Critics say hospital plan is too slow

It was hailed as a revolutionary plan to bring hospital services for Kilkenny and Carlow into the 21st century. Two hospitals were to close and the area would lose its orthopaedic services to Waterford.

But the promised compensations were many: a new unit for the elderly, a new community hospital, a dedicated coronary care unit, improved paediatric services, all the way down to more car-parking.

Now, one year after the hospital plan was unveiled, many people in Kilkenny and Carlow are asking if the whole thing was a pipe-dream. And will it be out of date before it's even happened?

The South Eastern Health Board insists that the Kilkenny Plan is proceeding at "breakneck pace". But one board member, Kilkenny County Council chairman and Fine Gael TD Phil Hogan, says the delay in implementing it is "crazy".

With a project team to oversee the development not due to be appointed until next May, Mr Hogan claims it will be at least three further years before the buildings are completed.

Others are less pessimistic, pointing out that the new psychiatric and coronary care facilities will go ahead in advance of the project team's formation.

One thing all sides agree on is that the plan is a good one. After all, any decision to shut Lourdes Orthopaedic and St Canice's Psychiatric Hospitals, both in Kilkenny city, would never have been accepted without the carrot of substantial improvements elsewhere.

Even the general manager of the private Aut Even Hospital, Michael Lyons, is enthusiastic. "Anything that raises the profile of the health services in Kilkenny is welcome," he says. Aut Even's services will benefit directly from the increase in local diagnostic services.

The plan is to turn the city's major general hospital, St Luke's, into a "one-stop shop" with a range of services not yet available in the city.

With plenty of land in St Luke's for building on, a new community hospital for elderly and convalescing patients, many of whom occupy high-cost acute beds in the main hospital, is a key element.

A new 45-bed acute psychiatric unit; a new unit for the elderly from Kilkenny city, now cared for in Thomastown or Castle comer; a consultant-led paediatric service; improved X-ray and accident and emergency facilities and the coronary care unit are also high on the agenda.

After objections were raised in Kilkenny about the loss of Lourdes' orthopaedic services to Waterford, the £34 million plan was unanimously approved by the health board last November.

You'd have thought it would be all systems go, but the Department of Health and Children, which approved the plan in principle earlier this year, only recently asked the board to identify the priority aspects in it.

"That will take us a few months, then the formal project team will be appointed by the Department next May," says the board's chief executive, John Cooney. "I think that's reasonable. I wouldn't regard it as being delayed."

Some elements have been set in motion. Tenders have been invited for the psychiatric unit and departmental approval for the coronary care unit was given last week.

The board chairman, Dr Finian Gallagher, says that while he is a "little bit disappointed" at the rate of progress, he is pleased with the developments that have taken place. But even Mr Cooney admits it will take three years before the entire plan is functioning.

If it takes any longer to complete, then Ms Renagh Kennedy of the Friends of St Luke's Hospital group warns: "Sometimes by the time a plan comes to fruition it's already out of date. The technology is all the time changing and demand is increasing."

Heavy demand on the services is certainly a problem in Kilkenny, as it is throughout the health services. Nearly 300 adults have been waiting for elective surgery in St Luke's for over a year.

Mrs Teresa Mullen, founder of the Prevent Poverty Action Group, says such people are the last to be consulted about hospital development plans. She says: "You should always talk to the people it affects. Patients themselves should be given a voice."

Mr Cooney replies that publication of the details in the Kilkenny People before the plan was approved resulted in just four queries from the public, a fact he attributes to satisfaction with the plan rather than apathy.