North Western Health Board annual report 1985
Item Type Report
Authors North Western Health Board (NWHB)
Publisher North Western Health Board (NWHB)
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Tuairisc Bliana 1985 Annual Report 1985 Health Board North~AreaLocatton of Principal Centres.
A Headquarters
B General Hospitals
C District Hospitals
D Community Hospitals
E Psychiatric Hospitals
F Geriatric Hospitals
f 1/ Pre-Schoo I/ Day Centres G forRes Mentalid.:m lal Y Handicapped
H Welfare Homes
Commum. t y Care Offices
J Commum.t Y Nursing Units K Training Centres Tuairisc Bliana 1985 Annual Report
OFFICE OF CHIEF EXECUTIVE OFFICER, B6rd Sl6inte an lar· Thuaiscirt, Cluainln, Co. liatroma. F6n: (0721 55123 Teleics: 40414
JULY 1986.
Submitted to Members of North Western Health Board at Annual General Meeting on 21st July. 1986.
Os comhair Baill 86rd Sl6inte an lar-Thuaiscirt ag Cruinniu Chinn-bliana 21u 1un. 1986. CONTENTS
Page Chairman's Report 5 N.W .H.B. Demography/ Financial Cut-Backs 11 The Board and Management Team 23 N.W .H.B. Standing Committees 29 Local Health Advisory Committees 33 Hospital Care 39 Community Care 61 Personnel 81 Finance 87 Appendices ... Hospital Care 95 Appendices ... Community Care 107
4 Chainnan's Report
5 6 Tuairisc Chairman's An Foreword Chathaoirligh
As has been the case each year of this Cosuil le chlls gach blisns 6 thUs nA decade, 1985 was once again a year when hochtoidl i l~ith, dob ~ an gearradh ar an the major concern and preoccupation of ndeontas Birgid on Roinn SI!Jinte agus nB the Board were the severe difficulties fsdhbanna da bhtJ" ssn is rn6 bs chuis mini posed by the shortfall in the allocation agus ghnlmh an BhOird i 1985. Bhl briJ thsr received from the Department of Health to chuimse sr an bhfoireann sgus sr ns run our services. Stsff and services wfthout seirbhisl uile chun chsighdeAn sgus libMsl exception \IYBre under severe pressure in an !Jr bhfreastail a choinne!JI in !Jirde, effort to maintain the level and quality of d'sinneoin an ghsnntainis. our services within the constraints of the I rlth ns bliana, nior csil/eadh son deis financial allocation received. chun sire an Aire Slainte a dhiriu ar thorthsl an ghanntainls maidir le seirbhisl anseo, During the year no opportunity was agus chun ins lul sir gur d~ine 11 bhl an missed to bring to the attention of the gearradh ar an mBord seo nA arson Bhord Minister for Healh the effect of the financial Slsinte eile. cutbacks on services within this region and S~ an Bord seo is m6 a dhin dul-chun to highlight the fact that our Board seemed chinn seirbhisl phObsil a fhorbairt sgus to be more harshly treated in terms of chun sn beim a athriJ 6 churam ospidell go cutbacks than any of the other boards. dti curam phobail. Is d61As ansin na seirbhisl phobsil c~sdns s bheith tJ As the Board which has, probably more ngearradh. Ar bhea/ach, s~ an forbsirt rn6r than any other, made significant progress attJ desnta againn is m6 is cuis le chomh in the trtmsfer of care from hospital to dian is attJ sn isliu deontsis ss ~igiun seo. community, and which puts a higher Rinne an Bord 11 dhlchesll chun sicml proportion of its alocstion into community !Jirithe den phobsl s chossint, go h!Jirithe services, it is psrticulsrly depressing to see ns sesndsoine sgus ns dsoine these community services now being cut cithrimeachs. C~ go raibh gesrradh siar back as s result of these shortfalls in ann, 6sc/1Jiodh ns hsonsid scsgdheslbhu funding from the centre. In fact, it seems - dusin i Leitir Cesnsinn sgus i Sligesch that our very success in implementing this sgus tA ~ broduil ss sn tseirbhls, an policy over the years has been the cause fsoiS88mh sgus sn s6/ss etA A dtsbhsirt sg of our cuts being higher than those of any ns hsonsid seo. other Board. Ts suim mh6r I gCo. Listhroma, mo chonndse fh~in sr nd6igh, sgus ins ns Within this context of severe financial seirbhisl 11 chuirtesr sr f!Jil intf. Bhl m~ constraint the Board accorded prhrity to imnloch fsoin chosulscht s bhl ann go trying to protect the level of service ndunfsl ionsd /se Chsrraig-Droms-A 'Ruisc provision to the WNker ssctions of the sch ~ ~ slsts go ndesrnsdh socriJ chun community psrticu!IJrly the 11ged and the sn tionsd S80 choinneai OSCIIIte sgus chun hsndic11pped 11nd to find ways to iofllld N110mh Cia~n 11 fhorbllirt dons p{Jistl strengthen and m~~inttlin priority services. agus dsoine fists ~~~ lsg-intinnHch. 7
l N.W.H.B. DeDtography I Financial Cutbacks
11 12 The trend, which commenced in 1981, of decreasing financial resources being made available to run the North Western Health Board's services brings into focus the particular demographic and other factors which accentuate the difficulties posed by cutbacks in finance.
Compared to other health board areas, the North Western Health Board area has the highest percentage of elderly persons, the highest dependency ratio, the lowest average weekly household income, one of the lowest population densities, and a very high ratio of population living over 3 miles from a general practitioner. This Board has also the lowest ratio of acute hospital beds per 1,000 population. Notwithstanding the relative disadvantages posed by many of the factors outlined above. the Board has suffered the greatest cut in financial allocation of all Health Boards. Graphs illustrating the position of the Board as outlined above are detailed in the following pages.
13 ELDERLY PERCENTAGE OF POPULATION AGED 65 & OVER 20 -r------19 + ------·-·------, 1a -r ------·---·------·------·-·· -- ___ _. I l :: t ==== =~~ =-== ~-~- :~=--=-- =-~-~-~~~ ~= -~---~~~=~--== - :... · :_=~ ·_: -·=:~--~- _j ~: ---·------~~----~ -~-=-=------~--~~-~=~~-~----=~-=~-~-:~-~~=~~:~~- -~~: -~~~-~~--~ :-~~:- =:. ~ 13 ·------·-··-··--- -··--.. ·----·--- ______·j ~~ --~~--- -.. ·:_~ ------~ ------~~---:= _-_ -~ ~
9 ------... ------; 8 7 6 5 4 3 2 1 0 NWHB WHB SHB MWHB MHB SEHB NEHB EHB HEALTH BOARD SOURCE: TABLE A2, STATISTICAL INFORMATION RELEVANT To THE HEALTH SERVICES (DEPT. OF HEALTH, 1984) ..... DEPENDENCY RATIO ( 1981)
100
90 --+------·· -~------· -·------·------
80 ·- ·-- · -----~· ·· ------
70 0 ~ 60 b z w 50 Q z w a. 40 w 0 30
20-
10
0 NWHB WHB SEHB MHB NEHB MWHB SHB EHB HEALTH BOARDS SOURCE: BASED ON 1981 CENSUS OF POPULATION REPORT: C.S.O. iii AVERAGE WEEKLY HOUSEHOLD INCOME 1980 CLASSIFIED BY PLANNING REGION 200 190 180 170 ------·------· ----·------·· ------1
ID 160 ·------· ·---- -·------1 ~ 150 ------··-----· w ::::E 140 ~-·- -- --·--- 0u ------·--- z 130 ·------... -~------g 120 0 110 I w 100 (/) :::> 90 0 I 80 ~ 70 w~ w 60 ~ 50 C) 40 30 20 10 0 NWHB WHtj NEHB SEHB MHB MWHB SWHB EHB
HEALTH BOARDS
SOURCE: TABLE 3 HOUSEHOLD BUDGET SURVEY 1980. C.S.O. ~ % DISTRIBUTIO~~ BY DISTANCE FROM DOCTOR MEDICAL CARD HOLDERS DECEMBER '81 100
90
80 ------t
70 -+---- -·------·------;
'"'(/) w ..J 60 ~ rt) 50 a:: w > ...... ,0 40 ~ 30
20
10
0 NWHB WHB NEHB MHB SEHB SHB MWHB EHB
HEALTH BOARDS SOURCE: GENERAL MEDICAL SERVICES (PAYMENTS) BOARD ANNUAL REPORT, 1981. ~ POPULATIO N DE~~ SITY 1981
280
260
240 ------
220 w a: 200 ...J..------·------· ---·------1 ~ ~ 0 180 ...J 52 160 0 en 140 - 0::w n. 120 ----·- ---· --- - en z 100 0en a: w 80 n. 60 ··------
40
20
0 NWHB WHB MHB MWHB SEHB SHB NEHB EH B HEALTH BOARDS SOURCE: TABLE 11 CENSUS OF POPULATION OF IRELAND 1981 (VOLUME 1) CUTS IN HEALTH BOARD ALLOCATIO NS 1985 ON 1982 10
9 --· - -
8
7 -+--·------~I
6 ------··-----
~ 5 --· ______I 4 .._
.3
2
1
0 ' NWHB WHB MWHB MHB NEHB SEHB SHB EHB
HEALTH BOARDS SOURCE: BASED ON REPLY BY MINISTER FOR HEALTH AND SOCIAL WELFARE TO DAIL QUESTION ON 19 FEBRUARY, 1986. iD PERCE~~TAGE CUT CUTS IN HEALTH BOARD ALLOCATIONS - 1985 ON 1982 6 ~------·------~
5 ----·- ··-· -- --
4 '""' .._~ N IX) m 3 ..... a:: w > 0 2 I{) IX) m.... 1
0
-1 1 NWHB WHB MWHB SEHB MHB NEHB SHB EHB
HEALTH BOARDS SOURCE: REPLY BY MINISTER FOR HEALTH AND SOCIAL WLEFARE TO DAIL QUESTION ON 5 DECEMBER, 1985. ~ BEDS IN ACUTE HOSPITALS DISTRIBUTION BY HEALTH BOARD DEC. 1979 10
9
8
Ul z 7 0 Ul er w a. 6 0 0 0... 5 cr w a. 4 Ul 0w m J
2
1
0 NWHB NEHB MHB MWHB SEHB WHB SHB EHB
HEALTH BOARDS SOURCE: IRISH MEDICAL CARE RESOURCES: AN ECONOMIC ANALYSIS (A, DALE TUSSING) ~ •
22 / The Board a ad ······-··t
23 24 The North Western Health Board consists of 27 members, 14 of whom are nominated by the 3 County Councils in the region. The Minister for Health nominates 3 members to the Board. The remaining membership of 6 doctors, 2 nurses, 1 chemist and 1 dentist are elected to the Board by the respective professions in the region. The Board holds 12 meetings per annum including the Annual General Meeting which is held in July. The Board meets on the third Monday of the month. Eight meetings are held in the Boardroom, Head Offices, Manorhamilton and the remaining four take place in Donegal Town.
MEMBERSHIP OF N.W.H.B. 1985
Mr. P. McKeon, M.C.C. (Chairman) Mr. T. Deignan, M.C.C. (Vice-Chairman) Miss M. Bonner Mr. D. Bree, M.C.C. Dr. M. Cooney Mr. H. Conaghan, T.D. Mr. P. Conmy, M .C.C . Dr. P. Delap, M.C.C. Dr. P. Dockry Mr. W . Farrell, M.C.C. Mr. J. Faughnan, M.C.C. Dr. S. Geraghty Mr. M. Guckian, M.C.C. Mr. P. Harte, T.D. Mr. J. J . Hamilton Mr. T. Lavin, M.C.C. Dr. J. McCioskey Dr. B. McDonagh Dr. F. C. McAteer Dr. A. McFarlane Mr. N. McGinley, M .C.C. Mr. B. McGiinchey, M.C.C. Mr. L. McGowan, M.C.C. Mr. P. O'Donnell Mr. S. Rodgers, M.C.C. Rev. Canon C. Thomton Rev. Fr. J. Young
MEMBERSHIP OF MANAGEMENT TEAM, N.W.H.B.
Mr. D. O'Shea, Chief Executive Officer. Mr. M. Mcloone, Programme Manager, Community Care. Mr. M. Ward, Programme Manager, Hospital Care. Mr. M. Lynch, Personnel Officer. Mr. D. McDermott, Technical Services Officer. Mr. M . Kenny, Planning and Evaluation Officer. Mr. J. Murphy, Finance Officer.
25 26 SuDlDiary of Reports and Activities considered by the Board during 1985
January, 1986:-
• Report on the Special Housing Aid for the Elderly Scheme adopted. • Report of Review Committee on Adoption Services adopted. • Report of Ad-Hoc Committee on the Homeless adopted. • Government's Policy Statement on Equality of Opportunity between Men and Women in Employment adopted. • Establishment of National Co-Ordinating Committee on Drug Abuse noted.
February, 1985:-
• Ambulance Service Report, 1984 adopted. • Report on arrears due from Local Authorities adopted. • Arrangements agreed for first presentation of Nursing Certificates at Letterkenny General Hospital by the Minister for Health and for official opening of Buncrana Nursing Unit on 4th March, 1986. • Report on transfer of patients to new Community Nursing Unit c>t Ballymote, Co. Sligo with effect from 13th February, 1985 noted by the Board.
March, 1985:-
• Report on "Psychiatric Services- Planning for the Future" considered by the Board. • Report on Radiology Services adopted. • Report adopted by the Board on Care of the Aged - Home Security.
• Official Opening of Hostel for the Handicapped, Dungloe.
The hostel for the handicapped at Dungloe was officially opened by the Board Chairman, Mr. Hugh Conaghan, T.D., on 8th March, 1985. A plaque dedicating the hostel to the memory of the late John O'Donnell, Community Care Administrator was unveiled.
April 1985:
• Visit to Sligo by Mr. P. W. Flanagan, Secretary, Department of Health.
The Secretary of the Department of Health, Mr. P. W. Flanagan, visited Sligo on 1st April, 1985 to present certificates of nursing to graduates from both St. Calumba's and Sligo General Hospital Schools of Nursing. This was Mr. Flanagan's first official visit to Sligo since his appointment as Secretary of the Department of Health.
• Comhairle na n-Ospideal Document on Longterm Institutional Care - the Medical Aspects, considered by the Board. • A Report on the extension of the Remit of the Ombudsman to include the Health Boards was adopted. • Report on National Fuel Scheme 1984/ 85 adopted. • Health Centre Gweedore - the Board agreed to the purchase of the Radio na Gaeltachta property in Gweedore for development as a Health Centre.
• Maintenance Dialysis Units at Letterkenny and Sligo.
The Board noted that the unit in Letterkenny accepted its first patient in March, 1985 and that the unit in Sligo would accept its first patient on 22nd April, 1985. • A Report on the Children Care and Protection Bill, 1986 was adopted by the Board.
• Report on "Psychiatric Services- Planning for the Future" adopted.
• Annual Conference of Association of Health Boards in Ireland. The above conference was held from 15-17 May, 1986 at the Ostan na Rosann Hotel in Dungloe. The theme of the conference was "Services for the Elderly in Ireland." • Residential Service for Adult Mentally Handicapped, Stranorlar. This centre was officially opened on 31st May, 1986 and a wing of the centre was dedicated to the memory of the late Sean O'Hare, Director of Nursing Services for the Mentally Handicapped. June.1986:- • The Board adopted a report on General Surgery in the region. • Sligo General Hospital Major Extension-the C.E.O. reported to the Board that progress was made in relation to the planning permission for the above project following a special meeting of Sligo Corporation held on 4th June, 1986. • Paediatric Clinics at Dungloe and lnnlshowen. The Board noted that arrangements had been made for the commencement of paediatric clinics at Dungloe and for the lnnishowen area commencing in August, 1986. July.1986:- • Report on the European Social Fund adopted. • Annual Report of Comhairle na n-Ospideal considered. • Bomb Explosion at Ufford. Members received a report on damage caused to Lifford Hospital and condemned the bomb explosion at Lifford bridge. September. 1986:- • Annual Report of G.M.S. (Payments) Board considered by the Board. • Measles Immunisation-launching of new campaign noted. • Report on National Fuel Scheme, 1986/86 adopted. • Report on Activities of Irish Psychiatric Hospitals and Units, 1982 considered. October, 1986:- • ~ew arrangements for the financing of the Supplementary Welfare Allowance Scheme were announced. • Report on arrangements for funding of pre-adoption placements in the nurseries at Fahan and Sligo was adopted. • The Home Help Service Report was considered. • A Report on Services for the Physically Disabled was adopted. November, 1986:- • PracticaRy all the November, 1986 meeting was devoted to discussion of resolutions from the Local Advisory Committees. • The Board agreed to the purchase of a site for a residential centre for the physically disabled at the junction of Cranmore Road and Condon Hill, Sligo from the Sisters of Mercy.
December, 19116:- • St. Calumba's Hospital Laundry-the Board agreed to re-build the laundry on the site of the building destroyed earlier In the year by fire. • The Board adopted a report on Family Planning Services. • A Report on Out-patient Services was adopted by the Board. • Annual Report of Medico Social Research Board considered. • Obstetrician/ Gynaecologist Out-Patient Clinic at Carrick-on-Shannon, Co. Leitrim the Board agreed to proceed with the provision of this service. • Jo~harlng Scheme. The C.E.O. advised the Board about the introduction of a job-sharing scheme for Health Board workers. • £300.000 allocation for Purchua of X-Ray Equipment. The C.E.O. advised the Board of the approval by the Department of Health of an allocation of £200,000 in respect of the purchase of X-Ray equipment for Sligo General Hospital and an allocation of £100,000 to purchase x-ray equipment for Letterkenny General Hospital. 28 N.W.H.B. Standing CoDIDiittees
29 30 The North Western Health Board has 3 Standing Committees, one each for: General Hospital Care Special Hospital Care Community Care Each Standing Committee consists of 9 members, i.e. one-third of the Board membership. The Chairman and Vice-Chairman of the Board for the time being are ex offico members of each Standing Committee. Membership is reviewed and rotated at the Health Board annual general meeting. The Standing Committees continue the role of the former Visiting Committees, deal in detail with proposals and reports under consideration by the Health Board and give Board members an opportunity for increased involvement in the development of health service policy in the region . All requests for deputations to the Health Board are dealt with by the appropriate Standing Committee.
N.W.H.B. STANDING COMMITTEE MEMBERSHIP JULY 1985- JULY 1986
General Hospitals Special Hospitals Community Care Mr. S. Rodgers, Chairman Mr. P. McKeon, Chairman Fr. J. Young, Chairman Mr. J . J. Hamilton Ms. M . Bonnar Mr. P. O'Donnell Mr. B. McGiinchey Canon C. Thornton Mr. H. Conaghan Mr. J. Faughnan Mr. P. Harte Dr. B. McDonagh Dr. F. C. McAteer Dr. M. F. Cooney Dr. M . McCioskey Mr. W. Farrell Dr. S. Geraghty Mr. N. McGinley Mr. T. Deignan Dr. P. Dockry Mr. P. McKeon Dr. P. Delap Mr. L. McGowan Mr. D. Bree Dr. A . MacFarlane Mr. M. Guckian Mr. T. Lavin (Mr. P. McKeon) Mr. P. Conmy (Mr. T. Deignan)
Mr. Pascal McKeon, M.C.C., Board Chairman and Mr. Tom Deignan, M.C.C ., Vice Chairman, held ex-officio membership of each Standing Committee .
.•. -. -. • • J
31
Local Health Advisory CoDlDlittees
• 33 3 In the North Western Health Board area, each of the three counties of Donegal, Leitrim and Sligo has a Local Health Advisory Committee. Local Health Advisory Committees were set up under the Health Act, 1970. Their principal function is to advise the health board on the provision by the Board of health services in the functional area of the committee.
Meeting Arrangements: DONEGAL: In the County Council offices, Lifford on the Wednesday week prior to the meeting of the North Western Health Board. (This is generally the first Wednesday of the month). LEITRIM In the County Council offices, Carrick-on-Shannon, Co. Leitrim on the first Monday of the month. SLIGO: In the A.C.O.T. offices, Riverside, Sligo on the first Wednesday of the month.
MEMBERSHIP OF LOCAL HEALTH ADVISORY COMMITTEES, 1985
DONEGAL LOCAL HEALTH ADVISORY COMMITTEE: Cllr. S. McNelis, Chairperson, Glenties, Co. Donegal. Cllr. Edward J. Fullerton, 66 Cockhill Park, Buncrana. Cllr. D. Harkin, Kiltoal, Convoy, Co. Donegal. Cllr. Paddy Keaveney, 'Loreto', Moville, Co. Donegal. Cllr. P. Kennedy, 25 St. Joseph's Tee., Donegal Town. Cllr. Patrick Delap, Bunbeg, Co. Donegal. Cllr. P. McGowan, Edenmore, Lifford, Co. Donegal. Cllr. Harry J. Blaney, Rossnakill, Letterkenny, Co. Donegal. Cllr. N. McGinley, Ballyboes, Creeslough, Co. Donegal. Cllr. D. McGonagle, Kiernaleague, Carndonagh, Co. Donegal. Clr S. McEniff, Bundoran, Co. Donegal. Cllr. L. McEihinney, Lifford, Co. Donegal. Cllr. E. O'Donnell, Ballyherrin, Kilmacrennan, Co. Donegal. Mr. C. Coughlan, T.D., Cranny, lnver, Co. Donegal. (Deceased June '86) Mr. Pat the Cope Gallagher, T.D., Dungloe, Co. Donegal. Dr. M. F. Cooney, Director of Community Care and Medical Officer of Health, Community Care Offices, Ballybofey. Dr. B. Callaghan, Consultant Physician, Letterkenny General Hospital. Dr. B. Forkin, Stranorlar, Co. Donegal. Dr. W . J. Wray, Ballyholey, Raphoe, Co. Donegal. Dr. M . McMenamin, Dun-Emer, Stranorlar, Co. Donegal. Mr. S. Cleary, Mountcharles, Co. Donegal. Mr. F. Maloney, County Manager, Donegal County Council. Mr. J. P. Duffy, M.P.S.I., Buncrana, Co . Donegal. Mr. Leo Friel, Superintendent Community Welfare Officer, Ballybofey. Mr. F. Callaghan, Main St., Buncrana, Co . Donegal. Mrs. A. Kelly, Superintendent Public Health Nurse, Ballybofey. Mr. Charlie Gallen, St. Canal's Hospital, Letterkenny.
R.I.P.
The Chairman and members of the Board, the members of the Local Health Advisory Committees and the CEO and staff of the NWHB extend sincerely felt sympathy to the family of the late Catha I Coughlin, T.D., former member of Donegal Local Health Advisory Committee, on Cathal's untimely death in June 1986.
35 SLIGO LOCAL HEALTH ADVISORY COMMITTEE. 1-
Cllr. Tony McLoughlin, Chairperson, "Beechlawn", Bamasraghy, Sligo. Cllr. M. Brennan, T.D., Ragoora, Cloonacool, Tubbercurry, Co. Sligo. Cllr. Peter Kivlehan, Belra, Lavagh, Ballymote, Co. Sligo. Cllr. Paul Conmy, Meenaun, Culleens, Co. Sligo. Cllr. Leo Conlon, Coolmurla, Geevagh, Co. Sligo. Cllr. Declan Bree, 13 Ash Grove, Maugheraboy, Sligo. Cllr. M. Gormley, Carrowloughlin, Bunninadden, Co. Sligo. Cllr. Ita Fox, Colgagh, Calry, Co. Sligo. Cllr. T. Higgins, 82 Treacy Ave., Sligo. Cllr. M. Carroll, Carney, Co._Sligo. Cllr. A. Colleary, Cullykerry, Charlestown P.O., Co. Sligo. Cllr. P. Henry, Blue Lagoon, Riverside, Sligo. Cllr. T. Lavin, Lord Edward Street, Ballymote, Co. Sligo. Cllr. J . Leonard, Cloonaghbawn, Ballinfull, Co. Sligo. Cllr. S. O'Dowd, Killeenduff, Easkey, Co. Sligo. Dr. J. K. Heagney, Director of Community Care and Medical Officer of Health, Markievicz House, Sligo. Dr. S. Geraghty, Chief Psychiatrist, St. Columba's Hospital, Sligo. Dr. T. Foley, Ard Caoin, Sligo. Dr. James Healy, Camiga, Ballincar, Sligo. Dr. Eileen Caulfield, Riverstown, Co. Sligo. Dr. P. Dockry, Senior Dental Officer, Health Centre, Cleveragh Road, Sligo. Mr. W~liam Gilmartin, Psychiatric Nurse, St. Columba's Hospital, Sligo. Mr. Paul Byme, County Manager, Sligo County Council, Riverside, Sligo. Mr. N. Rowe, Superintendent, Community Welfare Officer, Cleveragh Road, Sligo. Mr. E. Horan, 1-3 Castle St., Sligo. Mr. Philip O'Gorman, Tubbercurry, Co. Sligo. Fr. C. Jones, Sligo Social Service Council, Charles St., Sligo. Mrs. K. Lyons, P.H.N., Markievicz House, Sligo.
38 LEITRIM LOCAL HEALTH ADVISORY COMMITTEE. 1986
Councillor F. McEigunn, Summerhill, Carrick-on-Shannon (chairperson) Councillor M. Bohan, Main Street, Drumkeeran. Councillor D. Brennan, Drumlegga, Cloone. Senator J. Ellis, Fenagh. Councillor M. Gallagher, Askill, via Ballyshannon. Councillor J . McGee, Mohill. Councillor M. Guckian, Drumsna. Councillor J . McPadden, Upper Annagh, Dowra. Councillor C. Cullen, Minkeeragh, Glenfarne. Councillor T. Ferguson, Dooard, Rossinver. Councillor A . Flynn, Screeney, Manorhamilton. Councillor J .J. McGirl, Main St., Ballinamore. Councillor P. McKeon, Drumdoo, Mohill. Councillor J. Mooney, Drumshanbo. Councillor J .J . Shortt, Lisagarvan, Ballinamore. Dr. J. K. Heagney, Director of Community Care, Markievicz House, Sligo. Mr. N. Rowe, Superintendent, Community Welfare Officer, Sligo. Dr. P. MacManus, "Grove House", Manorhamilton. Mr. J . L. McGowan, Psychiatric Nurse, St. Calumba's Hospital, Sligo. Dr. D. Loftus, Drumshanbo. Mr. P. Doyle, Manager, Leitrim County Council. Mr. B. Kiernan, M.P.S.I., Main St., Carrick-on-Shannon. Mr. B. Healy, F.R.C.S.I., Orthopaedic Surgeon, General Hospital, Sligo. Sr. M. De Lellis, P.H.N., St. Patrick's Hospital, Carrick-on-Shannon. Dr. P. J. Dockry, Senior Dental Officer, Cleveragh Road, Sligo. Ms. B. Healy, McDermott Terrace, Manorhamilton. Mr. J. O'Donnell, Railway Road, Ballinamore. Dr. S. Geraghty, R.M.S., St. Calumba's Hospital, Sligo.
Hospital Care
39
HOSPITAL CARE PROGRAMME The Hospital Care Programme consists of services provided by the Board's general, district and geriatric hospitals, psychiatric services and the ambulance and transport service. As in previous years the management of these services during 1985 was influenced by Government and Board policy which required that the reduction in expenditure necessary because of the decreased financial allocation was to be secured in the institutional services area to the maximum degree possible. Consequently a programme of cut-backs for the general hospitals similar to that which operated in 1984 was agreed by the Board at the beginning of the year. In Letterkenny over 40 beds were closed during July and August in the surgical, medical and gynaecological departments and in Sligo a total of 70 beds in the orthopaedic, gynaecological, surgical and E.N.T. and ophthalmic departments were closed during August. However, all emergency or urgent cases were dealt with during these periods. In the psychiatric, geriatric and district hospitals strict financial controls were imposed. Developments and improvements in these services were carried out within already agreed budgets and met from savings elsewhere in the programme. The budgetary policy documents adopted by the Board identified a number of areas in which progress could be made in the development of alternative settings for the delivery of services and for a corresponding transfer of resources.
A helping 1!11nd for 11 p11tient in St. Pstrick's Hospft11/, Cll"ick-on-Shannon, Co. Leitrim. 41 Day Hospital, St. Patrick's Hospital, Ca"ick-on-Shannon, Co. Leitrim.
Returning home •fter • trending St. Petrick's DeiiJI----.. ,._ • ·------Nursing care at St. Patrick's Hospital, Caffick-on-Shannon, Co. Leitrim.
In the psychiatric service, 1985 will be remembered for the publication of " Planning for the Future" which aims to provide an infra-structure of care and treatment in the community and provide specialist assessment treatment, day care, residential, rehabilitation and training services close to where people live and work.
43 STANDING COMMITTEE MEETINGS During the year the Board and its Standing Committee on General Hospita.ls Services exa~ i ned in detail various aspects of the services in the Hospital Care Programme. The ma1n aspects cons1dered during the year were:- Month Venue Reports Considered February '85 Our lady's Hospital, Review of Services at Our lady's Hospital. Manorhamilton. Report on General Surgery. March '85 Donegal District Hospital. Review of Services at Donegal District Hospital. Sligo General Hospital - Geriatric Unit. April '85 lifford District Hospital. Review of Services at lifford Hospital. long Term Institutional Care - The Medical Aspects - Comhairle Report. May '85 Dungloe District Hospital. Review of Services at Dungloe Hospital. Dungloe Hospital Catchment Area - Services Provided. June '85 Buncrana Community Review of Services at Buncrana Community Nursing Unit. Nursing Unit. Institutional Services for the Elderly - Sligo/leitrim Area. October '85 letterkenny General Review of Services at letterkenny General Hospital. Hospital. Radiology Services - Access by General Practitioners. Renal Dialysis Units - Progress Report. November '85 Carndonagh District Review of Services at Carndonagh Hospital. Hospital. Out-Patient Services. December '85 Our lady's Hospital, Review of Services at Our lady's Hospital. Manorhamilton. Transport Services.
The Standing Committee on Special Hospitals visited each of the Psychiatric and Geriatric Hospitals and examined the services provided in each location. During the past year they examined developments in the following areas: - Month Venue Reports Considered January 1985 Sheil Hospital, Review of Services at the Sheil Hospital. Ballyshannon. Catering Services. February 1985 letterkenny General letterkenny General Hospital Psychiatric Unit. Hospital. Residential Services for the Elderly - Progress Report. Alcohol Dependancy Unit, St. Conal's Hospital - Progress Report. March 1985 Carndonagh District Services for the Elderly - lnishowen Area. Hospital. Geriatric Services - leitrim/ lnishowen Comparative Study. April 1985 St. Patrick's Hospital, Review of Activities at St. Patrick's Hospital. Carrick-on-Shannon. Psychiatric Services - Planning for the Future. May 1985 St. Calumba's Hospital, Psychiatric Services - Sligo. Planning for the Future. June 1985 Buncrana Community Services for the Elderly - lnishowen Area. Nursing Unit. Review of Activities at Buncrana Community Nursing Unit. July 1985 J.C.M . Unit, Carndonagh James Connolly Special Unit - Report. September 1985 St. Conal's Hospital, Review of Services - St. Conal's Hospital. letterkenny. Farm Report.
October 1985 St. John's Hospital, Planning for the Future - Psychiatric Services for Sligo. Co~nty Done?al. Sligo Hospitals - laundry Services Genat1c Hosp1tal Activity - Year Ending August 1985. November 1985 Ramelton Community Planning for the Future - Psychiatric Services Nursing Unit. for County Donegal. Ra~elt~n Co~munity Nursing Unit - Raport. Genatrlc Hospital Activity. laundry Services. December 1985 St. Calumba's Hospital, Pl~nning .f~r the Future - Psychiatric Services - Sligo. 44 Shgo, l81tnm and South Donegal. GENERAL HOSPITALS The designated general hospitals in the Boards area are located in Letterkenny and Sligo. Letterkenny General Hospital serves a catchment area of 115,000 population and the specialist services provided are Medicine, Surgery, Obstetrics, Gynaecology, Paediatrics, E.N.T., Oral Surgery, Radiology, Pathology, Maintenance Home Dialysis, with various visiting specialists. lt has a complement of 274 beds-31 of which have not been commissioned because of lack of resources. On the basis of the Comhairle Report " Guidelines on Consultant Medical Staffing and Related Population Catchment" there is justification for the creation of the following additional consultant posts in the hospital-3rd Physician, 3rd General Surgeon, Orthopaedic Surgeon, 2nd Pathologist, 3rd Radiologist and E.N.T. Consultant. However, further reductions in the allocation to the hospital meant that existing services hAd to be curtailed and these additional posts which were required could not bo created or filled.
Nurses at work in the Casualty Department, Letterkenny General Hospital.
A young casualty is attended to at Letterkenny General Hospital by Dr. Martin Coyne. 45 Sligo General Hospital serves a catchment area with a population of 95,000 and has a number of specialities (Orthopaedics, E.N.T. and Ophthalmics) which serve the entire region. In addition to the regional specialities the services provided are Medicine, Surgery, Obstetrics, Gynaecology, Paediatrics, Radiology, Pathology, Maintenance Home Dialysis and various visiting specialities. The revised bed complement following the closure of the investigation unit in 1984 is 285 beds. Further cutbacks in the hospital's allocation in 1985 meant that 25% of the beds were closed for a period during the summer months. Improvements in the management systems in the hospital brought better control on ordering, distribution of drugs, medicines and medical and surgical supplies-this was achieved through the introduction of mechanised systems to these services. In other areas the method of delivery of service including purchasing, utilization of products etc. was revised to operate in a more efficient and economic manner. •
\l~
The mod_em lllboratory fllcilities lit Letterkenny General Hospitlll (llbove) contrllst shllrp/y with the poorly mid out lint! ove!Crowded IBbomtory lit Sligo Geneml Hospm.J (below). New IBboratory fscilities Bf'fl plsnned for m the long delsyed Sligo hospitlll extension. Overcrowding in the Lllboratory lit Sligo Geneml Hospitlll. The continued lack offacilities at Sligo General Hospital during 1985 meant that overcrowdmg and beds in the COffidor remained a feature of hospital life there. Nursing staff et Sligo Geneml Hospital tJJke pert in 11 fire drill with the Board's Fire Prevention end Safety Officer, Amn Tmcey (second from right}. 47 At a reception to unveils plaque scknovvledging the magnificent efforts of the people of Co. Donegal who raised over £1fXJ,(X)() to enable the Letterkenny Kidney Dialysis Unit to open in March, '85. Seated left to right: Mr. Peter McLean, Consultant Urologist Dublin and 1986 'Donegal Men of the Year' who as special guest unveiled the pleque, end Mr. Patrick Hervey, Hospital Administrator. StiJnding, left to right: Mr. PtKJdy Hsrte, T.D.; Dr. L. Bannon, Consultant Physician; Miss M . Banner, rapresenting the Fund-raising Committees; Mr. Hugh Coneghsn, T.D., and Dr. Brian Cellsghsn, Consultant Physician. At the reception to launch the Fund-raising for the extension to th K"d . . . left to right: Mrs. Mary McGinley, Sec., County Co-ordi ti F, e .1.ney D1s/ys1s Unit. Seated Mr. N. O'Conne/1, Chairman, C.C.F.C.; Mrs. B. Grim;: ~gC und-~lsmg Committee (C. C. F. C.); Urologist end Donegal Man of the Year, and Mrs. McL~an · SF. C.~ Mr. P. Mc.Lesn, Consultant Cleary, Vice Chairman, Donegal Local Health Advisory co,;,;tttan~'f.l' left to nght: Mr. Sesmus S. Doherty, C. C. F. C.; Mrs. P. Foley, C.C.F.C.; Mr. Noel Me'!:' le rs:. Keyes, C.C.F.C.; Mrs. Marmer; Mr. Sean McNe6s, M. C. C., llfld Chairman of Local Helllth ~ ·C. C. e'!d Health Board Rodgers, M . C. C. and Health B011rd Member. ry Commtttee; Mr. Seemus The following graphs illustrate the trends in recent years in patient throughput and average duration of stay in the medical, surgical, obstetric/ gynaecology and paediatric departments of each general hospital. As the population served by Letterkenny General Hospital is 27% higher than the population served by Sligo General Hospital the graph showing the rates of admissions per 100,000 population is a better indicator of the referral patterns to each hospital. The referral rates for general medicine and general surgery in Sligo General Hospital are very much higher than the referral rates for Letterkenny General Hospital, even though the population served by Sligo General Hospital has more support none-acute beds, and beds/ places for the elderly in the other hospitals in the catchment area. If the Letterkenny admission rate operated in Sligo there would be 1000 less patients admitted each year, the % bed occupancy would be 78%, and there would be no beds in the corridor. NWHB ORTHOPAEDIC ADMISSIONS 1978 - 1985 2 1.9 1.8 1.7 1.6 1.5 1.4 ----- 1.3 7 ~ ---- 1.2 ""'ll "0 1.1 I 1l ~ -11 I c ::J I ::::> 0 0.9 I s 0.8 I 0.7 I I I 0.6 I 0.5 __.a- 0.4 - I T ~ 0.3 -...._ 0.2 / / ""-r- 0.1 V 0 I I I ' I I 1978 79 80 81 82 83 84 85 Year C Throughput + W.J iting Urt 49 MEDICAL THROUGHPUT-GEN. HOSPITALS - • 1171 ·- A. L a ...... - / ~__. ------___ ... / ~ •I .... ~/ ,r" ~ • ' ' I ' . ,.,. 77 11 • • .. • + ... AVERAGE DURATION OF STAY-GEN. HOSPITALS WflliCAL 11112 1183 IH4 1186 IZZI l..tt&r~ MEDICAL RATES OF ADMISSION PER 100000 4 ~------'-"-'---'Ma__ (~~~~~~~=~~ ------~ 3.a ------ 2.1 ------& ,... ---- -=· ~ ~1 2~$-__,==:-::!~==~==------~ ~~ ------·------. I------I - ·------4I o.a ----- I ------·-- ~ 0 ~ --- 1111 1112 1184 ~ 1186 SURGICAL THROUGHPUT -GEN. HO SPITALS 4,------,1871 - 11111 ------·--, ------·------ 1 J...______------1 I 0.11 ,-----·------ 04---~---,----,----,---~r---~----r----r--~ 1171 n 71 71 10 11 12 Ill 0 Lo1ta11Conny + Sleo AVERAGE DURATION OF STAY- GEN. HOSPITALS ,:,.---~------~~---_------,1 ....,------· ------, ----.a ---I 1111 1M2 1113 1114 y- IZZ! Lott~"ic6MY IS:sJ ... SURGICAL-RATES OF ADMISSION PER 1 00,000 1111 - 1115 (GEHDW. HOSPITALS) 4 ------~~~~~·------~------. l.ll ~'""'··=-----:::l:J--.--~=-.==-====9=4 I l ------··------·---- ~I 2------t.a ------ 1------· 0.11_.__ _ - .. -- -·------ o4------.------~------.------~ 1112 1114 ,... 1111 0 Lot~ 51 MATERNilY THROUGHPUT -GEtJ. HOSPITALS 4,------1171------, - 11111 3.a ------ 3 ------·------I 2.5 ------~~..--a---~--:&='-~ 2 ~ '"""=?' ,.------a: - ...... --~ ./' 1.a ±:=:::ir~------~ ~------o.a -r------1 01----.----r----r----.---.--~.---.----,--~ 1171 n 78 71 110 11 12 14 0 LJtttorkoo.~y + 5lto AVERAGE DURATION OF STAY-GEN. H OS P~TALS W.TUINilY 10 .....------, I-- · ------·-- - --· ---· ·------·--·------· ------7------ 1181 11112 1113 1114 11115 MATERNilY-RATES OF ADMISSION PER 100000 1111 - 18115 (GENEJW.. HOSPITAI.S)c______4 -r- 1 3.5 ------ 3 - -- 2.5-- -- 2 • - ~ -- ' 1.a ------, , __ .,I 0.5- - - 1111 1812 1183 ..... 1114 GYI~AECOLOGY THROUGHPUT -GEN. HOSPITALS 11711 - 11115 3.: ~t--=----_-_-_------======--=--,1 3 -+------i 2.5------______, AVERAGE DURATION OF STAY-GEN. HOSPITALS 10 ...,..------~ -r----..-- ---·------I 8 _,_ ------·------·-----·-·-·-· 7 ------. ------• ------ & 0 ------·-- --, 2 1181 11112 1183 11114 118$ y..., [Z2} L•t:·.rbnny ~ llto GY1-JAE. - RATES OF ADMISSION PER 1 00000 1181 - 18115 (GENERAL HOSPITAI..S) 4 ---·------ 3.5 - ·- --- 3------.. 2.15 ------·---- ~Ic, 2------:I 0 · t 1.5--- - - B • B "!= 0.5 ------ 0 1181 1112 1183 1184 11115 r- 0 lAttottl.,.,y + ... 53 PAEDIATRIC THROUGHPUT - GEN. HOSPITALS 4,------1171 ------1115 ------, u -+------·------. :s-1 ------___ j I I l.ll ------·-----· ------' 0.5------ 0~-~~-~-~~---r--r---r--r---.-~ 1171 n . 11 eo 11 0 Let!.ri!OIIII) + ... AVERAGE DURATI ON OF STAY-GEN. HOSPITALS 1 0~------~ I ~------· . I I ·------· ------· - ---·-----, 7 ------1 Yeor !ZZJ Lett•rl<•nn)' IS:sl Sligo PAEDS . - RATES OF ADMISSION PER 100000 11111 - 1885 (GOIERAL. HOSPITALS) 4 ------· -··------.., __ , 3.5-- · - 3 - ·-·· - ' l.5 - -- ..... ll ~ c, -:lo· E. 2~-~ - ~ _ : · ______: 1.5~ --· -·· - - -·- 1 • - -- -· . • • -- ., I 0.5 - -- . -· ------· -. . I ! ; 0 -+------~ -...------r--- - ~ 18111 11112 1183 1884 11!15 DISTRICT HOSPITALS- CO. DONEGAL During the year the Standing Committee for General Hospitals examined the role of the district hospitals in the context of the developments in the hospital services. Prior to the building of the extension to Letterkenny General Hospital the district hospitals in Co. Donegal supplemented the small number of beds available for acute care in the old County Hospital in Letterkenny by providing post-operative and convalescent care. With the development of Letterkenny General Hospital the role of the district hospitals has changed. There is only a small number of transfers from the acute hospital and a large number of beds in the district hospital are now used to meet the demand for extended nursing care particularly for elderly patients. On the basis of a survey of the referrals to each district hospital during 1986 the purpose for which the beds in the district hospital were being used could be clarified as follows:- C.rndonagh Donegal Dungloe Ufford Shell SHORT STAY G.P. Referrals 14.0 14.5 23.0 15.0 22.0 Transfers from Acute Hospitals 6.0 4.0 8.5 11.0 7.5 LONG STAY G.P. Referrals 20.0 11.5 17.5 22.0 22.5 TOTAL BEDS 40.0 30.0 49.0 48.0 52.0 The survey examined the G.P. referrals to the general and district Hospitals and it seemed clear (a) that General Practices with access to a District Hospital have a higher rate of referral than those who have no access and (b) that the proximity of a Practice to a general hospital is also a major factor in the rate of referral. Of the eight general practitioners with the highest rate of referral 5 had G.P. Access to district hospitals and 3 were in the Letterkenny area. In February 1984 the North Western Health Board reviewed its community nursing unit programme as it related to the provision of services for the care of the elderly in Co. Donegal. The Board agreed that a plan should be drawn up for the development of community nursing unit facilities based in the hospitals at Carndonagh, Lifford, Dungloe, Donegal and Ballyshannon utilizing both existing and available facilities while retaining the present role of these hospitals in the proviSion of comprehensive non-consultant in-patient services for all age-groups in the catchment area. Planning of extensions to Camdonagh and Dungloe District Hospitals was completed in July 1985 and application was made to the Department of Health for funds for the building of these extensions. OUR LADY'S HOSPITAL, MANORHAMILTON The in-patient service provided in Our Lady's Hospital, Manorhamilton consists of 37 medical beds, 2 maternity beds and 20 rheumatology beds with full consultant out-patient services provided in the specialities of medicine, surgery, paediatrics, obstetrics/ gynaecology, orthopaedic surgery, psyschiatry and rheumatology. Fully equipped x-ray, physiotherapy and occupational therapy departments are also in operation in the hospital. There were 861 patients treated in the medical ward in the year ended 31st December 1986. The average duration of stay was 13.7 days. In addition to direct referrals from general practitioners these beds are used for convalescent care of patients transferred from acute general hospitals. General practitioners in the Leitrim area are encouraged to refer their ,. .. patients to Manorhamilton where possible-however, patients with more acute conditions •• E.;; are referred to Sligo General Hospital. ~ ,.~.. i· •. ' The regional Rehabilitation/ Rheumatology service continues to develop. Twenty beds "' are operational at Our Lady's Hospital and the Consultant Rheumatologist in the unit also provides out-patient services at Sligo and Lettekenny General Hospitals. Plans were completed in July 1985 for the development of facilities at the hospital incorporating a new expanded physiotherapy department, complete with hydrotherapy pool, occupational therapy, out-patient and other departments. Funds for this development were to be provided from E.S.F. monies, but the reduction in the Board's allocation from this Fund meant that ,. the Board had to seek altem~tive funding arrangements for t~ Manorhamilton " . ·.} ,.:. ·- . .- .-~ development. Application was made to the Department of Health for a spacial capital graot, ... -~ a grant of £43,000 was promised by the ~rthritis Fdundation of Ireland and a local Fund . Raising committee was formed. Plans have been prepared for the eXtension to incorporate the hydrotherapy pool with a view to commencing work before the end of 1986. 55 AMBULANCE AND TRANSPORT SERVICE The Board operates a fleet of 37 vehicles located at 13 stations throughout the North Western Health Board area . The fleet consists of 27 purpose-built ambulances, 1 estate car ambulance, 1 Land Rover ambulance, 5 minibuses and 3 Major Accident Vehicles. The two main bases are located at Sligo and Letterkenny while 9 smaller bases are located at Manorhamilton Hospital, the District and Geriatric Hospitals and at Killybegs. The ambulance and transport supervisors are based at the Control Centres in Letterkenny and Sligo. Each is responsible for the control and operation of the ambulance/ transport service in his area. The overall co-ordination of the service is carried out by the Ambulance Officer. The ambulances based at the two main control centres are manned by two ambulance men, except where the services of a nurse are specifically required. The ambulances based at the smaller stations are staffed by an ambulance driver and a nurse. A breakdown of the calls answered by the Board's vehicles during 1985 is given in an appendix to this report. Car Hire Service The Board continued to operate transport for ambulant patients by private car hire. During 1985 a further demand was made on the service with the opening of the new nursing unit in Buncrana, the day centre in Stranorlar and the renal units at Letterkenny and Sligo. Details of the car hire service are given in the appendices. Regular replacement of front-line vehicles for the Ambulance snd Emergency Service hss to bs undertaken. Doengsl bssed ambulance drivers sre pictured wrrh their new vehicles. Mr. Petsy Mol/or. Trensport Supervisor, is second from left. ' 56 PSYCHIATRIC SERVICES The report on the psychiatric services "Planning for the Future" received detailed examination and consideration by the Special Hospitals Standing Committee during 1985. The committee noted that many of the recommendations contained in the report had already been adopted as Board policy and a large percentage of these were in various stages of implementation. In particular they emphasized the progress made in the last 15 years in the following areas:- (i) The development of a comprehensive service both within the community and in the hospitals in-patient and out-patient services. (ii) The development of comprehensive services for the mentally handicapped and geriatric patients where previously these patients were admitted to psychiatric hospitals. (iii) The general up-grading and modernization of both hospitals and (iv) The development of therapeutic programmes and rehabilitation services at both psychiatric hospitals. " Planning for the Future" envisages a gradual transition from a service provided mainly in the large psychiatric hospitals to one which is mainly community-based and where in patient treatment is only one component of a network of services. As a first step, the populations of both hospitals have been classified according to their primary diagnosis geriatric, mentally handicapped and psychiatric. lt is planned to segregate the geriatric patients, of which there are approximately 200 in each hospital, and designate part of the hospital as a geriatric unit to accommodate these patients. The units will no longer be part of the psychiatric service, but will be part of the geriatric programme. Each unit will have its own medical officer, and an appropriate mix of psychiatric and general nurses supported by care assistants. In future the majority of persons suffering from dementia will be cared for by the primary care service or the geriatric service and the practice of routinely admitting demented elderly patients to psychiatric hospitals should cease. There will be a need for some psychiatric trained nurses on the staff complements of all the district and geriatric hospitals. In proposing the plan for the future development of a community oriented service the area has been divided into districts forming a sector with a multidisciplinary psychiatric team responsible for the provision of a comprehensive service to the population living in the particular district or sector. The development of a community based service will allow a greater integration of the primary care teams in the delivery of general care with specialist support in specific instances. The general practitioner will become a central part of the psychiatric care teams of the future with complete access to the support and service of all specialist skills of the psychiatric team. Crisis intervention can be carried out at the base in each district by either the psychiatrist, the community nurse, the psychologist or social worker. The day facilities in each district will provide services which will include assessment and treatment, rehabilitation and occupational therapy for chronic psychiatric, crisis intervention, counselling etc. In-patient services for short and medium stay patients will be provided in the 50 bed psychiatric unit at Letterkenny General Hospital and the 44 bed admission unit at St. Columba's Hospital (pending the building of the psychiatric unit at Sligo General Hospital). Each consultant psychiatrist will have a fixed complement of beds for patients from his/ her sector or district. Beds in peripheral hospitals may be used for less serious cases. The report recommends that new long-stay patients should be accommodated in high support hostels in each sector. The provision of these hostels are seen as a longer term development by this Board and initially it is planned to allocate 15-20 beds in the existing psychiatric hospitals to each consultant psychiatrist for his/ her new long stay patients. The Board has agreed to the establishment of one Child Guidance Team for the region initially with the subsequent development of a second team . The initial appointment of a Child Psychiatrist is planned for late 1986, to be based in Sligo. The graph showing the in-patient population in the two psychiatric hospitals for the years 1971-1985 clearly illustrates the decreasing trend - the decrease will occur at a more rapid rate as the developments outlined above take effect. The number of patients in St. Calumba's Hospital decreased from 780 in 1971 to 490 in 1985, and in St. Conal's the decrease was from EK)() in 1971 to 430 in 1986. The population of the catchment area served by St. Calumba's Hospital is 95,000 and the catchment area served by St. Conal's Hospital has a population of 115,000. fiT A trtlnSBction tlllkn p'-ce on the new persofiiJ/istld banking syStlllm introduced at St. Columba's Hospitll/, Sligo during 1985 and opemted by the Board's stlllff. IN-PATIENT POPULATION-PSYCHIATRIC HOSP. 1971 - 11185 0.9 0.8 ...... g- ,_ -s.... 0.7 -- ~ ,... 0.6 ,.....- "0• r ..__ -s- __.._ - ,~ T -11 -s-. C;, 0.5 :lo ~ 5 0.4 0.3 0.2 0.1 0 I I I I I I I I I 11111 n 73 74 75 76 n 78 79 80 81 82 BJ 84 85 Ye or D ST. COWUB4S + ST. CONALS Slicp Letteri ADMISSIONS PSYCHIATRIC HOSPITALS 1971 - 1985 1.5 1.4 1.3 1.2 ..... 1.1 ...... - 1 / ~ ~ / / "'111. 0.9 ~ " D. "0• £__ .., • c 0.11 .-a"' \... / ... 0 l!t"'"' -.c :J ~ / :lo 0.7 ·~ ...... -z -e 5 0.& 0.5 ' 0.4 O.J 0.2 0.1 0 I I I I I I 1971 12 73 74 75 76 n 78 79 80 81 82 BJ 6-4 85 Year 0 ST. COLUIJO/.S + ST. C'iiV,L!; SJ 1c.p Lrllt'l k' " IY 59 The Board has rented from Leitrim County Council, a house on the new estate for elderly people which adjoins St. Patrick's HospitB/, Carrick- 60 CODIDIUDity Care 61 62 COMMUNITY CARE PROGRAMME INTRODUCTION This section of the report will attempt to reflect some of the trends and developments in the Community Care services in the last calendar year. Some of these will be discussed under the various 'Need' headings or under Administrative/ Management Service. While many of the professional groupings and residential centres may not be mentioned by name the value of their contribution to the maintenance of our service cannot be over-stated in these difficult times. RESOURCE ALLOCATION The Board's total allocation for direct expenditure in 1985 was 71 .360m. representing a cut of 3.2% in our spending in order to live within our 1985 allocation. Priority was to be given to reducing/ eliminating overruns of previous years and overall to reflect the strategy of the National Plan, i.e. disease prevention and community services. Services for Mentally and Physically Handicapped were further developed as were the Services for the Elderly and Children. Developments in the field of preventive health services included the introduction of a Measles Immunisation Scheme and an assessment of the availability of family planning services. The resources of the social work services were focussed more sharply on child care services and particularly on children at risk. The Lifeskills Project was extended to 50 Schools. The Dental and Ophthalmic Ad Hoc Schemes had to be discontinued due to financial constraints. Photographed st the site of the ntJW Health Centre, Csffigsllen, Co. Leitrim. Left to right, Mr. M. O'Donovsn, Administrator, N. W.H.B.; Msry Hsyes, Public HtNI/th Nurse; Chris Dowd fO'Riordsin & Co. Arch.); Rev. Fr. Young, P.P., Chsirman, N. W.H.B., Standing Committee, Community Cera; Mr. Pt,schsl McKeon, M. C. C., Chairmen, N. W.H.B.; P. J. O'Donohoe, Contractor; SsffY O'Riordsin, Architect; Mrs. P. Morris, Secretllry, LOCIII Voluntllry Committee, end Vice-Chsirmsn, Frank McGiynn. 63 BOARD REPORTS The Board reviewed the operation of and updated policies on the following community care services during 1984. Details are available in the individual reports listed hereunder. Report Month Special Housing Aid for the Elderly Jan. 1985 Review Committee on Adoption Services Jan. 1985 Report of Ad-Hoc Committee on the Homeless Jan. 1985 Care of the Aged-Home Security March 1985 National Fuel Scheme March 1985 Children's Care and Protection Bill April 1985 Annual Report on G.M.S. May 1985 Measles Immunisation Sept. 1985 National Fuel Scheme Sept. 1985 New Arrangements for Financing of S.W.A. Scheme Oct. 1985 Funding of Pre-Adoption Placements in the Nurseries at Fahan and Sligo Oct. 1985 Home Help Service Report Oct. 1985 Services for the Physically Disabled Oct. 1985 Report on Family Planning Services Oct. 1985 REPORT ON SERVICES Services for the Mentally Handicapped, Mentally ill and Physically Disabled. General The Board further extended its services for the mentally and physically handicapped in 1985. The policy of admitting patients with mental illness to day hospitals/centres and of admitting psychogeriatric patients to C.N.U.s marked the initial stages of implementing plans to provide community based services as alternatives to residential care. The appointment of a Director of Services (Mental Handicap) has marked the first step in improving the organisation and management of services. DAY CENTRES AND HOSTELS FOR THE HANDICAPPED OPERATED BY THE BOARD IN 1986 Name of Unit Nos. H.B. in Co-operation with Day Centre College Farm Road 14 Letterkenny Hostel 5 Letterkenny Day Centre 11 North West Handicap Dungloe Association Hostel Dungloe Day Centre Carndonagh 7 Day Centre Nursery Parents & Friends Buncrana 8 lnishowen St. Agnes Day Centre Parents & Friends Donegal Town Mental Handicap Donegal St. Ciaran's Day Centre, Carrick-on Shannon 7 Parents & Friends Mental Handicap Sligo Day Centre 12 Sligo/ Leitrim New Developments A number of the above units were opened in 1985. They include: Carndonagh and Buncrana Day Centre The Board in conjunction with the lnishowen Parents and Friends Association of the Mentally Handicapped opened two day centres in 1985. The Buncrana centre provides pre-school services for children while the Carndonagh centre provides day care/activation services for adults. Chldren tmd Csre Attendsnt st the Dsy CentrB for MBntBiy Hsndicsp/)Bd which wss opened in rBntBd premises in Buncrens during 1985. Dungloe The hostel for the handicapped at Dungloe was officially opened by the Board's Chairman on 8th March, 1985. A plaque dedicating the hostel to the memory of the late John O'Donnell, Community Care Administrator was unveiled. This hostel which was built in association with the North West Handicapped Association and assisted by the AnCO Training Centre, provides accommodation for trainees attending the training centre and adolescents and adults attending the day centre and special class. Other Services for the Handicapped planned or opened in 1985 are detailed below. 65 I The new Training Centre provided for the Mentally Hendicaped Unit, Strenorler, Co. Donegal was opened during 1985. Second from left is Mrs. Bernedette O'Hare, Unit Supervisor. Stranorlar-St. Joseph's The Stranorlar centre for the mentally handicapped was officially opened in May, 1985. A wing of the centre was dedicated to the memory of the late Sean O'Hare, Director of Nursing, Services for the Mentally Handicapped. This unit has a bed complement of 30, i.e. 25 residential beds and 5 crisis relief beds. J.C.M . The prov1s1on of a purpose-built activation/day centre attached to the J.C.M., Carndonagh was planned in 1985. Relevant documentation is now with the Department of Health for approval. Some of the residents and day attenders at the James ConnoHy Memon"al Unit, Carndonagh, Co. Donegal, like to help with maintaining the grounds. 66 Children a"iving by Health Board funded transport at the new Day Centre for the Mentally Handicapped, Donegal Town. The splashpool in the new Day Centre for the Menta/Jy Handicapped at Donegal Town IS popular with the children. PLANNING OF SERVICES FOR THE PHYSICALLY DISABLED: Donegal Town The Board's staff worked closely with the Cheshire Home Committee in Donegal Town to identify a suitable site for a new unit which is to be a small integrated residential unit with community support. Sligo Residential Centre The Board approved the acquisition of a site in 1985 for the provision of a special small residential unit for the physically disabled in County Sligo and north Leitrim. The accommodation will provide 10 residential places in the form of separate flatlets supported by common facilities and amenities. The unit will also provide a domiciliary support service to disabled persons in the area. TRAINING OF SERVICES FOR THE HANDICAPPED: Summary of Trainees Centre No. Attending Ballyraine 58 Gweedore 38 Gweedore Activation 10 Kilmacrennan 55 Sligo 49 St. Joseph's, Stranorlar 9 Cloonamahon 56 The Board provided training and activation services in 1985 for an average of 275 trainees. Special Olympics The European Special Olympics commenced in Dublin on 3rd July, 1985 and ran for four days. A team of 44 adult mentally handicapped athletes from Doneg~l competed in the events where 13 countries were represented and 2,000 competitiors took part. The athletes were drawn mainly from the Training Centre in Letterkenny (38) and the balance (6) came from St. Joseph's, J.C.M., Cloonamahon (6) and the community. They recorded a magnificent achievement by winning a total of 57 medals. They also recorded great victories on the football field beating Belgian teams (16-0) and Northern Ireland team (13-0). They were defeated in the football final (2-1) as well as in the basketball final. Congratulations are due to all of the athletes who took part and to the organisers in Donegal and Sligo who contributed to this magnificent achievement. !wo •th.'e~s from DonegiJI w;rh Mrs. Schreiber-Kennedy, President of the World Special Olympics : Dub/m m July, 1985, for the European Social Olympics. Long Stay Residential Accommodation Long stay residential accommodation for the handicapped in the region continued to be provided in Cloonamahon, J.C.M. and St. Joseph's Unit, Stranorlar and services and facilities were developed to the extent that resources permitted. The most significant achievement in this regard was the completion of a workshop at the Stranorlar unit which is being used for the activation and training of severely handicapped residents and to provide workshop facilities for day attenders. SERVICES FOR THE ELDERLY Residential Services Services for the elderly in the region were maintained in our residential units as set out in the table below: - Residential Units for the Aged Name of Unit Bed Complement No. of No. of Nursing Welfare W.H. Mohill 40 40 W.H. Manorhamilton 40 40 W.H. Ballyshannon 35 35 C.N.U. Buncrana 45 30 15 C.N.U. Ramelton 38 22 16 C.N.U. Falcarragh 35 20 15 lt is policy to maintain one or two beds in each unit for short term admissions/ respite care. This policy has worked well in providing emergency services and in helping families cope in times of difficulty. Development of Services for the Aged: Individual Care Plans The Board's policy of providing each resident with an individual care plan based on their personal and unique needs was extended to the Ramelton Community Nursing Unit in 1985. (This policy was piloted in Buncrana Community Nursing Unit in 1984). These new models of care are designed to meet the total needs of each resident, i.e. physical, personal, social, spiritual and emotional needs. Aimed at encouraging a minimum level of resident dependency, they place a firm emphasis on a participative style of management in the units and the acceptance by the residents of the units as homes rather than institutions. Boarding Out Scheme Formalised arrangements were drawn up by the Director of Community Care and Medical Officer of Health, Donegal Community Care Area for the Boarding Out of the Elderly Scheme covering items like standards of accommodation, visits by board staff and capitation payments. Where possible only one or two placements are made with a family so that a 'home' environment is preserved as far as possible. lt is aimed at placing people in a family environment and if possible convenient to the persons's former home. An allocation was made to initiate and test this approach in 1985 in Donegal. The new Nursing Unft at Ballymote, Co. Sligo, which was o~ned during 1985. Ballymote Community f\Jursing Unit All patients were transferred from the old nursing home to the new unit on 13th February, 1985. The accommodation comprises of 25 nursing beds and is being managed and run for the Board by the Sisters of St. John of God. The service is provided for all eligible patients from the area who are referred to the unit through an admissions committee. Welfare Home, Tubbercurry A brief was forwarded to the Department of Health in 1985 regarding the proposed development at Tubt:>ercurry. This development is to be run in conjunction with the Sisters of Mercy, Collooney. lt is aimed at providing a comprehensive and integrated service for the aged of the area. The provision of sheltered housing on the same site or on adjacent sites if necessary has been discussed with Sligo County Council. (This development would provide for the 'welfare home' type accommodation of a C.N.U.). Killybegs C.N.U. Arrangements were made to purchase a site for the unit and plans were devised for submission to the Department of Health. General Board staff and voluntary agencies continued throughout 1985 to provide a valuable service to the elderly in the community with the provision of either their professional skills or with physical requirements like meals on wheels, laundry or home help service. The valuable service provided by our day centres must also be mentioned. CHILDREN There was a shift in policy in 1985 regarding pre-adoption placements. The Department of Health, following publication of the adoption report, confirmed that the Board should no longer make capitation payments for pre-adoption placements in residential units/nursery (Sligo and Fahan). Short term fostering is being promoted as an alternative service. Social work services have been diverted throughout 1985 to meet the growing caseload of children at risk. Cashelgarron Family Group Home continued to provide residential accommodation, for up to 10 children in 1985. Residential Accommodation was also provided in Nazareth Houses in Sligo and Fahan. 71 PREVENTIVE HEALTH SERVICES In line with Department policy, preventive health services continued to play an increasingly active role in the Community Care Programme. Developments in 1985 included the Measles Immunisation Programme, the extension of the Lifeskills Programme to all second level schools, the development of the Mother & Infant Welfare Programme as well as the maintenance of the Board's general range of health education services provided mainly through field workers. Sligo General Practitioner, Dr. Psddy Henry, administering the messles vsccine. Measles Immunisation A mass measles immunisation programme was adopted country-wide in 1985. The national uptake was 84% and the North Western Health Board region uptake was 92% in Sligo/ Leitrim, 90% in Donegal. This programme was so successful in 1985 that it was extended into the first three months of 1986. Great praise is due to all of the health care personnel who were involved in ensuring the high take-up of this scheme in the North Western Health Board region. General Health Education Programmes The Mother & Infant Welfare Programme ran very successfully in Sligo and Leitrim in 1985 through the unit in Sligo General Hospital as well as the community programmes. 1t is intended to extend this programme to Donegal in 1986. The Community Addiction Programme is also to be extended in 1986. Other programmes on alcohol/ welfare intervention and parent groups were planned in 1985 for implementation in 1986. Lifeskills The Lifeskills Programme was extended to all of the 50 second-level schools in 1985. A summary of schools involvement is given below:- Total number of Schools in the Region 50 Total number of Schools in the Programme 50 (100%) Total number of Pupils in the Region 19,011 Total number of Pupils taking part in the Programme 12,047 (63%) Number of Class Groups involved 441 Number of Teachers participating 366 ____n Discussion group at tha Lifeskills Teaching Symposium in Donegal Town in November 1985. Participants representing some of the second level schools in the region who attended the Symposium on Lifeskil/s Teaching in November, 1985. A symposium on the Lifeskills Programme was held in Donegal Town in November, 1985. Objectives of the Symposium were to inform various groups about the work done, to give recognition to schools and teachers, to mark the completion of the developmental phase of the work and to look to future developments. Participants in the symposium included representatives of Board members and staff, Health Education Bureau Board, Departments of Education and Health and Principals and Teachers from the 50 second level schools. In the course of his address at the Symposium, Mr. D. Brennan, Secretary, Department of Education said: - "With regard to the lifeskills project for schools sponsored by the North Western Health Board I am informed that all of the post-primary schools, in the Health Board area, are participating in the project now. Since participation is wholly voluntary on the part of schools, this in itself is a measure of the success of the work and of the level of trust which has been built up among school authorities. There are other aspects of this project which deserve to be noted. My information is that this project, as it has been carried out, has been marked by a special sensitivity to what 1 called earlier the culture of the school and to the mission of the school in the community. 73 This is a sign that the people who sponsored and introduced the project were people who gave some thought to what they were about and had some understanding of how schools might relate to communities. 1 know, as well, that care has been taken to communicate with parents, especially with regard to work in areas such as human relationships and sexuality. We have a distance to travel in establishing links between home and school in Ireland and it may be that we al have a lot to learn from your experience here· I am aware as well that care has been taken to inform and communicate with the managements and patrons of schools. The fact that my Department has been kept informed and has been provided with such information as it requested is much appreciated. The importance of this process of communication should not be under-estimated. h is vital to the success of a project such as this. Those who sponsored, who planned and who implemented this project were obviously aware of the dangers I mentioned earlier in my address and they took the necessary sensible steps to take account of these dangers. I congretulate al concerned on a job well done. I am not going to speculate too much about the future. Apart from the CEB you are aware that other organisational changes have been proposed for our system of education. I will say, though, that I think that a good basis has been laid for continuing cooperation between the schools and the heahh authorities in this area. The local response aspect of your work is one of its more important and attractive features and I feel sure that the local schools authorities have shown good sense in choosing to cooperate with the Heahh Board. So it is with little hesitation that I say 'Rath Dear an obair'." MANAGEMENT SERVICES The review of the organisation of services was continued with particular emphasis on the roles and responsibility of senior staff as well as working and organisational relationships, and policies and procedures for delivery of services. The use of new computerised systems for financial services and allowances was subject to further modification and expansion. Further analysis and preliminary design work on the potential applications of new technology in assisting with the provision and management of professional services was undertaken with particular emphasis on the organisational implications of a more structured and systematic approach to provision of services. Special reviews on information services and day care centres were undertaken. ADMINISTRATIVE SERVICES T.he range of services ~ro~ided ~Y Administrative Staff was further expanded. Coupled to the1r normal range of dutieS 1nclud1ng those listed below, they had increased in o1ve t " hV I C . v men Wit o unt ary omm1ttees and on Management Committees of Day Care Centres. Th~ normal range of services provided by the administrative department incl d process1ng and payment of:- u es • A llow ances - e.g.. Disabled Persons Maintenance Allowance , lnf ec tl.ous D"1 sease Mamtenance Allowance, Blind Welfare. Services - Refund of Drugs, Long Term Illness Home Hel M Is La • Capitation Payments. ' p, ea • undry, • Section 65 Grants. They are also responsible for: The Organisation and payment of maint enance works and · Monitoring of the General Medical Services Scheme- this w~":ovements.. . . development ~n the role of the community care administrators in liaiso ~nt a S1Qnif1ca~t G.M .S. pract1ce patterns. n With G.P.s on the1r Processing and issue of medical cards. Administration_of _Housing A_id for the Elderly Scheme. Numerous duties mvolved With capital developments '"'-~....~ .-4,. ... nn s;.ome of their activities is g_iven in the · . aDOen<:tiC8S - Communitv C..arR SERVICES TO THE FINANCIALLY DISADVANTAGED/SOCIALLY DEPRIVED Income maintenance and family support services continued to be provided by the Supt. C.W .O.s and their staff. The review of eligibility for services, particularly medical cards was brought well up to date in 1985 and this represents a significant achievement on the part of the C.W.O. service in view of the large backlog of reviews. Expenditure on the income maintenance schemes of Supplementary Welfare Allowance and Single Exceptional Needs in 1985 for Donegal, Sligo and Leitrim is given below. No. of S.W.A. Recipients Cost Sligo/Leitrim 265 crn,2f!IJ Donegal 600 £1,358,845 No. of S.E.N.P. Recipients Cost Sligo/ Leitrim Z79 £23,801 Donegal 2,176 £154,602 REVIEW OF SELECTED SERVICES As in previous years it is proposed to carry out in more detail a review of a selected service. The service selected for this year is the Environmental Health OffiCer Service. Environmental Health Officers The services provided by the Environmental Health Officers (formerly Health Inspectors) . are the statutory responsibility of the Health Boards and the Local Authorities. These services can be divided into two broad categories. Mr. R•y McL•ugh6n, SMior Envronmenml HHith, Sligo, ~nying out • cold 8tore in8p«tion •t St. John'$ Hospitlll, Slgo. 75 !a I Control of hygiene standa and disinfestation. (b) Control of public health nuisances and risks to health in the environment by monitoring adherence to legislative and other standards in relation to such diverse environmental influences on health as water supplies, sewage disposal, physical planning, housing, temporary dwellings, public health nuisances, pollution from effluent and noise and disposal of refuse. Monftoringfrom e public the health disposal viewpoint. of refuse is en i mport ant part of the work of the EnvironmentBI Health Officer The staffing of the service in 1985 was as f allows: TABLE 1 : E.H.O. STAFFING 1985 Donegal Sligo/leitrim Supervising E.H .O. 1 1 Senior E.H.O. 2 2 District E.H .O. 6 6+ Note: OffThereic~rs inwere 1985 two: fundamental eh anges'". relation to Environmental Health The title of Health Inspector was h 11 I The qualification changed from thc ang~ to Environmental Health Off (2) at of diploma to th at of degree leer. . The level of activity in 1985 in relation t . e IS. summansed In the followinQ tables. o the vanous services provl'd d . . A .number of comments in relation to th .. . recordmg: e pnonti8S for the se rvlce· .In 1985 are worth (a) Formalf hygiene/ health education courses for food eature· • of .the approach._ to im prov1ng. hygiene standaworkers ds . became an established ------=-='~~~n~h~o~te~ls, restaurants and (b) Programmes of inspection of food premises were closely related to their standards of structural and operational hygiene, i.e. premises with the lo'(Vest standards are visited more frequently. (c) Monitoring of hygiene standards in primary schools was resumed. (d) More systematic monitoring of the quality of public water supplies was established in consultation and agreement with the sanitary authorities. During 1985 systemetic monitoring of the qus/ity ofpublic water supplies was established in consulation with the sanitary authorities. Ramelton, Co. Donegal is the location featured. Mr. John Ha yes, Enwonmental Health Officer, preparing to inspect mussels from a raft anchored on Mulroy Bay, Co. Donegal. n (e) Killybegs and Rathmullan were approved as sea ports for the issue of deratting exemption certificates and two E.H .O.s were assigned duties as Port Health Officers. (f) Monitoring of shellfish and the water in which they grow was systematically established particularly on the shores of Mulroy Bay, Lough Swilly and Lough Foyle. (g) A new problem for the service in 1985 was the surveillance of the border area for the illegal importation of casualty meat, i.e. unfit meat. New legislation is required to tackle the problem as the meat must be found on a food premises or it cannot be presumed to be on sale for human consumption. TABLE 2 : LOCAL AUTHORITY DUTIES SUgo/Leitrim Community Care Area Description Number of inspections Milk and Dairies: Cow Houses 8 Dairies 7 Water Samples Chemical Samples 528 Bacteriological Samples 1439 Fluoride Samples n Wells inspected 40 Planning: Applications 374 Follow up to Approved and Unauthorised Development 15 Temporary Dwelling: Licenced Sites 38 Unlicenced Sites 12 Burial Grounds: Inspections 23 Grave Soundings 29 Dance Halls Inspections 38 Drainage and Effluent Septic Tanks 2 Existing Drainage 12 Fluorescence Tests 4 Housing: Housing meetings 68 Allocations 278 Inspections/ Sligo 612 Inspections/ Leitrim 427 Essential Repairs Grants 60 Rural Cottage Sites 13 Swimming Pools: Samples 35 F. Chlorine and P.H. Tests ffl Public Health Nuisance 90 Public Toilets 27 Public Dumps 7 Derelict Sites 4 Factories Act 15 Air Pollution and Noise Control 70 71 TABLE 3 : FOOD HYGIENE CONTROLS TOTAL NUMBER OF FOOD PREMISES INSPECTED Sligo/Leitrim Community Care Area Public House (Food) 35 Public House (non-food) 311 Shop - Retail Food Premises 350 Hotel 35 Restaurant n Butcher 73 Slaughter House 40 Wholesalers 19 Bakeries 14 Manufacture 4 Poulterers and Fish Monger 2 Ice Cream Manufacture 2 Occasional Food Premises 1 TABLE 4: FOOD HYGIENE INSPECTIONS Donegal Community Care Area 1. Number of Food Hygiene Inspections 1644 2. Food Sampling Duties 106 3. Rodent Control Inspections 46 4. Poisons Regulations Inspections 48 5. Shellfish Sampling 70 6. Schools Inspections 8 7. Hospital Inspections 35 TABLE 6 : ENVIRONMENTAL DUTIES Donegal Community Care Area (a) Number of Planning Applications Inspections 2115 (b) Number of Water Samples sent for Analysis 972 (cl Number of Housing Inspections 1916 (d) Temporary Dwelling Inspections 126 (e) Sewage Disposal Inspections 198 (f) Public Health Nuisance Investigations 1al (g) Dance Hall Inspections 58 (hi Slaughter House Inspections 120 (i) Milk and Dairies Inspections 110 (jl Gaming and Lotteries Inspections 110 (kl Factories Act Inspections 10 (I) OffiCe Premises Inspections 10 (m) Atmosphere Pollution Inspections 34 The new Health Centre at Carrigans, Co. Sligo. Personnel 81 82 NORTH WESTERN HEALTH BOARD PERSONNEL MATTERS 1985 In the context of human resources in general and of industrial relations in particular, the state of public finances, especially the severe financial restraints imposed on this Board, left little room for discretion or manoeuvre in 1985. Approximately seventy per cent of the Board's financial allocation is spent on payments to employees. Taking this factor into account it becomes very clear that there are extreme restraints on staff numbers and this in turn leads to added pressures on the staff at their workplace in carrying out their day to-day duties. CONCILIATION AND ARBITRATION SCHEME DISPUTE Towards the latter part of the year the Public Service Arbitrator, whose term of office expired in July 1985 was not reappointed as the Government wished to have discussions on changes in the Conciliation and Arbitration Scheme. In response, the Public Service unions declared their intention to organise a National Public Service one-day strike on October 15, 1985 and this took place in all regions including the North Western Health Board area despite initiatives by the Minister for the Public Service to avert the strike. The Trade Unions reiterated their demands for the re-appointment of the Arbitrator as a precondition to commencement of talks on pay issues. Further strike action-a two day protest-was planned for the 10 and 11 December, 1985. After intense negotiation this proposed action was deferred and discussions commenced between all sides on pay issues and the revision of the Conciliation and Arbitration Scheme. NON-CONSULTANT HOSPITAL DOCTORS INDUSTRIAL ACTION Also towards the end of the year the non-consultant hospital doctors threatened industrial action in all hospitals throughout the country unless progress could be made to their satisfaction on a number of issues. Those issues included overtime payments, rotas, leave provisions, accommodation and study facilities. A limited form of industrial action took place countrywide on 11 December as the doctors took action to highlight their grievances, despite the fact that certain matters were under discussion with the Health Boards and that the Labour Court was directly involved at the time in reviewing the overtime element of their grievance. While there was limited action on the day in this Board's hospitals, it did not present undue hardship for patients, because of the temporary nature of the action. PROVIDING SERVICES IN DIFFICULT FINANCIAL CIRCUMSTANCES The changed climate in which all employers must operate creates the need for this Board just as for any employer, to review critically all its existing resources, practices and services in order to establish the priority needs and to establish how relevant each service is to current needs. lt is only in this way that the Board can continue to strive to provide the services that are efficient, effective and seem to meet the needs of the community which it serves. In providing these services the Board relies heavily on its manpower resource and therefore the effects of constant monitoring, evaluating and changing of services within budget constraints can and are very quickly felt by the staff providing those services. lt is essential that in achieving this balance in the provision of services the individual or groups in our society who are dependant on our services at community or hospital level can have a reasonable and adequate response to their needs . The Board believes that its staff have achieved this in the past year and while there have been many occasions when staff at various levels and in various locations have indicated their problems because of the financial constraints there has been a willingness to discuss and an acceptance of the consultative process to achieve accord on most matters that were a cause of concern. The Board therefore, must because of the continuing stringent economic environment within which it now operates, continue to seek out and introduce further policies which will enable it to meet this situation. lt acknowledges that without the ideas, support, understanding, co-operation and commitment of its employees it would be impossible to make progress in this way. 83 DECENTRALISATION OF CENTRAL SERVICES Management has in 1985 pursued the Board's adopted policy in relation to decentralisation of central services to the major locations. This will enable local management to have a greater degree of responsibility and flexibility in t~e pla_nning a~~ ~anagement of the Board's resources especially in the personnel and fmanc1al spec1aht1es. SPECIAL LEAVE SCHEME During the year a number of the Health Board's staff, representative of all cat_eg~ries , availed of special leave without pay in accordance with Department of Health gUidelines. Under this scheme permanent employees may avail of special leave, without pay, up to a maximum of three years. The scheme so far has been a success and the numbers availing of it is an indication of this. The Board, of course, had always in the past granted leave without pay for very short periods of time where it was required by employees in order to cope with unusual domestic difficulties and this policy will continue to operate. Also, in accordance with separate Department of Health guidelines, a number of the Board's medical, nursing and paramedical staff have availed of the opportunity to work abroad in countries whose health services are underdeveloped. The majority of those availing of this particular leave without pay have gone to work in the Middle East. DECENTRALISATION OF CENTRAL SERVICES Management has in 1985 pursued the Board's adopted policy in relation to decentralisation of central services to the major locations. This will enable local management to have a greater degree of responsibility and flexibility in the planning and management of the Board's resources especially in the personnel and financial specialities. SPECIAL LEAVE SCHEME During the year a number of the Health Board's staff, representative of all categories, availed of special leave without pay in accordance with Department of Health guidelines. Under this scheme permanent employees may avail of special leave, without pay, up to a maximum of three years. The scheme so far has been a success and the numbers availing of it is an indication of this. The Board, of course, had always in the past granted leave without pay for very short periods of time where it was required by employees in order to cope with unusual domestic difficulties and this policy will continue to operate. Also, in accordance with separate Department of Health guidelines, a number of the Board's medical, nursing and paramedical staff have availed of the opportunity to work abroad in countries whose health services are underdeveloped. The majority of those availing of this particular leave without pay have gone to work in the Middle East. These schemes, by releasing permanent staff, allow for job opportunities on a temporary basis to be taken up by those seeking employment. EQUALITY IN EMPLOYMENT Equality in employment continues to remain a major issue in the personnel area. Discussions at national level between employers and psychiatric unions continued on alternatives to the seni~rity sys~em of ap~ointment to supervisory posts in psychiatric nursing which had been m operation up unt1l recently. A procedural agreement had alread been accepted on the integration of male and female nursing staff at ward level in th~ hospitals. In January the Board itself adopted a report on the Government policy stateme t . be d . n on equality of opportunity twee~ men an wo~en _ m employment which encourages all organisations to promote and 1mp~ement leg1slat1on which prohibits discrimination in employment based on sex or mantal status. The Board as an employer h . . as a1 ways recognised the close hnk between equal opportumty and good employment P t" 84 rac 1ce. IN-SERVICE TRAINING AND EDUCATION The Board must strive through all its employers to achieve the maximum level and quality of care and service for its patients and clients. Group attending staff trsining session in Sligo with Mary Burns of the Boards Systems Unit (left background). To achieve this it always has been Health Board policy to try and ensure that each year there would be in operation a programme of continuing education, development and updating of skills and techniques for its employees. In 1985 this programme continued and some of the year's activities are outlined as follows: - (a) The first postgraduate course in the practice of Social Welfare and Mental Health was completed. This course was organised in association with the University of Surrey and all the participants completed the course successfully. The second postgraduate course commenced in the Autumn and is being presented in association with University College Galway. Twenty participants who are psychiatric nurses from Sligo and Letterkenny are attending the course. {b) A course dealing with the development of basic helping skills commenced in early Autumn. This course which deals with basic approaches to counselling and group work is being attended by twenty psychiatric nurses from St. Calumba's and St. Canal's hospitals. (c) A number of seminars on bereavement counselling and communication for wholeness were held for nursing staff in all the Board's hospitals. {d) In association with the Rheumatology Department at Our Lady's Hospital, seminars were held on rheumatology for all public health nurses within the region. (e) Further briefing seminars were held during 1985 for managers covering grievance and disciplinary procedures, absence counselling, staff appraisal and interviewing techniques. · (f) The Board continued to develop its programme of workshops and in-service training for staff in the geriatric hospitals and the community nursing units in association with the Irish Wheelchair Association. (g) Management seminars were organised during the year for managers and paramedical supervisors in the community care and hospital programmes. (h) As part of the continuing development of the Mother and Infant Welfare programme seminars were organised for public health nurses who are delivering the programme. (i) Arrangements were made during the year for staff to update their clinical skills or obtain training in new clinical procedures. 85 Community Welfllre Officers at a stliH training session in the Conference Room, Letterkenny Genersl Hospitlll. Ms. Anne O'Keefe, I. P.A., conducted the course. PSYCHIATRIC SERVICES-PLANNING FOR THE FUTURE In March 1985 this Board considered and adopted the very detailed report " The Psychiatric Services- Planning for the Future". In the transition stages which will be necessary in the achievement of the establishment of the new pattern of services as outlined in the report there will be a big involvement of staff in the discussion and consultation process prior to and during the implementation of the plan. This process has already been commenced in both our psychiatric hospitals in 1985 and will be continuing throughout 1986 . • Finance ~ . ~ --.. REVENUE EXPENDITURE SUMMARY 1985 1984 1985 £'()()() £'()()() £'()()() £'()()() 1.1 Health Expenditure Hospital Care 53,102 Community Care 26,239 Central Services 2,863 77,467 Total Health Expenditure 82,204 1.2 Non Health Expenditure Supplementary Welfare 4,017 Training Centres 1,976 5,362 Total Non-Health Expenditure 5,993 82,829 TOTAL REVENUE EXPENDITURE 88,197 Funded by 1. Supplementary Welfare Refunds and Contributions from Dept. of Social Welfare/ Donegal/ Leitrim/ Sligo 3,567 County Councils 4,017 2. Training Centres European Social Fund 1,385 Sales 584 1,795 Other Grants + Income 7 1,976 3. Health 6,246 Miscellaneous Receipts 6,560 12,553 71,221 Department of Health 75,644 82,829 TOTAL 88,197 89 PIE CHART 1 N.W.H.B. REVENUE EXPENDITURE 1986 S.W.A. 4.6% Central Services 3.2% ----r--- Training Centres 2.2% Community Care 29.8% HOSPITAL CARE 60.2% ANALYSIS OF TOTAL EXPENDITURE (REVENUE) 1984 1- Pay Non-Pay Totlil £'000 ['000 £'000 -£'000 20,554 General Hospitals 15,596 6,457 21,413 Special Hospitals 22,053 17,272 5,1n 5,992 Other Hospital/Homes 22,449 5,260 1,257 1,850 Ambulance 6,517 986 975 89 Extern Hospitals 1,961 122 122 49,898 Sub-Total Hospital Care ~ Programme ~ ~ General PractitionerI General 14,831 Medical Services 4,683 11 ,601 1,159 Maternity & Child Care Services 16,284 668 647 1,508 Dental, Ophthalmic & Aural Services 1,315 841 505 1,346 6,349 Rehabilitation 294 1,128 Other Services 5,6n 5,971 719 604 1,323 24,975 Sub-Total Community Care Programme ~ ~ ~ 3,567 Supplementary Welfare 345 Central Services 3,672 4,017 2,594 1,021 Training Centres 1,842 2,863 8,406 1,056 920 1,976 Total Expenditure 82,829 48,741 - -39,456 -88,197 55% 90 45% 100% N.W.H.B. PAY AND NON-PAY 1985 ANAI..'r'SIS OF EXPOIDmJRE --- -.._ -- -· -- _./ ,. / ,. , I ' ' \ \ I ' ; NON-PAY (48.'"') I I I I I I I I \ ! PAY (55.'*) : ' ' ' \ I ' ' / I ' ' .. / ' -... ______ 91 2.2 ANALYSIS OF EXPENDITURE HOSPITALS AND HOMES 1984 1985 Pay Non-Pay Total [ '()()() HOSPITAUHOME ['()()() ['()()() ['()()() 11 ,836 Sligo General 8,957 3,876 12,833 8,718 Letterkenny General 6,639 2,581 9,220 20,554 Sub-Total General Hospitals 15,596 6,457 22,053 6,896 St. Conal's 5,500 1,652 7,152 7,672 St. Calumba's 5,827 1,937 7,764 1,548 St. Joseph's 1,302 322 1,624 2,429 St. John's 1,935 607 2,542 286 J .C.M . 257 56 313 1 '118 Cloonamahon 1,033 276 1,309 199 St. Joseph's M.H. Unit 339 47 386 21,413 Sub-Total Special Hospitals 17,272 5,177 22,449 1,451 Our Lady's 1,160 305 1,465 597 Lifford 533 91 624 775 Sheil 641 141 782 542 Carndonagh 478 109 587 523 Donegal 443 101 545 612 Dungloe 523 113 636 125 Arus Breffni 111 30 161 158 Mohill Welfare Home 119 42 161 383 Falcarragh C.N.U. 334 75 173 Rock Welfare Home 409 140 51 412 Ramelton 191 376 80 70 Mohill Day Centre 456 64 12 171 Buncrana 76 338 107 445 5,992 Sub-Total Other Hospitals/ 5,260 1,257 6,517 Homes 1,850 Ambulance 986 89 Extern Hospitals 975 1,961 122 122 49,898 TOTAL ~ ~ 53,102 CHA RT 3 ANALYSIS OF PAY BY CATEGORY A Nursing, Medical & Allied £'000 % 26,544 8 Catering, Housekeeping, Porters etc. 54.5 c Para-Madical 7,311 15.0 D Clerical & Administrative 2,778 5.7 E Maintenance 4,425 9.1 F Pensions 1,316 2.7 G Others 1,823 3.7 H Board's P. R.S.I. Contributions 2,193 4.5 2,351 4.8 TOTA L 48,741 100 92 - N.W.H.B. ANALYSIS OF PAY BY CATEGORY 1985 , 8 H A • c D E CATEGORY ANALYSIS OF PAY BY STAFF CATEGORY 1986 (a) Nursing & Allied 54.5% (b) Catering, Housekeeping, Portering etc. 15.0% (c) Clerical & Administrative 9.1% (d) Paramedical 5.7% (e) Maintenance 2.7% (f) Pensions 3.7% (g) Others 4.5% (h) Board's P.R.S.I. Contributions 4.8% 93 ANALYSIS OF NON-PAY EXPENDITURE £'000 % 3.1 Drugs & Medicines 1,214 0.8 Blood & Blood Products 300 Medical Cases 112 0.3 Medical & Surgical Appliances 1,330 3.4 Dressings & Bandages 75 0.2 Medical Equipment 273 0.7 Pathology Expenses 637 1.6 X-Ray Expenses 248 0.6 Provisions 3,406 8.6 Catering Equipment 8) 0.2 Heating, Power & Light 3,626 9.2 Cleaning & Washing 756 1.9 Furniture, Crockery etc. 169 0.4 Bedding & Clothing 542 1.4 Maintenance 642 1.6 Farm & Garden 129 0.3 Transport 2,866 7.3 Finance (excluding G.M.S. Payments) 1,663 4.2 Office Equipment 318 0.8 Office Expenses 1,399 3.5 Sundries 8,145 20.6 Capitation Payments 2.~ 7.6 General Practitioners/ Pharmacists 8,547 21 .7 TOTAL NON-PAY 39,466 100 CAPITALEXPENDITURE1~ Expenditure on on-going Schemes during the year amounted to £2,087M. This does not represent the full cost of the Schemes but is the expenditure incurred on the Schemes in 1985. HOSPITAL CARE PROGRAMME: £'000 £'000 Letterkenny General 609 Sligo General 498 Our Lady's, Manorhamilton 59 Cloonamahon 53 Special Allocation-Improvement to District Mental Hospitals 190 Special Allocation -Replacement of Equipment in General Hospitals 100 1,509 COMMUNITY CARE PROGRAMME: Health Centres 57 Community Care Project 256 Ramelton 33 Buncrana 13 Ballymote 57 Housing Aid for Elderty 163 578 TOTAL CAPITAL EXPENDITURE Appendkes 96 HOSPITAL IN-PATIENT STATISTICS FROM JANUARY, 1986 TO DECEMBER, 1986 Hospital Bed Number of Average Duration %Bed Complement Patients Treated of Stay Occupancy Medical letterkenny 68 2,962 6.5 n% Manorhamilton 37 861 13.7 87% Sligo 55 3,205 6.7 107% Total 160 7,028 7.5 90% Surgical letterkenny 64 3,129 5.7 76% Sligo 69 3,147 6.3 81% Total 133 6,276 6.0 78% Maternity letterkenny 50 2,385 4.7 62% Manorhamilton 2 35 5.6 19% Sligo 30 1,642 5.3 ~% Total 82 4,062 5.0 68% Gynaecology letterkenny 19 1,327 3.9 76% Sligo 14 817 3.9 65% Total 33 2,144 3.9 70% Paediatric letterkenny 30 2,133 3.7 73% Sligo 34 1,811 5.4 ~% Total 64 3,944 4.5 n% Ophthalmic Sligo 14 591 5.7 68% E.N.T. Sligo 14 1,006 4.9 100% letterkenny 167 2.0 19% Total 14 1,173 4.5 ~% I.C.U. letterkenny 5 422 2.3 54% Sligo 3 255 3.7 87% Total 8 6n 2.8 66% Orthopaedics Sligo 52 1,609 9.5 84% Rheumathology Manorhamilton 20 416 14.0 79% Hostel letterkenny 7 Number of Blrths-letterkenny, Sligo and Manorhamllton from January 1• to December 1• Letterkenny 2,025 Sligo 1,466 Manorhamilton --13 Total 3,504 97 SUMMARY OF HOSPITAL IN-PATIENT STATISTICS FROM JANUARY 1985 TO DECEMBER 1985 %Bed Hospital Bed Number of Average Duration Occupancy Complement Patients Treated of Stay 71% Letterkenny 243 12,266 5.1 Manorhamilton 59 1,312 13.5 81% Sligo 285 13,867 6.3 86% Total 587 27,445 6.1 79% NUMBER ON WAITING LIST FOR ADMISSION TO GENERAL HOSPITALS (a) Sligo General Hospital Over Less than Speciality 2 yrs. 1-2 yrs. 9-12 mths 6-9 mths 3~ mths 1-3 mths 1 mth Total Medical Surgical 18 24 67 65 84 24 282 Paediatric 8 4 12 Gynae 6 4 13 10 33 Ophthalmic 4 60 48 16 128 E.N.T. 11 21 32 Orthopaedic 3 19 15 26 57 73 16 209 (b) Letterkenny General Hospital Over Less than Speciality 2 yrs 1-2 yrs 9-12 mths 0-9 mths 3-6 mths 1-3 mths 1 mth Total Medical Surgical 4 41 103 132 130 88 498 Paediatric Gynae OUT-PATIENT CLINICS (a) Sligo General Hospital Attendances Speciality Number Held New Recall Total Medical 90 279 Surgical 1,046 1,325 263 1,094 Gynae 2,007 3,101 104 334 A nte Natal 522 856 100 704 Orthopaedic 2,393 3,097 61 209 Fracture/ Plaster 923 1,132 102 4a) St. Luke's 2,487 2,967 24 212 Varicose Veins 942 1,154 93 137 Paediatric 218 355 130 328 E.N.T . 2,316 2,644 97 937 Diabetic 12 1,331 2,268 Ophthalmics 156 156 94 315 Refraction 1,650 1,965 81 633 Dermatology 323 956 11 194 Potrombine Activity 50 133 327 18 Rheumatology 449 467 39 129 Geriatric 353 482 96 129 Orthoptic 940 1,069 53 199 Audiology 100 969 1,168 1,050 513 1,563 Total 1,600 7,381 19,671 27,052 OUT-PATIENT CLINICS (b) Letterkenny General Hospital Attendances Specialty Number Held New Recall Total Medical 201 1,064 3,700 4,764 Surgical 174 1,445 4,570 6,015 Gynae 51 339 353 692 Ante-Natal 153 900 1,785 2,685 E.N.T. 76 870 934 1,804 Paediatric 193 553 2,042 2,595 Ophthalmic 69 707 1,059 1,n6 Orthopaedic 37 260 810 1,070 Dental 44 371 371 Varicose Veins 24 64 38 102 St. Luke's 11 240 487 727 Limb Fitting 22 90 66 156 Oral Surgery 11 154 48 202 Diabetic 96 12 1,342 1,354 Rheumatology 44 292 692 984 N eu rosu rgery 12 116 75 191 Orthoptic 120 439 1,898 2,337 " Dermatology 4 62 8 70 P.T. Clinics 44 1,197 1,197 1,386 7,607 21 ,475 29 . ~ * Dermatology clinics commenced in September 1985. SLIGO GENERAL HOSPITAL- OUT-PATIENT WAITING LIST 1986 Breakdown of Length of Waiting Ust at 31 /1211986 Over Less than Speciality 2 yrs 1-2 yrs 9-12 mths 6-9 mths 3-6 mths 1-3 mths 1 mth Total Medical 1 9 17 59 44 17 147 Surgical 2 1 1 20 55 79 Gynae 12 9 21 Ante-Natal 1 28 29 Orthopaedic 221 125 23 14 10 27 5 425 Varicose Veins Paediatric 7 22 29 E.N.T. 44 25 69 Ophthalmic 8 8 40 2 58 Refraction 72 33 3 4 8 45 37 202 Dermatology 12 15 11 9 10 fi7 Geriatric 1 1 St. Luke's LETTERKENNY GENERAL HOSPITAL - OUT-PATIENT WAITING LIST 1986 Breakdown of Length of Waiting U.t at 31/1211986 Over Less than Speciality 2 yrs 1-2 yrs 9-12 mths 6-9 mths 3-6 mths 1-3 mths 1 mth Total Medical 9 155 70 234 Surgical 120 79 199 Gynae 12 23 35 Ante-Natal 16 16 E.N.T. 135 142 m Paediatric 9 36 45 Ophthalmic 68 70 75 289 502 Orothopaedic 423 79 11 29 21 2 566 99 OUR LADY'S HOSPITAL MANORHAMILTON- OUT-PATIENT CLINICS 1986 Attendances Speciality Number Held New Recall Total Medical 9 26 11 37 Surgical 47 210 147 357 Gynae 20 48 38 86 Ante-Natal 26 50 80 130 Orthopaedic 20 52 147 199 Paediatric 12 18 158 176 Psychiatric 23 10 158 168 Rheumatology 43 187 300 487 Total 200 601 1,039 1,640 HOSPITAL IN-PATIENT STATISTICS FROM JANUARY 1986 TO DECEMBER 1986 District Hospitals Bed Number of Average Duration % Bed Complement Patients Treated of Stay Occupancy Medlc•l•nd Minor Surgery Ballyshannon 40 409 31 .2 87% Camdonagh 30 383 28.1 98% Donegal 26 504 17.0 107% Dungloe 37 683 16.8 85% Lifford 40 480 26.2 86% Maternity Ballyshannon 5 121 4.5 30% Camdonagh 8 119 3.5 14% Donegal 4 211 3.8 55% Dungloe 6 119 2.7 14% Lifford 6 75 5.1 17% Bed Number of Specialty Average Duration % Bed Complement Patients Treated of Stay Occupancy P•edlatrtc Ballyshannon 1 1 Camdoangh 3.0 1% 2 7 Dungloe 3.4 3% 6 85 Lifford 2 1.9 7% Orthopaedic Ballyshannon 6 48 36.5 80% Total Ballyshannon 52 579 Camdonagh 40 26.0 79% 509 22.0 Donegal 30 715 n% 13.1 Oungloe 49 887 99% 13.5 Lifford 48 555 67% 23.3 74% DISTRICT HOSPITALS - NUMBER OF BIRTHS _ JANUA RV 1986 TO DECEMBER 1986 Ballyshannon 3 Camdonagh 19 Donegal 13 Dungloe 10 Lifford 28 Total - OUT-PATIENT CLINICS 1986 - DISTRICT HOSPITALS SHEll HOSPITAL. BALLYSHANNON Attendances Specialty Number Held New Recall Total Medical 10 26 4 30 Ante-natal 31 129 347 476 Gynae 25 67 29 96 Orthopaedic 23 132 241 373 Dental 6 46 46 Chiropody 23 11 177 188 Psychiatric 48 18 311 329 Geriatric 26 41 102 143 Total 192 424 1,257 1,681 CARNDONAGH DISTRICT HOSPITAL Attendances Specialty Number Held New Recall Total Surgical 12 136 97 233 Gynae 26 279 417 696 Ophthalmic 12 150 221 371 • Paediatric 4 16 10 26 Psychiatric 51 15 563 568 Total 105 596 1,298 1,894 •Paediatric Clinics commenced in August 1985. DONEGAL DISTRICT HOSPITAL Attendances Specialty Number Held New Recall Total Surgical 26 138 153 291 Maternity I Gynae 26 384 628 1,012 Paediatric 48 103 434 537 Chiropody 22 29 275 304 Psychiatric 24 17 187 204 St. Luke's 12 50 376 426 Ophthalmic 15 176 205 381 Totals 173 897 2,258 3,156 DUNGLOE DISTRICT HOSPITAL Attendances Specialty Number Held New Recall Total Maternity/ Gynae 26 35 676 711 Chiropody 35 32 247 m Ophthalmic 22 284 294 578 Psychiatric 51 26 395 421 23 Paediatric 3 6 17 Surgical" J2 131 121 252 2,264 Total 149 514 1,750 101 LIFFORD DISTRICT HOSPITAL Attendances Specialty Number Held New Recall Total Ophthalmic 12 183 153 336 Dental 9 66 66 Total 21 183 219 402 BUNCRANA HEALTH CLINIC Attendances Specialty Number Held New Recall Total Maternity 26 354 587 941 Psychiatric 51 11 402 413 Surgical 13 158 102 260 Ophthalmic 17 256 213 469 Total 107 n9 1,304 2,083 ST. PATRICK'S HOSPITAL. CARRICK·ON-SHANNON Attendances Specialty Number Held New Recall Total Paediatric 35 105 408 513 Psychiatric 22 8 83 91 Orthopaedic 9 29 133 162 Total 66 142 624 766 GERIATRIC HOSPITALS IN-PATIENT STATISTICS FROM JANUARY 1986 TO DECEMBER 1986 Bed New Number %Bed Hospital Complement Admissions Admissions Discharged Occupancy St. John's 354 478 417 332 100% St. Joseph's 190 188 106 136 98% St. Patrick's 133 398 184 290 79% Total 6n 1,064 707 758 95% PSYCHIATRIC HOSPITALS IN-PATIENT STATISTICS FROM JANUARY 1985 TO DECEMBER 1986 Number on New Total Hospital Register Admissions Admissions Discharges St. Calumba's 495 849 158 848 St. Canal's 434 889 200 876 Total 929 1,738 358 1,n4 IN-PATIENT STATISTICS FOR WELFARE HOMESJNURSING UNITS FROM JANUARY 198& TO DECEMBER 198& Bed New Number %Bed Hospital Complement Admissions Admissions Discharged Occupancy Ballyshannon 35 9 7 2 91% Arus Breffni .a 6 5 5 99% Arus Carolan .a 9 8 97% Falcarragh 35 32 18 38 22 98% Ramelton 52 37 24 Buncrana 45 74 99% 59 50 73% 102 PSYCHIATRIC HOSPITALS- OUT-PATIENT CLINICS 1986 ST. COLUMBA'S HOSPITAL. SLIGO Attendances Clinics Centre Number Held New Recall Total Easkey 23 5 185 190 Ballyshannon 48 18 311 329 Pearse Road, Sligo 47 70 528 598 Ballymote 23 11 165 176 Cliffoney 12 52 52 Tubbercurry 24 6 122 128 Gurteen 10 57 57 Manorhamilton 23 10 158 168 Kinlough 22 1 119 120 Drumshanbo 22 9 100 109 M oh ill 23 22 228 250 Ballinamore 22 8 182 190 Carrick·on·Shannon 22 8 83 91 Total 321 168 2,290 2,458 ST. CONAL'S HOSPITAL Attendances Clinic Centre Number Held New Recall Total Carndonagh 51 15 553 568 Buncrana 51 11 402 413 Milford 23 22 136 158 Falcarragh 23 20 309 329 Dungloe 51 26 395 421 Glenties 24 10 271 281 Killybegs 23 14 256 269 Letterkenny 48 61 316 377 Ballybofey 24 8 198 206 Donegal 24 17 187 204 Bun beg 24 17 265 282 Total 366 221 3,287 3 . ~ 103 AMBULANCE SERVICE The following table gives a breakdown of the calls answered by the Board's vehicles during 1985. SLIGO/LEITRIM R.T.A.'s EMERGENCY NON-EMERGENCY TOTAL 1984 1985 1984 1985 1984 1985 1984 1985 Sligo 129 118 1294 1333 2192 2081 3615 3532 Carrick-ooShlnnon 26 42 221 279 1656 1610 1903 1931 M ohill 593 542 593 542 Manorhamilton 15 11 273 290 215 237 503 538 Ballyshannon 25 27 443 439 594 007 1062 1073 Sub Total 195 198 2231 2341 5250 50n 7676 7616 DONEGAL R.T .A .'s EMERGENCY NON-EMERGENCY TOTAL 1984 1985 1984 1985 1984 1985 1984 1985 Letterkenny 107 106 1198 1218 1716 1700 3021 3024 Donegal 34 25 394 573 154 72 582 670 Killybegs 27 24 301 303 45 87 373 414 Dungloe 17 22 404 404 490 575 991 1001 Stranorlar 19 10 183 171 236 238 438 419 Lifford 27 21 272 275 264 229 563 525 Camdonagh 26 25 253 292 210 192 489 509 Sub Total 257 233 3005 3236 3115 3093 63n 6562 TOTAL 452 431 5236 5577 8365 8170 14053 14178 DAY HOSPITALS EXTERNAL HOSPITALS (plus Letterkenny to Sligo) Runs Patients Centre Mileage Patients Sligo/ Dublin 213 436 Sligo 6,998 1,486 LetterkennyI Dublin 215 505 Ck.-on-Shannon 14,909 3,091 Sligo/ Galway 76 191 M oh ill 15,123 2,955 LetterkennyI Derry 135 236 Ballyshannon 14,549 1,969 Letterkenny I Sligo 342 796 Dungloe 14,275 2,083 Total 88,102 13,513 Overall Mileage/ Patients of the Board's vehicles during 1985. MILEAGE: 725,047. PATIENTS: 48,679. 104 PATIENT TRANSPORT SERVICE CAR HIRE SERVICE 1. Out Patient Clinics, X-Ray, Physiotherapy, Renal Dialysis, Handicapped Centres letterkenny, Donegal and Dungloe, Day Care Patients to St. Conal's/ St. Columbas Hospitals and little Angels School, letterkenny. MILEAGE PATIENTS Sligo Control Area 390,159 15,067 letterkenny Control Area 540,474 27,495 TOTALS 930,633 42,562 2. Admissions, Discharges, Clinics at External Hospitals (plus Letterkenny/SIIgol MILEAGE PATIENTS RUNS Sligo/ Dublin 97,920 2,474 320 Sligo/ Galway 32,800 355 164 letterkennyI Dublin 106,920 2,632 324 letterkennyI Galway 2,030 9 7 letterkennyI Derry 120 3 3 letterkennyI Sligo 43,960 2,056 314 TOTALS 283,750 7,529 1,132 DAY HOSPITALS/NURSING UNITS CENTRE MILEAGE PATIENTS CENTRE MILEAGE PATIENTS Sligo 57,326 3,214 Ramelton 40,676 4,607 Donegal 31 ,107 3,044 Falcarragh 19,248 1,910 Stranorlar 31 ,000 3,5n Dungloe 19,564 1,:Bl lifford 34,320 3,564 letterkenny Camdonagh 29,898 3,537 TOTALS 183,651 16,921 TOTALS 79,478 7,897 WORKSHOP TRAINING CENTRES MILEAGE PATIENTS letterkenny Control Area 227,685 36,078 CAR HIRE MILEAGE COMPARISON Year M lege Number of Patient JourMy~ 1983 1661 ,848 85,609 1984 1779,3n 98,750 1985 1756,197 108,931 106 Appendices Community Care 107 Number of towns and villages in the region in which this service was The Board's contribution this service was Laund~ Service Total number in receipt of service 351 405 351 404 418 515 711 616 510 Number of locations at which this service was provided the 37 43 41 43 44 44 The following number of seholds benefited 646 676 589 659 707 570 555 382 375 From the Home Help Service provided through the Voluntary Organisations in 73 77 80 74 64 66 68 53 70 The Board's contribution towards the service was In addition to the service provided through Voluntary Organisations the Board, by the direct employment of full-time and part-time Home Helps provided a home help service for a further 210 372 660 709 831 1031 Households so that the total number of households who benefited from the service was 1 144 1 367 1406 Fuel Service The National Fuel Scheme which was introduced in the latter part of 1980 replaced the Free Fuel Scheme which had previously been operated by Voluntary Organisations at locations throughout the region for certain categories of elderly people . The total number who benefitted from the National Fuel Scheme was 9,861 . The Board's contribution towards this service was £1 ,274,204. This figure represents no. of recipients for period October 1981 -April 1982 (i.e. operative dates of '81 -'82 fuel scheme) . National Fuel Scheme '82/'83 '83/'84 84/ 85 109 on Activities of Local Services c 1979 1980 1981 1983 1984 Chiropody Services were provided by Voluntary Organisations for a total of 142 186 125 133 146 109 97 Persons and the Board Committees who were set up Home improvements Where a Voluntary Organisation undertakes a home improvement for an eligible person and such improvement does not qualify for financial assistance from State or other sources (e.g. supplementary grants from the housing authority) the Board will pay up to a ma)(imum of £30 in any case where the improvement can be seen to be of benefit to the health and/ or welfare of the eligible persons concerned. A total of 1 53 47 23 57 22 2 23 persons benefited under the scheme for which the Board Maternity Cash Grant Year 1sn 1978 1919 1980 1981 1982 1983 Milk for Mothers and Children Numbers who benefited under schem Year Women Children 19n 17 645 1978 7 782 1979 39 542 1980 73 763 1981 76 1982 3 349 --~-~110 Births Assigned Assigned Assigned Registered to Donegal Register to Leitrim Register to Sligo 94 445 1,322 1977 2,246 2.411 60 506 1.429 1978 2,302 2,490 468 1,564 1979 2,315 2,540 53 45 497 1,564 1980 2,317 2,583 29 533 1,595 1981 2,257 2,508 465 1,591 1982 2,309 2,550 25 Allowance towards the Cost of Drugs 1977 1978 1979 1980 1981 1,321 per month 1982 1,196 per month 1983 690 per month 1984 525 per month LONG TERM ILLNESS SCHEME Number of persons availing of scheme with the following Diseases Brucellosis Diabetes Infectious Diseases (Maintenance) Allowance 1977 1978 1970 1980 1981 1982 1983 1984 No. of persons (excluding nts) allowances: Blind Welfare 1977 1978 1979 1980 1981 1982 1983 1984 No. of Blind Persons over 16 and under 21 Nil Nil Nil Nil Nil Nil Nil Nil No. of blind married men with ~•nnrF~n wife 14 13 11 8 8 7 7 8 9 No. of sighted married men with blind wife 10 Disabled Persons (Maintenance) Regulations 1977 1978 1979 1980 1981 1982 1983 1984 1985 No. of Recipients of such allowances (a) at appropriate maximum rate (b) at less than maximum rate No. of applicants 112