 13 4 1,930,622 19 10 66,944 12 5 2,092,011 5 7 st. Vincent's Hospital, Elm Park, Dublin 3,073,368 3 11 3,073,368 3 11 Sf. Vincent's Hospital, Tullamore, Co. Offaly 1,074 15 6 1,074 15 6 St. Vincent's Hospital, Athy 10,000 0 0 10,000 0 0 St. Vincent's, L1snagry, Co. Limerick 424,017 18 11 424,017 18 11 st. Mlchael's House, Cavendlsh Row, Dublin 10,000 0 0 10,000 0 0 School of Our Lady of Fair Lov•• KU!ctInny 11,000 0 0 11,000 0 0 Funds received Maintenance Capital Hospital or Health Agency from 1st six Payments Grants Totals Sweepstakes

Stewart's Hospital, Palmerstown, Co. Dublin 213,652 6 10 .213,652 6 10 Sean Ross Abbey, Roscrea, Co. Tipperary, N.R. 47,163 4 9 47,163 4 9 SI. Teresa's Home, Blackrock, Co. Dublin 38,207 3 7 38,207 3 7

Teach Ultaln, Dublin 62,757 4 6 183,408 0 0 51,193 3 8 297,358 8 2 Toghermore Re-ablement and Training Centre 7,500 0 0 7,500 0 0 Tuberculosis Hospital, Mulnebheag, Co. Carlow 31,732 13 3 31,732 13 3 Tuberculosis Hospital, Keadue, Co. Cavan 389 7 6 389 7 6 Tuberculosis Hospital, Llsdarn, Co. Cavan 82,013 1 1 82,013 1 1 St. Joseph's, Llsdarn, Co. Cavan (conversion from T.B •. to General Medical Hospital) 68,980 7 0 68,980 7 0 Tuberculosis Clinic, GraHan Street, Cork 191 4 0 191 4 0 ....en Tuberculosis Dispensary, Carrick-on-Shannon, Co. Leitrim 1,596 7 0 1,596 7 0 Tuberculosis Institution, Drogheda, Co. Louth 26 15 6 26 15 6 Tuberculosis Hospital, Monaghan 58,423 7 3 58,423 7 3 Tuberculosis Institution, Rathdrum, Co. Wicklow 19,459 13 6 19,459 13 6

Valentla Hospital, Co. Kerry 721 16 5 244 4 0 966 0 5 Vergemount Fever Hospital, Dublin 71,9.21 19 4 71,921 19 4 Victoria Hospital, Cork 103,04.2 14 9 - 103,042 14 9

Waterford Maternity Hospital 23,602 12 11 90,437 19 1 17,597 2 1 131,637 14 1 Woodlands Sanatorium, Co. Galway 214,633 12 9 214,633 12 9

GRAND TOTALS 2,659,322 1 4 37,819,605 5 1 44,026,839 5 2 84,505,766 11 7

GROSS TOTAL OF PAYMENTS FROM 1930 TO 1969 INCLUSIVE-£84,505,766 11 7. (This total includes £14.81 million Grants-In-Aid from the Exchequer to the Hospitals Trust Fund In the years 1953 to 1969.) MONKSTOWN HOSPITAL, Originally the Rathdown Infirmary, Monks­ town Hospital came to Its present site in 1835. A small hospital with ,26 bedsit treats over 2,000 out-patients a year and Is an Important asset to its community.

77 LIST OF CAPITAL WORKS CARRIED OUT OR IN THE PROCESS OF COMPLETION BETWEEN 1956.1969

VOLUNTARY HOSPITALS

COUNTY CORK St. Agatha's Radiotherapy Clinic: Establishment of clinic for treatment of cancer cases; Cobalt and Isotope Units. Eye, Ear and Throat Hospital: New sanitary annexes, etc. North Charitable Infirmary: New Nurses' Home. Mercy Hospital: Extension. Erlnvllle Hospital: New Maternity Block (55 beds). Cork Polio and General After Care Association: Adaptations to Tracton House to provide 30 beds for, mental handicap patients and new day­ rooms.

DONEGAL Shell Hospital, Ballyshannon: New Operating Theatre.

DUBLIN Rotunda Hospital: New Permanent Infants Unit (30 beds) and extension to Nurses' Home (30 bedrooms).

Royal City of Dublin Hospital: Cardio-Pulmonary Unit; Cardiac surgical unit; conversion of adjacent premises Into staff home; Improvements to East Wing.

Sir Patrlck Dun's Hospital: New Pathology Laboratory, Mortuary, Cafeteria, etc.

Hospitals Joint Services Board: Establishment of Central Sterile Supply Services and Central Laundry.

New St. Vincent's Hospital, Elm Park: New General Teaching Hospital of 455 beds.

New Coombe Hospital: New Maternity Hospital, 144 maternity beds, 58 gynaecological and 51 paediatric beds.

Meath Hospital: Alterations in the West Wing; Improved boiler facilities. Peamount Hospital: New workshops for mentally handicapped. Jervls Street Hospital: New Operating Theatre Suite.

78 Our Lady of Lourdes, Dun Laoghalre: Adaptations and Extensions to provide a National Rehabilitation Centre. St. Mary's Hospital, Cappagh: Improvements to Staff Accommodation. National Maternity Hospital, Holies Street: 50 bed extension. St. Luke's Hospital: Extensions to provide Cobalt Units and Isotope Department. Central Remedial Clinic, Clontarf: New clinic. Mater Hospital: Extension to provide Lecture Theatre, Casualty Depart­ ment, two extra operating theatres and ancillary accommodation. St. Mary's, Baldoyle: Increased patient and staff accommodation, etc. Children's Hospital, Temple Street: New Nurses' Home and X-Ray. Royal Victoria Eye and Ear Hospital: Additional Staff accommodation, etc. Stewart's Hospital, Palmerstown: 20 bed extension; Central heating. St. Teresa's, Blackrock: Improvements to Existing Dormitories. St. Vincent's, Cabra: New Sanitary Annexes, heating of chapel, etc. Beaumont Convalescent Home: 24 bed Unit for emotionally disturbed children including autistic patients. Adelaide Hospital: New O.P.D. and residential Quarters for medical and nursing staff.

Royal Hospital, Donnybrook: Maintenance Works.

GALWAY Portiuncula Hospital, Balllnasloe: New Staff Home for 70 Nurses. St. Joseph's, Kilcornan: Scheme of Renovations. Woodlands Sanatorium: Conversion to Mental Handicap Institution (110 beds).

KILDARE Moore Abbey, Monasterevan: Extensions to. provide Convent, Chapel and 155 beds for mentally handicapped patients. (This institution Is now being used for mental handicap.)

KERRY St. Mary of the Angels, Beaufort: Accommodation for moderate and severe mentally handicapped children (60 beds).

79 KILKENNY St. Patrick's, Kilkenny: Adaptations to former industrial school to pro­ vide 100 beds for mental handicap patients.

LIMERICK St. Vincent's, Lisnagry: Extensions to provide 220 beds, boilerhouse, kitchen, laundry, staff home and training school. St. John's Hospital: Training School and Nurses accommodation. Barringlon's HospItal: New Operating Theatre Suite and ancillary im­ provements, Fire Prevention Measures.

LOUTH SI. Mary's, Drumcar: New Staff Home and Assemply Hall. Our Lady of Lourdes, Drogheda: Extension (100 beds).

SLIGO La Sagesse Mental Handicap Institution: Extension (143 beds); Chalets for staff and senior girls

WATERFORD St. Patrlck's, Belmont Park: Adaptations to provide 60 beds for mental handicap.

WESTMEATH St. Mary's Delvin: Extensions to provide 140 beds for mental handicap, including 20 bed psychotic unit and staff chalet.

LOCAL AUTHORITY HOSPITALS

COUNTY CARLOW St. Dympna's Hospital -Maternity Unit (24 beds) Carlow Mental Hospital -Central Heating, Sanitary Annexes, Bathrooms, Ward Renovations and General Improvements.

COUNTY CAVAN Lisdarn Hospital -Conversion of Hospital for use as Medical and Mater­ nity Hospital (90 beds). -Erection of Nurses' Home (40 beds).

COUNTY CLARE Ennis County Hospital -New X-ray Department. Ennis Mental Hospital -Central Heating, Sanitary Annexes, Bathrooms, New Kitchen, General Improvements of Wards and Buil­ dings.

80 COUNTY CORK Castletownbere District Hospital -Scheme of General Renovation (30 beds). Cork Mental Hospital -Admission Unit (60 beds). -st. Brigid's Unit-Renovation Scheme. -Grey Building (in progress)-General Improvement Scheme (central heating, sanitary annexes, bath- rooms).

Mallow County Hospital -X-Ray Department. -Pathological Department (Extension).

St. Flnbarr's Hospital -New X-Ray Department. _Cubiclisation of Wards. -Renal Dialysis Unit -Professorial Unit (in progress). -Casualty Unit (in progress).

Youghal Mental Hospital -Central Heating, Sanitary Annexes and General Im- provements (in progress).

COUNTY DONEGAL Letterkenny County Hospital -90 beds. Letterkenny Mental Hospital -Improvements to Kitchen, Dayrooms and Diningroom. Carndonagh District Hospital -31 beds. Dungloe District Hospital -33 beds.

COUNTY DUBLIN o Ballyowen Mental Hospital -Pre-Adolescent Unit (12 beds). Grangegorman Mental Hospital -Reconstruction of Division 2. -New O.P.D. and Teaching Unit. -New Boilerhouse. -Female Visiting Hall and Cinema. -Electrical Installation -Unit for Drug Addicts and Alcoholics -Staff Accommodation

Portrane Mental Hospital -Replacement of Boilers. -New Nurses' Home (90 beds). -Replacement of External Heating Ducts (in progress)

81 St. Kevin's Hospital -Emergency Generating Equipment -Central Boilerhouse, Laundry, etc. -Hospital 3 Kitchen -Staff Canteen. -Nurses' Home -P.A.B.X. Telephone System (in progress) -Psychiatric Unit (40 beds In progress) -Extension to Maternity Unit (in progress) (50 beds) and O.P.D. facilities, Nurses' training school

COUNTY GALWAY Galway Regional Hospital -Medical Staff Residence. -New Gynaecological Theatre Suite -General re-equipment of Radiology Department (in progress) Ballinasloe Mental Hospital -Re-erection of St. Joseph's Unit -Dining Room. Kitchen -Unit for Mentally Handicapped -Catholic Chapel (in progress) -Sanitary Annexes (in progress)

COUNTY KERRY Tralee County Hospital -New X-Ray Department and Casualty Unit. Killarney District Hospital -Maternity Unit (10 beds) Killarney Mental Hospital -New Kitchen and Ancillary Works -Improved hot and cold water systems -Replacement of Boiler Plant

COUNTY KILDARE St. Vincent's Hospital, Athy -Maternity Unit (14 beds) Erection of Naas County Clinic -General Renovation of County Hospital, Naas (90 beds)

COUNTY KILKENNY Kilkenny County Hospital -New Nurses' Home (40 beds). Kilkenny Mental Hospital -Improvements scheme (central heating, kitchen, dininghall, etc.) -New 100 Bed Unit (in progress)

82 Kilcreene Orthopaedic Hospital -90 beds

COUNTY LAOIS Conversion of Abbeylelx Fever Hospital for use as District Hospital . -42 beds Portlaoise County !iospital -Conversion of Staff Quarters into a maternity and pre- maternity unit -Nurses' Home (60 beds) -Replacement of Boiler Plant

Portlaoise Mental Hospital -Boilerhouse and Heating Services. -General Rehabilitation Scheme (uPQradinQ of wards). dininghall, kitchen.

COUNTY LIMERICK Limerick Regional Maternity Hospital -107 beds Limerick Regional Hospital -X-Ray 'Equipment Limerick Mental Hospital -Replacement of boilers and improvements to heating services

Croom Orthopaedic Hospital -Electrical Rewiring (in progress)

COUNTY LOUTH Ardee Mental Hospital -Improvements Scheme (heating wards, toilet facili­ ties); Occupational Therapy Unit

Dundalk County Hospital -132 Beds

COUNTY MAYO Castlebar County Hospital -New Maternity Unit (40 beds) Castlebar Mental Hospital -Admission Unit (52 beds) Ballina District Hospital -General Renovation Scheme (in progress) (90 beds) I including new O.P.D.) COUNTY MEATH i Navan County Hospital -Centralisation of heating services and water supply Orthopaedic Unit (60 beds)

83 COUNTY MONAGHAN Monaghan County Hospital -Improv·ements Monaghan Mental Hospital -New Nurses' Home -Kitchen, Dininghall, Stores anI;! Boilerhouse (in pro· gress)

COUNTY OFFALY Tullamore County Hospital -Nurses' Home (60 beds)

COUNTY ROSCOMMON Roscommon County Hospital -Maternity Extension (10 beds)

COUNTY SLIGO Sligo County Hospital -Extension (121 beds) and new Operating Theatre, O.P.D. X-ray Department, etc.

Sligo Mental Hospital -Occupational Therapy Unit -Sanitary Annexes, Bathrooms and Kitchenettes (in progress)

TIPPERARY N.R. Nenagh County Hospital -New Nurses' Home (29 beds)

TIPPERARY S.R. Clonmel Mental Hospital I -General scheme of Renovation (Wards, heating, sanitary annexes) r/ -Admission,Unit (50 beds) . / -Renovation of Nurses' Home

COUNTY WATERFORD Waterford Mental Hospital -General Rehabilitation Scheme (diningroom, kitchen­ ettes, division of wards, electrical system)

COUNTY WESTMEATH Mullingar County Hospital -New X·Ray Department Mullingar Mental Hospital -Central Heating. -Boiler Replacement, Ward Reconstruction and Gene· rallmprovements (in progress)

84 COUNTY WEXFORD Enniscorthy Mental Hospital -General Scheme of Rehabilitation. Roof Repairs. Central Heating. Sanitary Annexes. Ward Reconstruc­ tion, etc. (in progress).

Wexford County Hospital -General Improvements Scheme (New O.P.D. Dept.. and X-Ray Dept.)

85 ST. LUKE'S HOSPITAL, Highfield Road, Dublin, was opened by the Cancer AssocIation In the year 1954 and has 147 beds, Deep Therapy Units and Cobalt and Isotope LaboratorIes.

86 ,

LIST OF PROJECTED MAJOR HOSPITAL SCHEMES DUE TO BE INITIATED

VOLUNTARY HOSPITALS Estimated Cost General Hospitals £980,000 (Including a new Neurosurgical Unit, extension to Out-Patient and X-Ray Departments and general improvements at St. Laurence's Hospital, Dublin; additional residential accommodation for partially deaf girls and for staff at St. Mary's School for Hearing-Impaired Children, Cab ra, Dublin; additional residential accommodation for deaf boys at MarY Immaculate School for Deaf Boys, Stillorgan, Co. Dublin; reconstruction and general improvements to Linden Convalescent Home, Blackrock, Co. Dublin; an extension to the Pathology LaboratorY at the Mater Hospital, Dublin; provision of a new Staff Home at St. Patrick's Infant Hospital, Blackrock, Co. Dublin; and a new Nurses' Home at Victoria Hospital, Cork). Institutions for Mentally Handicapped £3,350,000 (Including extensions at Tracton Park, Cork, for the Cork Polio and General After-Care Association to provide new units for severely mentally handicapped children, kitchen and boilerhouse, etc.; a scheme of adaptations to existing buildings and new buildings for adults at St. Patrick's, Upton, Cork; additional accommodation for adults plus a new work-shop and staff accommodation at Peamount Hospital, Co. Dublin; extra accommodation for adult patients, recreation centre, etc. at St. Joseph's, Kilcornan, Co. Galway; a new extension for children to relieve overcrowding plus workshop accommodation at Stewart's Hospital, Palmerstown, Co. Dublin; new patient units, Staff chalets, new children's unit and adaptations to existing buildings to provide accom- modation for adults at St. Raphael's Celbridge, Co. Kildare; a scheme of adaptations to existing buildings, plus staff home and new boiler plant, exten- sion to provide accommodation for adults at St. Patrick's, Kilkenny; a new children's unit, convent and chapel, extension to provide accommodation for adults at Cregg House, Sligo; adaptations and improvements to existing buildings at st. Anne's, Corville, Co. TipperarY (formerly Sean Ross Abbey); an extension to provide accommodation for adults and a new alcoholic unit at St. Patrick's, Belmont Park, Waterford; a new centre for adults at Banemore, Limerick; new accommodation for adults at st. Joseph's, Clonsilla, Co. Dub- lin; and a new centre to provide accommodation for mentally handicapped children at Galway). Institutions for Mentally III £550,000 (Including psychiatric units for adults and children at St. John of God's, Still- organ, Co. Dublin; a new psychiatric unit at St. Vincent's, Elm Park; and a new Psychiatric Unit in St. Vincent's, Fairview). Total Estimated Cost £4,880,000

87 LOCAL AUTHORITY HOSPITALS Estimated Cost

GENERAL HOSPITALS £10,370,000

CORK GENERAL HOSPITAL (600 beds) General and Dental Hospital and School

TRALEE GENERAL HOSPITAL General Surgical, Medical and Maternity Hospital

MALLOW COUNTY HOSPITAL (98 beds) Improvements Scheme including Staff Accommodation, Nurses' Din­ ;ing Room, Mortuary, Chapel, Boilerhouse.

SLIGO COUNTY HOSPITAL Nurses' Flatlets providing 54 beds.

WEXFORD COUNTY HOSPITAL New Maternity Unit providing 31 beds and 50 bed geriatric unit.

CHERRY ORCHARD Smallpox Unit.

MENTAL HOSPITALS Estimated Cost £880,000

CORK MENTAL HOSPITAL St. Kevin's Unit, Improvements Scheme (new kitchen, ce]ltral heat­ ing and general upgrading of con­ ditions).

SLIGO MENTAL HOSPITAL New Nurses' Home (52 beds), Central Boilerhouse.

ST. DYMPHNA'S HOSPITAL, CARLOW Maternity Unit (25 beds).

GALWAY REGIONAL HOSPITAL Psychiatric Unit (25 beds)

KILLARNEY MENTAL HOSPITAL New 50-bed Unit. PORTRANE MENTAL HOSPITAL Central Heating Installation.

WORK THERAPY UNITS At mental hospitals.

ESTIMATED COST £11,250,000

ESTIMATED TOTAL COST OF COMBINED VOLUNTARY AND LOCAL AUTHORITY HOSPITALS £16,130,000

88 FUTURE HOSPITAL PLANNING AND FINANCING

While considerable progress has been made In the extension, Improvement and adaptation of hospital services In Ireland-to an extent which would have been Impossible without the financial assistance provided by the Irish Hospitals' Sweepstakes, as the figures else· where In this publication show-there stili remains to be completed a varied and extensive programme of projects necessary to bring overall standards up to a level which will compare favourably with those obtaining In the more advanced countries of the world.

GENERAL HOSPITAL SERVICES Hospital services are by far the costliest element In the present health services, and for reasons of economy as well as for medical efficiency a long·term policy of re-organisation and Improvement Is required. The Report of the Consultative Council on the General Hospital Services has drawn attention to the delects In the present general hospital system and has made recommendations as to the manner In which they should be remedied. The recommendations envisage, briefly, the concentration of patients requiring acute medical care Into a small number of large hospitals of which there would be two categories, regional hospitals and general hospitals. As new and extended accommodation becomes available In these acute hospitals many existing Institutions would provide lor patients requiring less specialised care, including convalescent patients. A wide range of out-patient services staffed by the specialists from the main centres would also be available In the latter category of hospital. The Implementation 01 the recommendations of this Report, which have, In principle, been accepted by the Minister for Health, will Involve considerable capItal expenditure.

THE MENTALLY ILL AND HANDICAPPED Policy during the next ten years In relation to the mentally III will be based largely on the recommendallons of the Commission on Mental Illness. There are at present over 16,000 patients occupying beds In mental hospitals. About 10,000 01 these are long-stay patients and the aim Is to develop treatment methods so as to reduce to about 5,000 the number requiring such accommodation. A policy 01 establishing short-term residential treatment units In close association with general hospitals has already been Initiated and will be developed during the coming years. These units will be comprehensively staffed, and Industrial therapy units, sheltered workshops, day hospitals and hostels will also be provided as a means of restoring patients to their normal livelihood. Special units will also be established lor psychiatric children, disturbed adolescents and alcoholics, addicts and psychopaths.

89 A programme arising from the recommendations of the Commission on Mental Handicap has been In train during the last few years. Schemes In progress or In planning will provide over 1,400 additional places. Further schemes In the 1970·1980 period will Include special units such as sheltered workshops, accommodation for delinquent boys who are mentally handicapped and hostels for adults living In community. Existing reSidential homes will need to be upgraded and staff accommodation Improved. As In the case of the general hospitals, very substantial capital expenditure will arise In the Implementation of these programmes.

RESEARCH

Research on certain medlco-soclal subjects will be carried out during this period by the Medica-Social Research Board, a corporate body established by the Minister for Health and financed by the Hospitals' T~ust Fund. Two studies already Initiated will expand and continue Indefinitely. These relate (a) to a study of hospital In'patlents and (b) community mental health.

Three other studies now under way will be completed within two or three years. These are (a) a study of coronary thrombosis; (b) alcoholism study, and (c) a drug addiction survey. The scope of medica-social research Is unlimited and the demand for new and more detailed Investigations must be expected to Increase. The other, long established forms of medical research must, of course, continue at an Increasing level of activity In order that the standards of medical teaching and practice may be maintained. These activities also represent a growing demand on the funds available for the maintenance and develop­ ment of the health services. '

90 ST. VINCENT'S HOSPITAL, Elm Park, opened In November 1970, Is one of the largest general teaching hospitals In the country with 455 beds.

91 /

ASSOCIATED HOSPITALS' SWEEPSTAKE COMMITTEE

Chairman: The Rt. Hon. Viscount Powerscourt Vice·Chalrman: Dr. J. P. Shanley

James Adam, Esq., *Denls P. Kelleher, Esq., P.C., *B. G. Alton, Esq., M.D., F.R.C.P.I., *Mrs. B. D. KingsmlJl·Moore, R. Archer, Esq., The Hon. Mr. Justice KlngsmJII·Moore, Ivor Harte Barry, Esq., Richard Lane, Esq., R. J. Barry, Esq., Dr. James Maher, Dr. Violet Broderlck, Dermot Mahony, Esq., Dr. A. D. H. Browne, Dr. Kevin Malley, Esq., M.D., Dr. P. A. Browne, Dr. MI. Malone, * A. B. Clery, Esq., F.R.C.S.I., P. J. Molony, Esq., Commander J. C. Colville, R.N., Deputy Sean Moore, T.D., M. M. Connor, Esq., Mrs. M. McCabe, Dr. T. M. Corbet, M.B., F.R.C.P.!., Major T. B. McDowell, *Dr. H. E. Counihan, Dr. P. McNally, Dr. E. Cull en, Miss Ann MacNamara, F.S.A.A., W. H. de WyaH, Esq., F.R.C.S., Rev. Canon MacSwlney, P.P., John F. Donnelly, Esq., F.C.A., T. C. J. O'Connell, Esq., F.R.C.S., *John T. Donovan, Esq., B.L., Mr. Declan O'Connor, Mrs. Declan Dwyer, Dr. Rose O'Doherty, *Dr. E. T. Freeman, M.D., F.R.C.P.I., Mr. Denzil O'Donnell, Eugene Gallagher, Esq., Solicitor, Francls J. O'Donnell. Esq., F.R.C.S., Frank Gallagher, Esq., Solicitor, *John B. O'Donoghue, Esq., *C. Gore·Grimes, Esq., Solicitor, *Jerome O'Driscoll, Esq., E. Greene, Esq., *Frank A. J. O'Hare, Esq., M. E. I. Harvey, Esq., *J. J. O'Leary, Esq., A. Healy, Esq., T.D., T.C., M.C.C., John Declan O'Leary, Esq., Samuel Hegan, Esq., C. J. Orr, Esq., John A. Holmes, Esq., M.B., M.A.O., R. N. Pidgeon, Esq., M.R.C.O.G., T. D. Purcell, Esq., Dr. John Holmes, Dr. Harold Qulnlan, Commander Benthan Howe, R.N. (Retd.), Or: Desmond Reddin, *Mrs. L Hunt, Dr. D. J. Riordan, Mrs. N. Irwln, Dr. M. J. Roberts, R. W. R. Johnston, Esq., LL.B., James P. Roche, Esq., T. M. Kavanagh, Esq., M.D., Dr. Angela Russell,

92 Dr. Col man Saunders, Mrs. C. Treston, Mrs. J. A. Sealy, Miss Walker, *Frank E. Sheedy, Esq., *The Earl of Wicklow Mrs. John Silcock, T. G. Wllson, Esq., F.R.C.S. Mr. A. D. Thom,

* Denotes Executive Members

TRUSTEES FOR THE PRIZE FUND

Sean Lemass, Esq., T.D., Dr. Patrlck J. Hernon, Dr. J. F. Dempsey, Patrick Walsh, Esq.,

TRUSTEES FOR THE HOSPITALS' FUND Percy McGrath, Esq., James Troy, Esq., J. R. Miley, Esq., L. S. Furlong, Esq.

• 93 INDEX TO PHOTOGRAPHS

HOSPITALS ARCHITECTS PAGE Frontispiece: Central Remedial Clinic, Dublin Mlchael Scott & Partners 2 (Photograph by kind permission of the Architectural Journal) St. Vincent's Hospital, Elm Park, Dublin Downes, Meehan & Robson 42 Our Lady of Lourdes Hospital, Drogheda D. L. Martin & J. A. White 43 Mater Mlserlcordlae Hospital, Dublin W. H. Byrne & Son 44 Adelaide Hospital, Dublin Hope Cuffe & Associates 45 (Photographs by Desmond O'Rlordan) Galway Regional Hospital, Galway T. J. Cullen & Co. 46 Barrington's Hospital, Limerick Newenham & Associates 47 Sligo County Hospital Nolan & Qulnlan 48 (Photograph by Brlan Leech) SI. Agatha's Radiotherapy Clinic, Cork T. P. Kennedy 49 Louth County Hospital, Dundalk T. J. Cull en & Co. 50 District Hospital, Dungloe, Co. Donegal Ellis & Scally 51 County Hospital, Letlerkenny, Co. Donegal Nolan & Quinlan 51 St. Mary's Hospital, Baldoyle, Co. Dublin W. H. Byrne & Son 52 Cork Spastic School and Clinic, Cork Kelly & Barry & Associates 53 Our Lady of Lourdes Hospital, Dun Laoghalre W. H. Byrne & Son 54 Central Remedial Clinic, Dublin Mlchael Scott & Partners 55 (Photographs by kind permission of The Architectural 56 Journal) National Maternity Hospital, Holies Street, Dublin W. H. Byrne & Son 58 Coombe Hospital, Dublin T. P. Kennedy 58 (Photograph by "Irish Times") Rotunda Hospital, Dublin Alan Hope 59 SI. Vincent's Hospital, Athy, Co. Kildare Nlall Meagher 59 Coombe Hospital, Dublin T. P. Kennedy 60 County Hospital, Castlebar, Co. Mayo J. F. McCormack 60 St. Mary of the Angels, Beaufort, Co. Kerry W. H. Byrne & Son 61 St. Luke's Hospital, Clonmel, Co. Tipperary W. O. Morrissey 61 Nurses' Home, Portrane Hospital, Co. Dublin Vincent Kelly 62 St. Mary's, Delvln, Co. Westmeath Guy Moloney Associates 63 Peamount Hospital, Co. Dublin T. P. Kennedy 64 St. Paul's Hospital, Beaumont, Dublin W. H. Byrne & Son 64 Drawings by Fergus O'Ryan, R.H.A., A.N.C.A. (Design)

94 CONTENTS

PAGE 7 Tribute from Erskine Chllders, T.D., Tanaiste and Minister for Health 4

Foreword 6

Reamhr6 9

The Success of the Irish Hospitals' Sweepstakes 11

The Development 01 Hospital Services in Dublin 14

Recent Hospital Developments In Ireland 21

Development 01 Hospital Services in Rural Ireland 26

Photographic Supplement 42

',;;'\ Payments to Hospitals and Health Agencies Irom Sweepstake Funds from 1930-1969 (Inclusive) 66

List 01 Capital Works Carried Out or In the Process 01 Completion Between 1956-1969 78

List 01 Projected Major Hospital Schemes Due to be Initiated 87

Future Hospital Planning and Financing 89

Associated Hospitals' Sweepstake Committee 92

Trustees For The Prize Fund 93

Trustees For The Hospitals' Fund 93

Photographic Index 94

j Grateful acknowledgment Is made to all who helped In the compilation of this book. Editor E. de Barra, designed by Caps Publicity Ltd., printed by Abbey Printing Service Ltd.