North Western Health Board annual report 1981 submitted to the Board at the annual general meeting 19th July 1982

Item Type Report

Authors North Western Health Board (NWHB)

Publisher North Western Health Board (NWHB)

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Annual Report 1981 North Western Health Board Area Location of Principal Centres.

A Headquarters

B General Hospitals c D1stnct Hospitals 0 Commun1ty Hospitals

E Psych1atric Hospitals

F Genatric Hosp1tals

G Residential/Pre-School/Day Centres for Mentally Handicapped

H Welfare Homes

Community Care Offices

J Community Nursing Units K Training Centres Tharisc Bliana 1981 Annual Report Membership of the Board and Management Tham Submitted to Members of North Western Health Board at Annual General Meeting 19th July, 1982.

Os Comhair baill Bord Slainte An lar - Thuaiscirt Ag Cruinniu Chinn - bhliana 19u luil1982.

PRINTING OF 1981 NORTH WESTERN HEALTH BOARD ANNUAL REPORT

This report has been printed in the North Western Health Board Training Centre, Industrial Estate, , Co. . The Training Centre w as opened on February 2nd 1 981 as part of a network of four training centres and activation units in , Letterkenny and . As well as printing, many other activity areas are being developed w ithin the workshop programme, including social skills, service training, cutting and design, carpentary and joinery, electronics, light engineering, upholstery and ca t er i ng. Contents

Chairman's Report 3 Membership of the Board 5 Board Management Team 5 Local Health Advisory Committee 6 Hospital Care 9 Community Care 18 Personnel 25 Finance 28 Appendices (Hospital Care) 32 Appendices (Community Care) 40 Chairman's Report CHAIRMAN'S STATEMENT

Mr. P Harte T. 0 . Chairman, North Western Health Board.

Once again 1981 was a year of financial restraint In the hearth services and the Board's ongoing services had to be run within a budget some three percent down in real terms. However, the'l\ew developments which came on stream during 1981 mark it out as a remarkable year by My standards In the health services of the North West. The major extension of letterkenny General Hospital took in its first - patients in June and with that begun a new era In the acute hospital services In Co. Donegal. The new hospital is one of the ftrst in the country and Is one which the Board and all concerned with the development can be justifiably proud. lt even makes more urgent, by its way of contrasts. the lack of space and facilities at Sligo General Hospital.

At Sligo General Hospital the new orthopaedic unit opened In August, and the service which had been temporarily operated at Manorhamilton transferred there. With Its modern facilities. and equipment it must make a major impact on the provision of a comprehWtsive orthopaedic service In lhe region for which waiting lists and delays have been far too long.

The Board's first Community nursing Units at Falcarregh and opened during the year and with mem comes to life a new concept in the delivering of services for the aged and chronic sick In the region. The units which incorporate nursing services. reeldentlal acccommodetlon and day services serve a local community with full Involvement of the loclll community care services and voluntary committ.. s ancl are designed to futfl me loCal community's needs without hal(lng to tranlfer old people •way from thH familiar surroundings, family and friends in the years when they most need them.

The Improvements in the faclitlea for the delivery and development of the local community services c•ntlnued with the upgradinQ of several health centres and the official o~nSl of the Riverstown, Co. Sligo unit. This centre, like those others being planned at dte moment, while mo~est In scale, wiN provide a base both fot the deHvery ol the Health Boards own service and for the activities of a day centre for the aged and for other local social services in the area.

Nor has psychiatry be•" neglected In 1981. The community nursing service has been substantially d~veloped thioughout the region, with nurses based In towns outside the main hospitals, and working closely with the other coiT.munity services.

3 1t wu ciHppolntlng to me thM we did not get approv81 of the Depertment of HHith In 1981 for the appointment of a conaultant In Rh«.tmatology/Aehablltatlon M Manorhamllton, duplte Ita high priority rating. I wu alto concerned M the delay In getting approval for the beginning of MI'Yicel for mentally handicapped adulta M Stranortar. lt 11 my hope thM both Hrvlcea will gM underway In 1982.

The year 1981 waa the International Year of Dlaabled peraona and the Board both lntenalfled Ita existing programme of development• for the dlubled end carried out some special w.ork to mark the year. But the project with probably the moat long term benefit for dlubled was the opening during 1981 of the Board' • four training workshops with potential for training up to 200 dlubled people.

The Board has expreued Ita concern on a number of occasions durtng the year on the effect• of aubatance abuse, whether tobacco, alcohol or druga. While the flgurea for tobaccos seem to Indicate that anti - smoking programmes ere meeting with some aucceaa, nevertheless we cannot be complacent. In the fleld of alcohol and drugs however, we ere deeOng with a seriously growing problem, end the Board mutt redouble Ita efforts both within Ita own services and In co - operation with the other responsible authorities to deal meaningfully and effectively with these scourges of our society.

I wlatt to pay a tribute to the work during the year of the thousands of people throughout the region who give so generously of their time and resources In the work of the various voluntary social groups end organlutlona, which contribute enotmOutly to the quality of life for all In the area. From my own personal experience In this fleld I recognise both the extent of the work and Ita great value and our deepest appreciation la due to all Involved.

I wish to thank the staff of the Board, of all skills and In all the services for their contribution to carrying out the work of the Board. And flnally to each member of the Board goes my deep appreciation for their support and dedication, which made my year In offlce a great pleasure.

""-- - BOARD MEMBERS.

Mr. P. Harte. Chairman. Mr. M. Guckian, Vice - Chairman. Mr. B. McGiinchey. Mr. M. Melly. Mr. N. McGinley. Miss S. McGonagle. Dr. D. Morgan. Dr. J. M. Murray. Dr. F. C. McAteer. Dr. J. McCioskey. Rev. Canon C. Thornton. Mr. C. Gallen. Dr. M. P. Lalwer Mr. J. Loughlin. Mr. P. McKeon. Mr. H. Conaghan. Mr. L. McGowan. Fr. J. Young. Mr. P. J. Cawley. Mr. W. Farrell. Mr. T. Lavin. Mr. E. Henry. Dr. B. McDonagh. Mr. T. Higgins. Dr. J . K. Heagney. Mr. T. Guckian. Miss M. Bonnar.

MANAGEMENT TEAM.

Mr. D. O'Shea, Chief Executive Officer. Mr. M. Mcloone, Programme Manager Community Care. Mr. M. Ward, Programme Manager Hospital Care (1/9/81) Mr. M. Lynch, Personnel Officer. (7/12/1981) Mr. D. McDermott, Technical Services Officer. Mr. M. Kenny, Planning & Evaluation Officer. Mr. J. Murphy, Finance Officer.

5 Local Health Advisory Committees MEMBERSHIP OF LOCAL HEALTH ADVISORY COMMITTEES.

DONEGAL LOCAL HEALTH ADVISORY COMMITTEE: Mr. S. Cleary, Chairman, , Co. Donegal. Mr. S. McBride, Carnigrave, , Co. Donegal. Mr. Edward J. Fullerton, 66 Cockhill Park, . Mr. Paddy Keavney, 'Loreto', Moville, Co. Donegal. Mr. Brian , Quay Street, Donegal. Mr. C. Gallagher, Mountcharles, Co. Donegal. Mr. Michael J. Melly, East Port, , Co. Donegal. Mr. Fred Coli, , Co. Donegal. Dr. Patrick Oelap, , Co. Donegal. Mr. J. Kelly, , Co. Donegal. Miss S. McGonigle, Main Street, , Co. Donegal.

~r. P. McGowan, Edenmore, , Co. Donegal. Mr. J. J. Reid, Knockfair, Ballybofey, Co. Donegal. Mr. Harry J. Blaney, Rossnakill, Letterkenny, Co. Donegal. ,Senator J. Anthony Loughrey, , Co. Donegal. Mr. N. McGinley, Ballyboes, , Co. Donegal. Or. M. F. Cooney, Director of Community Care & Medical Officer of Health, Community Care Offices, Ballybofey, Co. Donegal,. Mr. P. McCarthy, County Manager, Donegal Co. Council. Mr. J. Hanley, Consultant Surgeon, General Hospital, Letterkenny. Or. P. D. Sweeney, Oungloe, Co. Donegal. Or. J. W. Wray, Ballyholey, , Co. Donegal. Mr. J. McAteer, Psychiatric Nurse, St. Canal's Hospital Letterkenny. Miss B. A. McFadden, Public Health Nurse, Donegal Town. Or. M . McMenamin, Dun - Emer, , Co. Donegal. Mr. J. P. Duffy, M.P.S.I., , Co. Donegal. Mr. L. Friel, Superintendent Community Welfare Officer, Ballybofey. Mr. Frank Callaghan, Main Street, Buncrana, Co. Donegal.

6 I ~ITRIM LOCAL HEALTH ADVISORY COMMITTEE. Mr. J. J. Shortt, Chairman, Lisagarvan, Ballinamore, Co. Leitrim. Mrs. M. Bohan, Main Street, Drumkeerin, Co. Leitrim. Mr. D. Brennan, Orumlegga, Cloone. Co. Leitrim. Mr. J. Clinton, Carrowlaur, Orumkeerin Co. Leitrim. Mrs K. Coleman, Main Street, Carrick- on - Shannon, Co. Leitrim. Mr. C. Cullen, Minkeeragh, Glenfarne, Co. Leitrim. Mr. F. McEigunn, Summerhill, Carrick- on - Shannon, Co. Leitrim. Mr. T. Ferguson, Oooard, Rossinver, Co. Leitrim. Mr. H. Flynn, Screeney, Manorhamilton, Co. Leitrim. Mr. J. J. McGirl, Main Street, Ballinamore, Co. Leitrim. Mr. M. Kilraine, Mohill, Co. Leitrim. Mr. P. McKeon, Corner House, Mohill, Co. Leitrim. Mr. J. McLaughlin, Fawnlion, Fivemilebourne, Co. Leitrim. Mr. J. Mooney, Orumshanbo, Co. Leitrim. Mr. P. J. Reynolds, Main Street, Ballinamore, Co. Leitrim. Miss B. Healy, McOermott Terrace, Manorhamilton, Co. Leitrim. Mr. J. O'Oonnell, Railway Road, Ballinamofe. Co. Leitrim. Or. J.K. Heagney, Director of Community Care & Medical Officer of Health, Markievicz House, Sligo. Mr. P. Ooyle, County Manager, Leitrim Co. Council. Or. P. J. Oockry, Senior Dental Officer, Markievicz House Sligo. Dr. S. Geraghty, Chief Psychiatrist, St. 's Hospital, Sligo. Mr. J. J . Hamilton, St. Columba's Hospital, Sligo. Sr. M. DeLellis, Public Health Nurse, Mohill, Co. Leitrim. Dr. E. Cadden, Mohill, Co. Leitrim. Or. L. O'Gorman, Carrick- on-Shannon, Co. Leitrim . Mr. V. Faughnan, Superintendent Community Welfare Officer, Oromod, Co. Leitrim, (since September 1981 ). Mr. B. Kieran, M.P.S.I., Main Street, Carrick- on- Shannon. SLIGO LOCAL HEALTH ADVISORY COMMITTEE. Mr. Tony McLoughlin, Chairman. "Beechlawn", Barnasraghy, Sligo. Mr. M. Brennan, T.D., Ragoora, Cloonacool, Tubbercurry, Co . Sligo. Mr. P. J. Marren, Curry, Ballymote, Co. Sligo. Mr. Peter Kivlehan, Belra, Lavagh, Ballymote, Co. Sligo. Mr. Paul Conmy, Meenaun, Culleens, Co. Sligo. Mr. Peter Barrett, Derk House, Dromard, Co. Sligo. Mr. George Finnerty, Carowmacbrine, Rathlee, Co. Sligo. Mr. Leo Conlon, Coolmurla, Geevagh, Co. Sligo. Mr. Gerard Murray, Calteraun, Gurteen, Co. Sligo. Mr. D. Bree, 1, High Street, Sligo. Miss M. Gormley, Carrowloughlin, Bunninadin, Co. Sligo. Mr. Thomas Fox, Colgagh, Calry, Co. Sligo. Mr. T. Higgins, 82 Treacy Avenue, Sligo. Mr. T. Deignan, Ardvarney, Riverstown, Co. Sligo. Mr. J. F. Shannon, Mahanagh, Cloonloo via Boyle, Co. Sligo. (deceased May 1982) Dr. S. Geraghty, Chief Psychiatrist, St. Columba's Hospital, Sligo. Mr. John McGowan, Psychiatric Nurse, St. Columba's Hospital, Sligo. Mr. Paul Byrne, County Manager, Sligo County Council. Dr. M . O'Connor, Wine Street, Sligo. Fr. C. Jones, Sligo Social Service Centre, Charles Street, Sligo. Mr. E. Horan, Castle Street, Sligo. Dr. J. K. Heagney, Director of Community Care and Medical Officer of Health, Markievicz House, Sligo. Dr. P. J. Dockry, Senior Dental Officer, Markievicz House, Sligo. Mr. S. Colreavy, Superintendent Community Welfare Officer, Markievicz House, Sligo. Mr. P. J. Kennedy, Ballymote Road, Tubbercurry, Co. Sligo. Mrs Mary Watters, Public Health Nurse, Hazlewood, Sligo.

8 Hospitalcare HOSPITAL CARE SERVICES. While much emphasis had to be placed on cost containment in hospitals during 1981 because of the reduced budget allocation it was possible through the various economy measures taken and the eo - operation of staff to meet the increasing demands on the services. The board was also fortunate to get the necessary additional resources to open major developments at Letterkenny and Sligo General Hospitals during the year.

GENERAL HOSPITALS. The patterns and trends of previous years continued during 1981 with increasing demands for treatment in the general hospitals. The total number of patients treated in Letterkenny and Sligo General Hospitals increased from 22,985 in 1980 to 24,889 in 1981 - an increase of 8%. The following table illustrates the patient throughput, average duration of stay and bed occupancy for the year ended December 1981 as compared with the same period thP. previous year.

Patient Throughput Average duration of stay % Bed Occupancy

Y/E Y/E Var. Y/E Y/E Var. Y/E Y/E Var. SPECIAL TY HOSPITAL Dec. 80 Dec. 81 Dec. 80 Dec. 81 Dec. 80 Dec. 81 Medical Letterkenny 2,104 2,415 + 1.5% 7.7 7.0 80% 87% +7% Sligo 2,404 2,566 +7% 10.1 9.7 121% 124% +3% Surgical Letterkenny 2,788 2,900 +4% 7.5 7.3 104% 96% -8% Sligo 3,412 3,387 - 1% 6.7 6.5 92% 87% - 5% Maternity Letterkenny 2,255 2,430 +8% 4.4 4.7 83% 73% - 10% Sligo 1 '718 1,867 +9% 6.7 6.0 106% 102% - 4% Gynaecology Letterkenny 1 '149 1,245 + 8% 4.3 4.0 91% 61 o/o -30% Sligo 819 790 -4% 6.6 6.2 106% 96% -10% Paediatrics Letterkenny 1,419 1,761 +24% 5.6 5.0 87% 71% - 16% Sligo 1,786 1.798 + 1% 7.0 6.3 101% 91% - 10% I.C.U. Letterkenny 262 282 +8% 3.3 3.1 80% 58% -22% Sligo 166 220 +33% 5.6 4.0 85% 81 o/o -4% Ophthalmic Sligo 618 687 + 11% 6.2 5.2 77% 70% -7% E.N.T. Sligo 1.1 81 1 ' 120 - 5% 5.0 - 4 .9 115% 109% - 6% Sligo 904 1,111 +23% 3.3 3.3 56% 64% + 8% 310 15.5 61%

9 Much of the increased throughput of patients in the two general hospitals can be attributed to the opening of the extension to Letterkenny General Hospital in June 1981 and the Orthopaedic Department in Sligo General Hospital in August 1981. These were the most significant advances in the hospital care programme during the year.

The new multi- storey biQck at Letterkenny General Hospital.

Letterkenny General Hospital Extension. In its submission for the draft national plan in 1974, the North Western Health Board identified Letterkenny as one of its two main general hospitals for the region, and gave its development first priority. In January 1975, a Project Team, with representatives of the Department of Health, the Management of the Health Board and the Hospital Staff set to work and in April 1976 produced the Brief for the Architects and Design Team. November 1978 saw the then Minister for ~ealth , Mr. Charles Haughey, T.D., turning the first sod of the major extension. At a total cost of £7 .3m., the project was divided into two phases. Phase I included the Multi - Storey Block, a new pathology block, major extensions to the boilerhouse and laundry at St. Canal's Hospital to provide services for the new general hospital, and Phase 11 which is the reconstruction of the original hospital. The new pathology block was handed over in December 1979 and the commissioning and equipping was completed in February 1980. The multi-storey block was completed in June 1981 and contains the following departments and facilities: Surgical, Obstetric, Gyndecology, Paediatric and Physiotherapy departments, intensive care unit, 4 operating theatres, recovery ward, C.S.S.D., 7 bed hostel, stores, administration and medical records, central staff changing facilities and a conference room and library.

10 Following discussions with the Department of Health a total of 145 additional staff were approved to meet the staffing needs of the main departments. Some beds in the paediatric, gynaecology and intensive care departments and the fourth theatre had to remain closed until extra staff was provided (possibly in 1982). Agreement was reached on the final staffing needs of the hospital but their recruitment will be dependant on budgetary considerations in the normal way.

X - Ray Department Lettterkenny General Hospital

C.S.S.D. Letterkenny General Hospital

11 Sterelizing Letterkenny General Hospital Autoclaves.

Physiotherapy Department L/!tterkenny General Hospital

Intensive Care Letterkenny General Hospital

12 Another development associated with the extension was the commencement of general nurse training at the hospital. The first intake of student nurses took place on 1st October, 1981. July 1981 saw the commencement of work on Phase (2) to provide a new medical department and extensions to the kitchen and staff dining facilities, the casualty department and the mortuary and post mortem facilities. Phase 2 is to be completed by July 1983. When Phase 2 is completed, letterkenny General Hospital will have a bed complement of 334 beds as compared to 1 84 beds before the major extension. Coupled with the increased staffing levels it will meet the requirements to give a general hospital service designed to meet the needs of the Donegal area.

SLIGO GENERAL HOSPITAL - ORTHOPAEDIC DEPARTMENT. The opening of the Orthopaedic Department in Sligo General Hospital on 13th August, 1981 was the culmination of many years of effort by the North Western Health Board to establish a separate orthopaedic service for the North West. Merlin Park Regional Hospital, had provided an orthopaedic service for the five Connacht counties and until 1978 when the Western Health Board had indicated its inability to continue providing a service to this region due to increased demands for services in its own area. Departmental approval was obtained for the erection of a 52 bed orthopaedic department at Sligo General Hospital in 1977 and while this was going ahead, temporary use was made of the facilities in Our lady's Hospital, Manorhamilton to establish the service. This temporary orthopaedic service continued until the unit was finally completed in July, 1981. Though it was c'11y possible to porvide a limited service at Manorhamilton because of its size and the necessity to give priority to fracture cases, a total of 1, 1 83 persons were treated during the period of its operation. The training and experience gained by the staff involved was a significant factor in the rapid build - up of the service when the new department opened in Sligo General Hospital. The new Orthopaedic Department in Sligo General Hospital has 52 beds, 2 Clean-air operating theatres, a plaster theatre and other ancillary service areas. lt works on the basis of 30 beds for elective surgery (such as joint replacement, foot and spinal disorders) and 22 for trauma. The opening of thr department increased expectations of early admissions among the many patients on the waitiog list for surgery, but in view of the bocklog of demand, it will take a year for the service to make a real impact on the waiting list. The w:...ting period for hip - replacements is causing the greatest problems as the demand for this type of operation has grown enormously over the years. The operation itself is a difficult procedure lasting usually in excess of three hours - 4 hip - replacement operations are carried out per week in Sligo General Hospital. There were a total of 1 48 persons on the waiting list on 30th November, 1981. Because of the magnitude of the problem, it was necessary to adopt an admissions priority system whereby patients assessed as having the hightest handicap would be considered for admission prior to patients with a lesser degree of handicap. This system has worked will since its inception. In the future the primary objective of the orthopaedic service is to reduce the waiting lists both out - patient and in - patient to manageable levels. In order to succeed in this, the co-operation of the public and particularly General Practitioners is required so that the facility is utilized fairly and with the best interests of the community in mind.

1? Theatre

Six bed Ward

Specially equipped bathrooJ

14 Physiotherapy department

OTHER 9 ENERAL HOSPITAL DEVELOPMENTS . . Work·on the planning of the major extension of Sligo General Hospital continued during 1981 . Approval was received for Stage 3 of the documentation in September 1981 ; stages 4 and 5, the final stages of the planning and design work are expected to be completed by December 1982 and it is expected that building work will commence in 1983. Another significant advance in 1981 was the approval by Comhairle na nOspideal to the creation of a post of Consultant Rheumatologist for Our Lady's Hospital, Manorhamilton following a decision of the board to establish a Medical Rehabilitation service at the Hospital. However tt"le fact that the sanction of the Minister for Health to the creation of the post was not received before the end of the year was dissapointing. The Medical Rehabilitation unit opened in Mid - August 1981 and there were 2 7 admissions in the four months to 31st December, 1 981 . Pending the appointment of the consultant rheumatologist, there is an agreed procedure for the operation of the service involving the medical officer at the hospital and consultants from Sligo General Hospital.

GERIATRIC HOSPITALS . .The geriatric hospitals in the North Western Health Board's area are located at St. John's Hospital, Sligo, St. Patrick's Hospital, Carrick - on- Shannon and St. Joseph's Hospital, Stranorlar. The following table shows admissions and discharges for the year 1 981 compared to 1980.

No. Admitted No. of New Admissions No. Discharged 1 980 1 981 1nc/Dec 1980 1981 lnc/Dec 1980 1981 lnc/ Dec St. John's 320 335 +5% 263 299 + 13% 213 190 - 11% St. Joseph's 140 160+14% 97 98 + 1% 73 138 + 89% St. Pat's 285 269 - 6 % 159 - 6 % 190 174 - 8%

15 As in the previous year emphasis is continuing to be placed on the day hospital and day care services for the elderly. There are 4 7 4 patients on the registers in the day hospitals and the number of attendances increased by 5% in 1981 . The availablitiy of day hospital services has enabled the geriatric hospitals to cope with the requirements of the ever increasing aged population.

District Hospitals. Table A compares the patient throughput, average duration of stay and % bed occupancy for 1981 compared to 1980 and Table B compares the births for 1 980 and 1981 .

Table A. Patient Throughput Ave. dur. ot stay %Bed Occupancy HOSPITAL Y/E Y/E Var. Y/E Y/E Var. Y/E Y/E Var. Dec 80 Dec 81 D.ec 80 Dec 81 Dec 80 Dec 81 Ballyshannon 678 669 - 1% 20.7 22.9 + 2.2 69% 76% + 7% 636 579 - 9% 19.3 19.2 - 0.1 84% 76% - 8% Donegal 806 750 -7% 12.7 13.7 + 1.0 97% 97% 1,078 1,123 + 4 % 12.9 11 .8 - 1.1 78% 74% - 4 % lifford 805 660 - 18% 15.9 19.9 + 4 .0 80% 75% - 5%

Table B. Births

Hospital Y/E Y/E Variance December ' 80 December ' 81 Ballyshannon 29 8 - 21 Carndonagh 95 82 - 13 Donegal 33 18 - 15 Dungloe 34 23 - 11 Lifford 132 132

PSYCHIATRIC SERVICES. Further progress was made during the year on the plans adopted by the board in 1979 for the development of the psychiatric services. The improvement and upgrading of the facilities in St Canal's Hospital, Letterkenny and in St. Columba's Hospital, Sligo was continued in 1981 . Notable developments during the year included:-

St. Conal's Hospital. The completion of the reconstruction of the rehabilitation wards. The implementation of more specialized t herapeutic and rehabilitative programmes in such areas as behaviour modification, alcoholism, counselling etc. The appointment.of a horticulturist and extension of the glasshouse enabled further developement of the training programmes to take place. Group session under way in the Bahaviour Modification Unit, St. Conals Hospital, Letterkenny.

St. Columba's Hospital. The achievement, for the first time, of a full complement of 4 consultant psychiatrists. The completion of the pre - hostel training unit. Completion of Phase 1 of the reconstruction of units 1 3/16 for use as a continuous treatment unit.

Community Psychiatric Nursing Service. The most significant development in 1981 was the establishment of a community psychiatric nursing service in the Sligo/Leitrim area by redeploying six psychiatric nurses from St. Calumba's Hospital to the community. Six permanent posts of community nurses were est~blished. The nurses occupying these posts are based in the community and districts to be served by the nurses. The posts were created at Ballinamore, Carrick - on- Shannon, Ballyshannon, South Sligo and Sligo. In Donegal the Community Psychiatric Nursing Service was extended by the redeployment of 4 nurses from St. Canal's Hospital to the community. This resulted in a total of 8 community nurses in Donegal. The total service was reorganised by basing the nurses in the Districts to be served. The posts were created at Falcarragh. Dungloe, Donegal Town, Ballybofey, Carndonagh, Buncrana and Letterkenny.

AMBULANCE AND TRANSPORT SERVICES. The board operates a fleet of 36 vehicles located at 1 3 stations throughout the North Western Health Board area. During 1981 the Boards ambulances answered 13,619 calls - an increase of 400 over the 1980 figure. Car hire is used by the Board for patients attending out- patient clini~s, day hospitals and training centres. The mileage for car hire services was up by 200,000 miles on the previous year.

17 Community Care COMMUNITY CARE

INTRODUCTION Community Care Services were further developed during 1981. Services continued to be assessed and agreed priorities in the development of services implemented as funds permitted. These developments included the opening of the second Community Nursing Unit at Ramelton, Co. Donegal thus enabling facilities to be provided for our senior citizens in their own environment in a further comr~unity in line with the Board's policy. The Board also commenced its own Training Programme for the Physically and Mentally handicapped at the Community Workshops and Activation Units which opened in February. Special emphasis has been placed on Health Education in recent years both at national and local level, and during 1 981 major effort was launched to introduce Lifeskills training into 2nd level education when a pilot programme was introduced into ten schools. Finally, 1981 was the International Year of Disabled Persons and the Board marked the year with a special programme of activities.

CARE OF THE HANDICAPPED The Board continued its policy of developing its services for the handicapped during 1 981, and as this was the International Year of Disabled Persons, a unique opportunity was provided for the Board to assess its existing programmes and plan new developments which will complement and enhance existing services in the Regior,1.

Training and Employing the Handicapped. The Community Workshops and Activation Units opened in February, 1981. These Units are at Gweedore, Letterkenny and Sligo. Each Unit has a capacity of 55 trainees, and 1 20 trainees were undergoing various training programmes at the four Units by the end of the year. The intake of trainees to the Workshops is on a phased basis of three per month. Many activity areas are catered for in the Workshop Prog1amme such as Electronics, Engineering, Catering, Carpentry, Sewing and Design, Printing, Social Skills. The criteria used in placement of trainees is to place each trainee in an activity area suitable to his/her aptitudes/capabilities.

Carpentry - Activation Unit, Rd., Letterkenny.

'IR Printing - Community Workshop, Ballyraine Industrial Estate, Letterkenny.

19 · ·-~ · if"

· Pre - school/Day Care Services. Pre -school and Day Care Services provide basic and important services for the handicapped. Plans to provide this service in Sligo, Letterkenny, and Carrick - on - Shannon have all been accepted during 1981 - a service commenced in Letterkenny in 1 981 and new buildings will shortly be available in Sligo and Carrick-on- Shannon. The Pre-school/Day Care Service in Letterkenny was established by the purchase of a bungalow type house. Stafffing was provided t hrough deployment of existing posts for the development of services for the handicapped in Donegal. A hostel has also been leased by the Board in Letterkenny to support the school for the moderately handicapped established by the Little Angels Co. Ltd.

Day Centre for Mentally Handicapped, Letterkenny, Co. Donegal.

20 Day care services for adults also commenced in Cloonamahon during 1 981, and day services for the psysically handicapped have been provided through the two day care units assodated with the Community Nursing Units at Falcarragh and Ramelton. Specially prepared and individual programmes are prepared by the staff in consultation with Psychologists and Counsellors for the mentally handicapped children and adults attending the day centres.

Identification and Classification of Handicapped Registers of mentally handicapped persons in the region based in each Community Care area have been completed during 1 981 , and this information is being used as a basis for evaluating our present services and in the planning of future developments for the mentally handicapped.

Assessment Service lt is the Board's policy that all handicapped persons be assessed and reviewed at pre - selected intervals by a multi-disciplinary assessment team comprising medical, psychological and social work specialists. Considerable progress has been made during 1 981 in consultation with the Sisters of La Sagesse at Cregg House in relation to the composition, referral procedure and location of such a team. Co-ordination If services to the handicapped are to be properly eo - ordinated and planned, eo - operation must exist at all levels between the Board, the various government departments and voluntary bodies. This close eo - operation is important between the various bodies if overlapping and duplication of services are to be avoided, and the best possible use to be made of all the available resources. In 1 981 the Board developed a Co - ordinating Committee with the voluntary groups, and the Sisters of La Sagesse, Cregg House. A formal Liaison Committee was also established between the Board and Cregg House to permit for the joint planning of services for the mentally handicapped in the region. Special Project. A special project was undertaken by the Chairman of the Board Mr. W. Farrell, in conjunction with voluntary committees to raise funds for the erection of a Holiday Home for the Disabled.

CARE OF THE AGED: Voluntary Committees. The Board continued in 1981 to maintain the level of grants, in real terms, to voluntary committees. The effect of the introduction of a national fuel scheme on the activities of some committees gave rise for concern but generally the committees intensified their efforts and resources in providing meals, laundry, home help services and, very importantly, visitations. Another very successful care of the aged week was held in Donegal.

Residential Services. The opening of the Community Nursing Unit at Ramelton and the commencement of work on the Buncrana Unit maintained the momentum on the implementation of the Board's policy for the provision of residential and day services for the elderly in the region. The official opening of Falcarragh Community Nursing Unit was performed by Miss Mary O'Fiaherty T.D., Minister of State, Department of Health & Social Welfare on November 23, 1981.

21 Miss Mary O'Fiaherty T.O., Minister for State officially openmg Ramelton Commumty Nursing Umt on November 23rd 1981. Also in picture (from left) Mr. D. Shea, C.E 0. N W.H.B; Mr. P. Harte T.D. Cha~rman N. W.H 8, Rev. Sr. Assumpte, Matron Ramelton C N U

Day Centres. The development of day centre services continued in 1 981. The 8oard provided a new premises at the Manse, Wine Street, Sligo for the Social Action Group who had commenced a service in G1lhooley Hall. The commendable initiative taken by this group is coming to fruition with the expansion of services in the New Centre. Day care services also commenced in Riverstown from the new Health Centre. Proposals were also discussed with various voluntary groups to provide day services in Letterkenny, Tubbercurry and on Island.

Fuel Scheme. The numbers benefitting from the national fuel scheme greatly increased during the year. The contribution for each eligible household was increased to £1 34. As far as possible the Board is encouraging voluntary committees to maintain an active interest by ensuring that eligible persons apply em u receive their entitlement.

HEALTH CENTRES: Work on a new health centre in Gurteen was well advanced by the end of the year. Riverstown Health Centre was officially opened on July 6, 1981 . A notable feature of this centre is its location on the same campus as the old persons dwellings provided by Sligo County Council and in close proximity to the standard County Council housing. lt is hoped to develop this concept further in the region. As well as a large day room the health centre can accommodate all of the essential community health services for it's catchment area - public health nurse, community welfare officer, occupational therapist, speech therapist and psychologist. There are over forty health centres in the region. The Board maintained it's programme of upgrading and adaptatio'n of these buildings to facilitate easier access by disabled persons. 22

' ! HOME HELP SERVICE: The objective of the Board's home help service is to provide an expert support service to those in need, in their own home. In addition to subventing the services provided through local voluntary organisations the Board also provides this service by the direct employment of full and part-time Home Helps. This personal service is invaluable as a support towards helping the elderly to live in their own home and native environment. Generally, the level of service may vary from a few hours per week to a number of hours per day depending on the circumstances. During 1 981 the Board continued to work closely with the local voluntary organisations in identifying persons in need of this service and in providing the required level of support. Overall therehavebeen signs of a growth in the demand for Home Help Service including some demand from sections of society who are in need of the service and can afford to pay. Possible developments in this area are currently being studied by the Board.

DENTAL SERVICES Problems arising from a lack of sufficient public dental officers have beP.n redressed somewhat through recruitment of a full complement in Donegal in 1 981 although recruitment efforts in the Sligo/Leitrim area were somewhat less successful. A total of eighteen private practitioners took part in the Choice of Dentist Scheme in the region in 1981, sixteen of whom are in the Donegal area. This scheme continued to provide valuable support to the Public Dental Service. There were also some developments in the area of secondary care facilities and an increase in the number of special clinics.

OPHTHALMIC SERVICES The new Sight Testing and Dispensing Service introduced in November, 1979 on a one year trial basis was continued in 1981. The scheme has operated successfully and is now an important aspect of the overall ophthalmic service.

HEALTH EDUCATION The Board has an active commitment to the development of the preventative and advisory aspects of its services, particularly through the work of its various field - staff, both in their normal day to day work and in specific health education programmes. This commitment was further strengthened during 1 981 with the delegation of responsibility for the development of health education programmes in each community care area to a specific area Medical Officer who works closely with the community care team in the planning and implementation of various programmes. A full - time health education officer was appointed to each community care area, to assist this officer and to organise and develop a resource centre and back - up facilities for all staff engaged in health educational activities. In addition the boards social and community workers and medical, para - medical and administrative staff w ere involved in a number of community health and information lectures throughout the year.

2nd Level Schools Programme In implementing the recommendations adopted by the Board on Health Education in Second Level Schools a Life - Skills Pilot Project was started in ten second level schools in 1 981 . This life-skills programme is based on the development of the decision making skills of pupils in relation to the situations that they will face in life. As part of this project a number of in - service training sessions were organised for the teachers involved in the project.

23 Food Hygiene During 1981 the Food Hygiene Campaign maintained its momentum. As part of the campaign the Board's Inspectorate organised a series of training courses in food handling for health board catering staff during the year.

Farmers Lung As part of theBoard's contmumgeducational activities in relation to farmers lung disease, a team of trained public health nurses carried out a pilot survey of the farming population in the region to evaluate the effectiveness of our programmes in this area. A very high level of awareness was found to exist among the farming community in the region and farmers were also generally aware of preventative measures.

CARE OF CHILDREN The Task Force's Report on Child Health Services was published during 1981. This has been discussed at lenght by those responsible for Child Health Services within the Board and the Department of Health. The Board is awaiting guidance on implementation of the report from the Department. Meanwhile the Board will continue to develop existing services which accord to the recommendations of the report. In 1 981 the Board launched a further advertising campaigt1 aimed at increasing public awareness of our Child Fostering Programme. lt was aimed also at increasing the number of short term foster parents. This campaign was very succ&ssful and will enable the Board to place children on short- term fostering while awaiting adoption or if there is a crisis in the home, and eliminates the necessity to place children in care when circumstances as above arise. The board increased its contribution to the Family Group Homes and is considertng expanding this aspect of its Child Care Services. During 1 981 the Board aided the activities of pre - schools run by Sligo Social Services for deprived children. The Board also aided the pre - school for deprived children in Carrick- on- Shannon and at a number of centres in Donegal. Among the many other services provided is a family suport service provided through the public health nurses, social workers and other health professionals.

Maternity and Infant Welfare Services As recommended by the Working Party on Child Health Services practical measures were taken to encourage mothers to visit their doctor earlier in pregnancy, i.e. not later than 16 weeks gestation. This was done through the introduction of a Combined Obstetric Card shared by the Consultant Obstetrician/Gynaecologist and the General Practitioner in recording all the relevant information regarding the pregnancy.

24 Personnel PERSONNEL FUNCTION Good Personnel Management continued to be a high priority in 1 981. The need for an improved personnel information system was agreed and the design and planning of an effective and efficient computerised system was completed before the end of .:he year. The Beards present personnel information is contained in a great many records at the various hospitals and locations. The speedy and accurate processing of this information at local and Board level will provide to the Board and its staff the benefits of improved over - all Personnel Management, by assisting in the processes of manpower planning, recruitment, superannuation, staff relations and leave management.

RECRUITMENT ~. The recruitment section was particularly busy in 1 981 in addition to the regular workload arising from resignations, etc. additional staff were needed for the opening of the new extension to Letterkenny General Hospital, the opening of the Orthopaedic Unit, Sligo General Hospital, the Community Nursing Unit at Ramelton and the Training Centres in Letterkenny, Gweedore and Sligo. Special efforts were made by the Board in 1 981, to recruit disabled persons. The Recruitment Officer working in very close co-operation with the Placement Officers of the National Rehabilitation Board succeeded in appointing 1 2 persons. The Board's Managers and Supervisors examined the possibilities that existed in their locations to employ the disabled. The three N.R.B. Placement Officers in the North West had meetings with Supervisors, Administrators and the Personnel Staff to explore fully the opportunities to increase the number of disabled persons employed and to discuss the process of recruitment. When the Placement Officers have a disabled person seeking employment the Boards Recruitment Officer discusses with local managers whether the work of other staff could be restructured etc. to find work for the disabled person which would be suitable in the context of his/her specific disability. Sponsorship of students of Occupational Therapy, Speech Therapy, Psysiotherapy and Medical Laboratory Technology continued. Because of the success of the sponsorship scheme in previous years the Board had succeeded by 1 981 in recruiting sufficient numbers of these staff. The numbers sponsored therefore in future years will be reduced. Because of the difficulties in recruiting Pharmacists and Dentists the Board commenced sponsorship of a small number of final year Dental Students and Pharmacy Students.

25 Throughout 1 981 very large numbers of applications for some posts made selection difficult and expensive. Fourteen hundred persons applied for the post of student nurse in Sligo. Competition for posts was equally keen in non- nursing areas. Eight hundred people applied for clercial officer posts and there was up to 500 applications for some posts of hospital porter.

Training. Because of the reduced financial resources available to the Board in 1981 priority was given to local training. In times of economic difficulties training in more efficient and effective methods of carrying out work are considered especially important . . The following Training Programmes were held in the region in 1981 .

1. A number of induction training courses were held in Letterkenny, Sligo and Manorhamilton. Induction sessions for non-consultant Medical Staff commenced in 1981. 2. Nurse training courses in the region in 1981 included: - Faculty of Nursing Diploma courses in Letterkenny and Sligo. Regular training sessions in Orthopaedics and in Rehabilitation Nursing, Seminars for Public Health Nurses in association with the Irish Cancer Society and the Irish Diabetic Association, courses in Behaviour Therapy, Alcoholism and Management for Psychiatric Nurses. 3. Continuing medical education for non - consultant medical staff included small study group sessions at Sligo General Hospital and educational sessions at Letterkenny General Hospital. 4. Forty - eight of the Board's Professional and clerical/administrative staff commenced the newly introduced Diploma in Health Administration Course run by the Institute of Public Administration. This four - year course involves study at the local Regional Technical Colleges, study of correspondence texts and week - end seminars at the Institute. The Board assists with payment of course feesand other expenses and with the provision of limited study and examination leave. Six of the Board's clerical administrative staff commenced the Diploma in Personnel Management course run by the Institute of Personnel Management. With the assistance of the Institute of Public Administration the Board held a number of development courses for clerical administrative grades. 5. In association with C.E.R.T. the Board held a number of training courses for catering and housekeeping staff ir~ Letterkenny and Sligo. Two-day courses for Porters were held in Letterkenny General Hospital. 6. Two selection interviewing courses by the Institute of Public Administration were held in Sligo, and Letterkenny. These courses were a continuation of the Board's policy to organise suitable training in interview techniques for staff members involved in selection interviewing.

STAFF RELATIONS. Local -~anagers with the Personnel and staff Relations Officers had regular and frequent negotiations throughout the year with the Unions, Organisations and Associations representing the staff. Following negotiations locally, agreement was reached on the following: -

Re - organisation and re - deployment of psychiatric nurses to establish a community based psychiatric nursin~ service.

26 The process to allow long term temporary psychiatric nurses to become permanent staff members Implementation of the nationally agreed rationalisation of all non- nursing grades of staff. Implementation of a re - organisation in laboratory emergency services Implementation of the nationally agreed common contract for medical consultant staff. A review of the community welfare officer services. Re - Organisation of the supplies function.

The Board is happy to record that as a result of discussion and negotiations and the use of the agreed procedures, the staff agreed to the productivity and flexibility needed in implementing these considerable changes towards better efficiency. Negotiations continued throughout the year at national level on many claims which involved the board's staff. The Board's senior managerial and personnel department Staff participated as appropriate with the Local Government Staff Negotiations Board to represent the management side in these negotiations. The Board's senior managerial staff participated in the management side in these negotiations. The Board's senior managerial staff also participated in the management side in cases which were referred at national level to the Labour Court or the Concilliation and Arbitration Scheme. The Board continued to olace a high value on a participative system of personnel management as the means towards achieving high productivity and job satisfaction by the staff. lt is intended to continue to improve this approach. The Board has increased training in Industrial Relations for Line Managers with the assistance of the Institute of Public Administration. The Board acknowledges the eo-operation of the various statutory bodies and of the staff unions, associations and organisations involved in assisting the Board with its staff relations matters during 1 9B 1.

27 Finance

Capital Expenditure 1981 Expenditure on Capita l Schemes during the year is summarised b elow: £000 Welfare Homes - Nursing Units Ramelton 176 Buncrana 646 Others 52 874 Training Centres Cloonamahon 3 Ballyraine 88 Kilmacrennan Road 73 Ballytivnan 81 Gweedore 57 302 Hospitals Programme letterkenny General 2,977 General Hospital, Sligo 969 St. Calumba's Hospital 66 St. Canal's Hospital 51 4,063 Other Projects Cloonamahon 67 Ambulances - Telecommunications 55 Administration Offices 141 263 Revenue Expenditure 1981 The revenue expenditure for each service head is summarised belo w .

SUMMARY OF EXPENDITURE 1980 1981 £000 £000 Hospitals and Homes 30,427 35,084 Extern Hospitals 315 192 **General Practitioners/ General Medical ServicP.s 8,676 10, 301 Maternity and Child 689 763 Children in Care 267 346 Infectious Diseases 118 149 Dental Ophthalmic and Aural 701 957 Rehabilitation 2,089 2,663 Ambulances 1,100 1,352 Supervision of Food and Drugs 132 165 Blind Welfare 54 68 Other Services 753 991 Supplementary Welfare and National Fuel Scheme 1,288 1,917 Central S<.lrvices 1,159 1,395 Training Centres 443

**This figure includes expenses of the G.M.S. (Payments) Board amounting to £5.826M for 1 981 . Allowances paid under the Social Welfare (Supplementary) Allowance Act, 1975 and expenditure under the National Fuel Scheme, 1 981 which are fully recoupable from the Department of Social Welfare and from Local Authorities, amounted to £1.917M. Expenditure on Training Centres is grant aided from the E.E .C. Social Fund. The minor receipts of the Board for the year were £3.443m which leaves the Net Expenditure for the year at £5 1.4 26,000. This expenditure of the Board was within the approved allocation of the Department of Health and consequently the Board has complied with Section 31 of the Health Act, 1970. The following new units were opened during the year: - 1 . Extension to Letterkenny General Hospital 2. Orthopaedic Unit in Sligo 3. Community Nursing Unit at Ramelton. 4 . Training Centres at Ballytivnan in Sligo, Kilmacrennan Road and Ballyraine in LEltterkenny and in Gweedore, Co. Donegal. These new units increased ~expenditure in 1981 over 1980 by £2. 2m

29 Excluding the Expenditure of the Payments Board, an analysis of expenditure between wages/salaries and ~eneral supplies is as follows: -

Non-Pay

36 %

Summary of Expenditure on Services was as Follows: -

1980 1981 1980 1981 £M £M % % General Hospitals 12.842 1 5.814 26.9 27.8 Special Hospitals 13.425 15.311 28.1 27.0 District Hospitals 3.824 4.410 8.0 7.8 Extern Hospitals .315 . 192 .7 .3 Community Care Services 16.203 19.221 33.9 33.9 Central Services 1.159 1.395 2.4 2.5 Training Centres .443 .7

30 General Hospitals Special Hospitals 27.8% 27%

. '

The expenditure as shown above relates to direct expenditure of the Board. lt does not include: Payment in respect of services provided for eligible persons in homes for mentally handicapped persons and in Voluntary Hospitals. These amount to £2.15M and £3.8M respectively and are paid directly by the Department of Health.

31 Appendices . 'Hospital In - Patient Statistics from Januarv 1 981 to December 1981 .

.Nlln;ber of Averag~p Bed Patl~s Du ratio" Bed Hospital Complement Trea~ed of Stay Occupancy Medical Letterkenny 53 2,41 5 7.0 8 7% Manorhamilton 30 701 16.9 109 % Sligo 55 2,566 9.7 124 % TOTAL 138 5,682 9.5 107 % Surgical Letterkenny 64 2,900 7.3 96% Sligo 69 3,387 6.5 87% TOTAL 133 6,287 6.9 92% Maternity Letterkenny 50 2,430 4 .7 73% Manorhamilton 5 115 5.7 36% Sligo 30 1,867 6 .0 102% TOTAL 85 4,412 5.3 8 1% Gyanecology Letterkenny 28 1,245 4 .0 6 1% Sligo 14 790 6.2 96% TOTAL 42 2,035 4 .8 74% Paediatric Letterkenny 4 2 1, 761 5.0 7. 1% Manorhamiiton 3 27 7 .1 18% Sligo 34 1,798 6.3 9 1% TOTAL 79 3,586 5.7 78% . Ophthalmic Sligo 14 687 5.2 70% E.N.T. Sligo 14 1,120 4.9 109% I.C.U. Letterkenny 5 282 3 .1 58 % Sligo 3 220 3.1 8 1% Investigation Unit Sligo 16 1, 111 3.3 98% Orthopaedics Sligo 52 3 10 15.5 6 1% Rehabilitation

32 !\lnm' ·u of Births - letterkenny, Sligo and Manorhamilton

t-' . pital In - Patients Statistics from January 1981 to December 1981 Letterkenny 2,065 Manorhamilton 20

Summary of Hospital In - Patient Statistics from January 1981 to December 1981 .

Number of Average Bed Patients Duration Bed Hospital Complement Treated of Stay Occupancy * Letterkenny 249 11,033 5.8 80% •• Manorhamilton 66 1,073 16.2 72% *** 301 6.6 93%

• Bed complement increased in June due to opening of multi storey block . •• Rehabtlltation Unit opened Mtd-August 1981 - 1,073 includes Orthopaedic patients treated for the year. * -1( * Bed complement increased in Mid - August due to opening of Orthopaedic Unit.

Number on Waiting list for admission to General Hospitals at 31 / 1 2/81 s General een Up to Specialty 2 yrs 1 - 2 yrs 9 - 1 2 mths 6 - 9 mths 3 - 6 mths 1 - 3 mths 1 mth TOTAL Medical 2 3 16 14 35 Surgical 11 7 13 28 34 36 129 Paediatric 6 5 6 6 23 Gynaecology 7 7 3 1 1 14 43 Ophthalmic 5 12 55 8 80 E.N.T. 32 24 3 59 Geriatric

letterk Between Between BatwPP.n BetwP.en Uo to Specialty 2 yrs 1 - 2 yrs 9 - 1 2 mths 6 - 9 mtl')s ~ - 6 mths 1 - 3 mths 1 mth TOTAL Medical ------Surgical 2 14 4 1 11 2 72 24 1 Paediatric

33 Out - Patient Clinics - 1981 Sligo General Hospital

Specialty Number held Number of Attendances Medical 97 1,657 Surgical 251 3,823 Gynaecology 101 775 Ante - Natal 97 2,11 1 Orthopaedic 57 662 St. Luke's 24 1,076 Varicose Veins 100 323 Paediatric 140 2,436 E.N .T. 95 1,914 Ophthalmic 99 2,292 Refraction 68 682 Dermatology 9 306 Geriatric 100 1,0 79 Orthoptics 23 73

Letterkenny General Hospital Specialty Number held Number of Attendances Medical 137 3,769 Surgical 174 5,290 Gynaecology 63 866 Ante - Natal 139 2, 142 E.N.T. 79 1,584 Paediatric 147 2,506 Ophthalmic 65 1,369 Orthopaedic 47 718 Dental 20 164 Varicose Veins 47 74 St. Luke 's 12 904 Fitter 25 218

34 Sligo General Hospital - Out- Patient Clinics 1 9 81 Breakdown of length of w aiting list at 31 I 1 2/81 Specialty Over 1-2 9 - 12 6 - 9 3-6 1 - 3 Less than TOTAL 2 yrs yrs mths mths mths mths 1 month Medical 24 60 14 98 Surgical 11 9 '155 36 311 Gynaecology 3 3 Ante Natal 4 4 Varicose Veins Paediatric 3 3 E.N.T. 148 47 195 Ophtha lmic 37 20 10 67 Refraction 42 64 106 Dermatology 5 5 13 24 Geriatric Orthoptics 17 12 29 Orthopaedic 413 207 96 94 98 108 48 1064

Letterkenny General Hospital - Out- Patient Clinics 1981 Breakdown of le of waiti list at 31 1 2/81 Specialty Over 1 - 2 9 .,.., 12 6 - 9 3 - 6 1 - 3 Less than TOTAL 2 yrs yrs mths mths mths mths 1 month Medical 3 95 55 153 Surgical 100 193 52 345 Gynaecology -. 68 68 Ante - Natal 51 5 1 E.N.T. 30 85 11 5 Paediatric 25 25 Ophthalmic 8 4 5 4 3 80 61 249

Pathology Number of Tests 1980 1981 Sligo General Hospital 483,688 54 8,21 2 Letterkenny General Hospital

3 5 Our Lady's Hospital, Manorhamilton - Out - Patient Clinics 1981

Specialty Number held Number of Attendances •\, Medical 10 t .. ~,· 43 Surgical 48 ,.1'.. ~ 272 ...,., ' Gynaecology 2 1 I ·• . ~ 89 Ante - Natal 22 158 Orthopaedic 35 434 Paediatric 11 126

Hospital In - patient Statistics from January 1981 - December 1981 District Hospitals Bed Number of Patients Average duration % Bed Hospital Complement Treated of stay Occupancy Medical and Minor Surgical Ballyshannon 47 498 30.7 95% Carndonagh 30 332 29.9 9 1% Donegal 22 480 19.5 11 2% Dungloe 37 769 15.3 88% lifford 40 427 28.5 83% Maternity Ballyshannon 5 167 5.4 28% Carndonagh 8 232 4 .4 35% Donegal 7 280 4 .2 46% Dungloe 6 226 4 .2 4 3% lifford 6 223 4 .8 49% Paediatric Ballyshannon 3 4 7.5 5% Carndonagh 2 15 5.6 12% Dungloe 6 128 6 .3 14 % lifford 2 10 2.5 3% TOTAL Ballyshannon 55 669 22.9 76% Carndonagh 40 579 19.2 76% Donegal 29 750 13.7 97% 49

36 Number of Births Hospital In - patient Statistics from January 1981 December 1981 Ballyshannon 8 ------~------Carndonagh 8 2 Donegal 18 23

Out- patient Clinics 1981 District Hospitals Sheil Hospital, Ballyshannon Specialty Number held Number of Attendances Medical 25 63 Ante-Natal 24 211 Orthopaedic 19 259 Dental 4 28 Chiropody 16 220 Psychiatric 20 249

Carndonagh Disctict Hospital Specialty Number held Number of Attendances Surgical 12 151 Gynaecology 21 454 Ophthalmic 19

Donegal District Hospital Specialty Number held Number ot...Attendances Surgical 12 203 Maternity/Gynaecology 19 674 Speech 14 514 Paediatric 52 617 Psychiatric 24 210 Chiropody '24 240 St. Luke's 11 370

37 Out Patient Clinics 1981. (Continued).

Dungloe District Hospital Specialty Number held Number of Attendance Maternity/Gy naecology 23 791 Chiropody 33 ------290------Ophthalmic 21 . 514 Surgical 12

Lifford District Hospital Specialty Number held Number of Attendances Ophthalmic 263

Statistics for Geriatric Hospitals from January - December 1981

Bed Number of Number of new Number % Bed Hospital Complement Admissions Admissions Discharged Occupancy St. John's 356 335 299 190 100% St. Joseph's 211 160 98 138 100% St. Patrick's 133 269 159 94%

In - patient Statistics for Psychiatric Hospitals from January 1981 - December 1981 Number on Register Total Total New Total Hospital at end of month Admissions Admissions Discharges St. Columba's 581 795 154 911 St. Conal's 502 1,11 5 260 1,093

38 In-patient Statistics for Welfare Homes from January 1981 - December 1 981 Bed Number of Number of new Number % Bed Welfare Homes Complement Admissions Admissions Discharged Occupancy · Ballyshannon 35 8 8 4 94% Manorhamilt9.n 40 5 3 4 99% M oh ill 40 6 5 98%

Psychiatric Hospitals - Out- patient Clinics 1981 S,t. Calumba's Hospital, Sligo. Clinic Centre Number held Number of Attendances Easkey 20 207 Ballyshannon 20 249 Charles Street 51 903 Ballymote 22 169 Tubbercurry 20 361 Manorhamilton 21 193 Kin lough 22 127 Drunshanbo 23 86 Mohill 22 351 Ballyinamore 19 105 Carrick - on- Shannon 26 100

St. Conal' s Hospital, Letterkenny Clinic Centre Number held Number of Attendances Carndonagh 48 499 Buncrana 48 .419 Milford 24 209 Falcarragh 24 330 Dungloe 24 460 24 195 Killybegs 24 246 Letterkenny 24 304 Ballybofey 3 6 185 210 111

39 Appendices Community Care Analysis of the Coat of Medicines In the General Medical Services ·1 ~ - 1981

1977 1978 1979 1980 1981 North North North North North Western Western Western Western Western Health National Health National Health National Health National Health Na1ional Board Average Board Average Board Average Board Average Average ----- Board Analysis of payment to Pharmacists in respect of prescriptions (a) Total Cost of . Prescriptions £1 ,610,233 £1 ,974,692 £2,401 ,075 £3,022.624 £3,869,936 (b) Average Cost per prescription form £ 3.88 £ 3.83 £ 4.53 £ 4.38 £ 5.48 £ 5.30 £ 6 .53 £ 6.35 £ 8.03 £ 7.90 Cost of prescriptions per patient (Total Cost of prescriptions divided by total No. of eligible persons less those for whom doctors Qispense) £ 16.96 £18.94 £ 20.82 £22.77 £ 27.36 £27.40 £ 32.27 £34.31 £ 41 .10 £44.13 ~ 0 Cost per patient for whom doctors dispense !£ 16.09 £13.75 · £ 18.93 £14.94 £ 17.31 £16.15 £ 21 .40 £19.52 £ 25.39 £24.67 Overall cost of medicines

...

~~ ~ ~ a> ~ Infectious Diseases (Maintenance) Allowance

1976 1977 1978 1979 1980 1981 1. No. of persons (excluding dependants) receiving allowances: (a) in institutions 4 1 1 1 2 2 (b) at home 30 35 29 26 24 32 (c) for domesHc help 2 5 9 (d) outgoing on premises 1 2. No. of dependants - (a) adult 8 10 8 (b) child

Allowances for Domiciliary Care of Handicapped Children

Number of children in respec; l of Year whom allowances are being paid 1976 145 1977 148 1978

Blind Welfare

1976 1977 1978 1979 1980 1. No. of blind persons over 16 years and under 21 years Nil Nil Nil Nil Nil Nil 2. No. of blind persons over 21 years who are either single, widows or widowers (a) living alone 24 ' 22 22 22 23 27 (b) not living alone 86 95 98 80 75 79 3. No. of blind married men with sighted wife 16 14 13 11 8 8 4. No. of sighted married men with blind wife 9 10 8 8 . 7 4

Disabled Persons (Maintenance) Regulations

1976 1977 1978 1979 1980 1981 No. of Recipients of such Allowances 2.258 2,1 02 riate maximum rate1,643 1,428 5 674 No. of applicants year 343 No. of applications granted

41 Maternity Cash Grants

Year Number of Applicants 1976 1,287 1977 1,045 1978 972 1979 692

Milk for Mothers and Children

Numbers who benefited under scheme Year Women Children 1976 10 760 ------1977 ------17 782 1978 7 645 1979 39 542

Births

Assigned Assigned Assigned Year Registered to Donegal Registered to Leitrim Registered to Sligo 1976 2,188 2,315 110 444 1,210 1,014 1977 2,246 2,411 94 445 1,322 1,019 1978 2,302 2,490 60 506 1,429 1,015 1979 2.315 2.540 53 468 1,564 1,117 2,317 2,583 45 4'97 1,564 1,038

Allowance towards the Cost of Drugs

Year Number of Claims 1976 326 per month 1977 373 per month 1978 555 per month 1979

42 Long Term Illness Scheme

Number of persons availing of scheme with the following illnesses 1976 1977 1978 1979 1980 1981 Mental Handicap 13 15 20 38 43 49 Mental Illness 14 10 10 18 19 20 Phenylketonur'a 10 9 11 13 13 14 Cystic Fib~osis 11 13 17 21 20 27 Spina Biftda 12 19 21 30 29 29 Hydrocephalus 6 5 5 6 6 6 Cerebral Palsy 6 4 7 8 9 8 Haemophilia 1 1 1 4 4 Epilep~ 173 151 232 308 346 384 Multiple Sclerosis 13 11 15 29 31 38 Muscular Dysfrophies 2 2 2 5 5 5 Parkinsonism 18 21 24 28 31 32 - 1 2 5 11 -Acute Leukemia Brucellosis 3 4 5 14

43 ' Extract from Report on Activities of Local Volu~tary Committees from 1975. 1981

Services f975 1976 -1977 1918 1979 1980 1981 Number of Committees 73 79 83 91 93 96 98 Meal Service Total number of meals supplied 56,701 68,016 68,396 68,637 83,066 85,289 57,045 Number of towns and villages in the region in which this service was provided 40 47 48 53 59 61 49 The Board's contribution towards this service was £28,400 £29,394 £51 ,030 £ 44,146 £ 57,973 £ 62,368 £80,090 Lau Service Total number in receipt of service 311 281 351 405 351 404 418 Number of locations at which this service was provided throu the ion 29 33 38 40 40 37 43 The Board's contribution towards this £ 3,377 £3,709 £14,868 £7,281 £8,740 £10,320 £18, 181 Home Help Service The following number of households benefited 528 569 646 676 589 659 707 from the Home Help Service provided through the Voluntary Organisations in towns and villa,ges 73 73 73 77 80 74 64 The Board's contribution towards the service was £77,000 £90,532 £93,836 £154,776 £189,372 £210,060 £277,387 In addition to the services 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 183 236 210 372 504 485 660 households so that the total · number of households who benefited from the service was 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 b.y Voluntary Organisations at locations throughout the region for certain categories of elderly people. The total number who benefitted from the National Fuel Scheme was 8,357*. The Board 's contribution towards this service was £586,293. ' This figure represents no. of recipients for period October 1980 -April 1981 (i.e. operative dates of 80/81 fuel scheme)

44 Extract from Report on Activities of Local Voluntary Committees from1975 - 1981\(continued)

Serv1ces 1975 1976 1977 1978 1979 1980 1981 ~h iropody Services Chiropody Services were provided by Voluntary Organisations for a total of 76 96 142 186 125 133 187 persons and the Board contributed £ 306 £ 394 £ 554 £ 1,009 £ 1,303 £ 2,895'£22,58 Priming Grants ~nm 1ng grants totalling 1£ 365 £ 75 £ 200 £ 500 £ 155 £ 150 £300 were paid to ~ 2 3 8 3 2 4 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 ass1stance from State or other sources (e.g. supplement~ry grants from the housing authonty) the Board will pay up to a maximum ·of £30 in any case where the *1 /9/79 £ 60 improvement can be seen to be of benef1t to the health and/ or welfare of the eligible persons concerned~ A total of . 9 9 7 53 . 47 23 57 persons benefited under the scheme for wh1ch the Board contnbuted

45