Acute hospitals annual report 1992

Acute hospitals annual report 1992 Item type Authors Publisher Report Western Health Board (WHB) Western Health Board (WHB) Downloaded 28-Apr-2018 09:19:52 Link to item http://hdl.handle.net/10147/240512 Find this and similar works at - http://www.lenus.ie/hse

Bord Slainte an Iarthair Western Health Board Your Ref : TO: Telephone : Galway (091) 51131 Fax : (091) 52644 EACH MEMBER OF THE BOARD. Headquarters, Merlin Park Regional Hospital, Galway, Ireland. 1st June, 1993. RE: GENERAL HOSPITAL CARE- ACUTE HOSPITALS. Item Number 4 - Agenda for Board Meeting, 8th June, 1993. Dear Member, Herewith, the Annual Statistical Report for the Board's Acute Hospitals for the year ended 31st D ecember, 1992. A total of 47,8 12 persons were treated as in-patients in 1992 while the level of out-patient attendances increased to 250,820 during the year. These figures indicate an increasing demand for hospital services. Considerable pressure was imposed on staff and facilities to cope with this demand during a time of reduced resource availability. 1 should like to take this opportunity to record my appreciation of the services given during the past year by all the staff in this Programme. Yours sincere! y, E. Hannan, Chief Executive Officer. m f.

TABLE OF CONTENTS Page No. Introduction 1 University College Hospital, Galway 9 Merlin Park Regional Hospital 30 Mayo General Hospital 47 County Hospital Roscommon 62 District Hospitals 79

BORD SLAINTE AN IARTHAIR WESTERN HEALTH BOARD ANNUAL R EPORT FOR 1992 GENERAL HOSPITAL CARE PROGRAMME Introduction The General Hospital Care Programme provides secondary and tertiary care to the Western Health Board area and beyond. Services are provided through the Galway Regional Hospitals of University College Hospital and Merlin Park, Mayo General Hospital, at Castlebar, and the County Hospital Roscommon. In addition, four District Hospitals at Ballina, Bel mullet, Swinford and Clifden operate in close liaison with the larger acute Hospitals. This Programme also embraces the Ambulance Service and patient transport which is the subject of a separate Annual Report. The year 1992 proved to be extremely difficult for the General Hospital Care Programme with pressure on beds increasing at an unprecedented rate. The percentage increases in admissions in 1992 as against 1991 were as follows:- University College Hospital + 6.18% Merlin Park Regi onal Hospital + 1.00% Mayo General Hospital + 11.67% Roscommon County Hospital + 11.68% This resulted in an overall increased in activity of 7.54% for the Programme. Similar trends were experienced by Out-Patient Departments with an overall increase of 2.46% in outpatient activity. Despite this unprecedented increase in activities, excess expenditure was kept to a minimum with the variance on the nett budget being 1.89%. This was achieved through increased income generation, Value for Money Initiatives and control of the pay-budget through the Whole Time Equivalent System. Appreciation is due to all the staff of the General H ospital Care Programme for their diligence in maintaining a quality service despite the ever increasing pressures and other difficulties encountered.

FINANCIAL ANALYSES:- In 1992, for the first time, the Department of Health acknowledged that University College Hospital, Galway, and Mayo General Hospital were under-funded and adjusted the budget to a small degree to acknowledge the Casemix for those Hospitals. Expenditure for the General Hospital Care Programme amounted to 71.98lm gross in 1992. Pay accounted for 71.73% of the total expenditure. Income generated totalled 7.479m which was ahead of the budget target. Fl NANCIAL SUMMARY: GENERAL HOSPITAL CARE PROGRAMME: CATEGORY ACTUAL BUDGET %VARIANCE '000 '000 PAY 51.635 5 I,529 0.21% NON-PAY 20,346 18,413 10.49% GROSS 71,981 69,942 2.91% INCOME 7,479 6,804 9.92% NET 64,502 63,138 2.16% ABSENTEEISM: Absenteeism for the General Hospital Care Programme averaged at 2.52% compared to the Health Board average of 2.95%. The efforts of the Hospital Administrators, Matrons and the Staff are acknowledged in maintaining this exceptionally low rate of absenteeism. 2

GENERAL HOSPITAL CARE ACUTE HOSPITALS<ACTIVITY 1971 & 1992 & BUDGET ALLOCATIONS 1971 & 1992 v.> BED ALLOCATION NO. IN- PATIENTS AVE. DURATION OF STAY %OCCUPANCY NO. OUT-PATIENTS 1AIE ATTENDANCES STAFF- NURSING NON NURSING TOTAL GROSS EXPENDITURE OOO's 1992 1971 1992 1971 1992 445 625 213 636 226 23,745 16,991 5,394 2, 146 14,924 6.46 12.10 10.23 46.40 4.59 HXUO% 90.20% 73.02% 79.00% 80.17% 103,404 46.273 13,664 1.826 22,114 43,542 24,566 - - 16,421 665 478 206 199 '245 678 432 287 195 245 1343 910 493 394 490 35,889 1,695 11,373 7151 13,396 1 1971 204 8,366 7.42 83.30% 8,792 7,100 121 129 250 566 1 > 1992 1971. ' 1992 1971 86 137 970 1,602 3,749 2.985 47,812 30,488 6.49 10.90 6.33 n.30% 60.00% 87.23 11,740 3,200 150,922 60,091 13,354 1,800 73,31T 33.466 71 59 1,187 857 107 54 1,317 810 178 113 2,505 1,667 4,513 1 258 1 65.171 I 3,234 Notes: (/) U.C.H.G. COMPLEMENT FOR /992 EXCLUDES 43 PSYCHIATRIC BEDS. (2) MERLIN PARK COMPLEMENT FOR /992 EXCLUDES 30 PSYCHIATRIC & 87 GERIATRIC BEDS. (3) CASTLEBAR GENERAL HOSPITAL COMPLEMENT FOR 1992 EXCLUDES 44 PSYCHIATRIC BEDS.

GENERAL HOSPITAL CARE ACUTE HOSPITALS ACTIVITY 1991 & 1992 & GROSS EXPENDITURE 1991 & 1992.- "' SITY. 'rou ~G ~E,,...: :.. : r':n...:..u ;.;; nt;.:::' ~ /V.I, :?' og ~ ~,,, ''"''' -. '' 'oo.. c.r-':...,.. ::.. r.:..,.,...,...;c,-~- -...,,.,,,,.,.,,:,;.i'''''j~'~''*''*'*'' u lver.,,... c:,,.,..,.,, Mc::n't.fn -r.'ann::, Rr;:;ulvn'AL:. :c" MA~ C:NERAL.,,.,..,.:,.::,:.:..,,,,.. vo..:ommon:.cvjnty'..,,,,,,,,.,,,total ~ ~,,,,,,.,,,.,,,,,,.,,~"~~'''''''' t~osm.4t,::jr:::;::thu::i:::,.::::;''~f:~:.:: ::.:: ::::i JJ6setrlli1i.~~:~:;::;:::;:Wfi~:;;:.::,.:,:: r:, : H':f1i ;;;iffospfbit i ;.8Y:m*,l H.:'.'.::.,: :.:ti'' i.~ijos#ifjc::,::::r.~::::::::: :-:::.:-m:l'::::;:::-: ~.:.:.! ::w:r::~~: r, ;:;.;:::;) ;,::.:;::;~[~;.~tw: 1992 1991 1992 1991 1992 1991-1992 1991 1992 1991..&:>. I BED ALLOCATION 445 445 213 202 226 226 86 70 970 943 NO. IN-PATIENTS 23,745 22,567 5,394 5,381 14,924 12,703 3,749 3,348 47,812 46,220 AVE. DURATION OF STAY 6.46 6.75 10.23 10.21 4.59 5.81 6.49 6.04 6.33 6.84 %OCCUPANCY 100.2QOAl 96. 1 60Al 73.02% 74.34% 80.17% 80.87 A: n.30% 78.39 A: 87.23.ril 86.16% NO. OUT-PATIENTS 103,404 98,471 13,664 13,746 22,114 21,779 11,740 18,560 150,922 152,891 AlE ATTENDANCES 43,542 42,727 - - 16,421 16,1 20 13,354 6,501 73,317 65,649 STAFF- NURSING 665 665 206 203 245 242 71 68 1 '1 87 1,182 NON NURSING 678 674 287 275 245 242 107 93 1,317 1,287 TOTAL 1343 1339 493 478 490 484 178 161 2,505 2,468 GROSS EXPENDITURE OOO's 35,889 31,262 11,373 11,107 13,396 12,014 4,513 I 3,840 I 65,171 I 58,223.

BORD SLAINTE AN IARTHAIR WESTERN HEALTH BOARD CENSUS OF POPULATION - YEARS 1986 AND 1991 AGE GROUPS GALWAY MAYO ROSCOMMON TOTALS.. Ul Age Group 1986 1991 Cbll.rige 1986 '1991 Cb1t0ge 1986 1991 Change 1986 % 1991 % Chmge :- :c 0-14 51436 49292 2144-- 33269 31244 2025-15220 14122 1098-99925 28.69 94658 27.61 5267-15 - 19 17323 18152 829+ 96 15 9324 291-4584 4283 301-31522 9.05 31759 9.26 237+ 20-24 14098 13476 622-6601 5705 896-3157 2618 539-23856 6.85 21799 6.36 2057-25 - 44 44441 46341 /900+ 27111 26524 587-12604 12327 277-84156 24.16 85192 24.84 1036+ 45-54 14955 16885 1930+ 9818 10388 570+ 4953 4977 24+ 29726 8.53 32250 9.4 1 2524+ 55-59 7043 6972 71-5043 4723 320-2744 2489 255-14830 4.26 14184 4.14 646-60-64 7090 6770 32D- 5273 4803 470-2734 2568 /66-15097 4.33 14141 4.12 956-. 65 + 22166 22416 250f- 18454 17985 469-8596 8492 104-49216 14.13 48893 14.26! 323-1 I TOTALS 178552 180304 1752+ 115184 110696 4488.:. 54592 51876 2716-348328 100 342876 100 5452-1 --- ---. I

WESTERN HEALTH BOARD BIRTH STATISTICS 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 UNIVERSITY COLLEGE HOSP. 3133 2991 2823 2635 2673 2650 2405 2320 2461 2426 2613 CASTLEBAR G. H. 2212 2140 2016 1915 1847 1679 1583 1409 1442 1435 1318 ROSCOMMON CO. HOSPITAL 116 63 23 16 13 4 3 2 3 0 0 0\ BALLINA D.H. 3 7 9 0 0 2 1 0 0 0 0 BELMULLET D.H. 70 60 63 47 53 42 35 28 21 24 14 CLIFDEN D.H. 2 3 0 3 6 1 1 2 1 4 0 PORTIUNCULA 2469 2395 2514 2455 2543 2372 2219 1933 2004 1920 1810 TOTAL 8005 7659 7448 7071 7135 6750 6247 5694 5932 5809 575~

WESTERN HEALTH BOARD WESTERN HEALTH BOARD AREA HOSPITALS -..J _,..._, (/) (I) Iu 1- c 0:: 0 -(I) Ol :J. 0 O.r:::. zc 3.4 ~----------------------------------------------~ 3.2 3 2.8 2.6 2.4 2.2 2 1.8 1.6 1.4 1.2 1 0.8 0.6 0.4 0.2 0 I E=:-' 1i * ~ ~ ~ ~ ~ '* ~ I 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 o U.C.H.G. + C'BAR G.H. o ROSC. C.H. D. PORTIUNCULA x B'MULLET D.H.

WESTERN HEALTH BOARD TOTAL BIRTHS 8.2 ~----------------------------------------------------~ 00,..., (J) m Iu t- c n::: 0 - m m :J. 0 o.r: zt:, 8 7.8 7.6 7.4 7.2 7 6.8 6.6 6.4 6.2 6 5.8 5.6 ~~----~--~----~--~----~--~----~--~----~--~~ 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 YEAR

UNIVERSITY COLLEGE HOSPITAL, GALWAY. 9

UNIVERSITY COLLEGE HOSPITAL, GALWAY Expenditure at University College Hospital amounted to 35.889m in 1992. Pay accounted for 71.1 % of total expenditure. The Whole Time Equivalent staff complement for the Hospital was 1343. Absenteeism averaged 2.06 in 1992. Income collected by the Hospital amounted to 4.030m. FINANCIAL SUMMARY. CATEGORY ACTUAL BUDGET % VARIANCE '000 '000 PAY 25,517 25,599 0.32% NON-PAY 10,372 9,410 10.22% GROSS 35,889 35,009 2.5 1% INCOME 4,030 3,646 10.53% NET 31,859 3 1,363 1.58% 10

UNlVERSITY COLLEGE HOSPITAL, GALWAY. DEVELOPMENTS 1992. OUT-PATIENTS DEPARTMENT: Work commenced on the provision of a new Out-Patients Department in January, 1991, and it was completed in January, 1992. The total cost of the project, including building conversion, equipment and furnishings was 500,000. The provision of this Department has allowed for: - (a) The dignity and privacy of patients to be respected. (b) An increase in Out-Patient activity (almost 5%). (c) Improved Clinic Scheduling, thus reducing waiting times for patients at clinics. The Department comprises:- Ground Floor First Floor Second Floor E.N.T. and Ophthalmology Clinics. 7 Consulting Rooms. I 0 Consulting Rooms. The facility was officially opened by Councillor P. McCormack, T.D., Mayor of Galway, at a ceremony held on 26th A pri I, 1993. EQUIPMENT: (a) INSTALLATION OF ANAESTHETIC EQUIPMENT: Old and obsolete equipment was replaced to maintain a quality service and to ensure the safety of patients. (b) REPLACEMENT OF HOLTER CARDI AC MONITOR SYSTEM: Replacement of this equipment was critical to enable the Consultant Medical Staff to provide an adequate Cardiology Service. (c) PROVISION OF NEW MAMMOGRAPHY MACHINE: Breakdown of old machine - Grant from the Department of Health. (d) P R 0 V I S I 0 N 0 F U L T R A - S 0 U N D S C A N N E R F 0 R OBSTETRIC/GYNAECOLOGY DEPARTMENT: This equipment was purchased in January, 1992, with all modern diagnostic facilities and Colour Doppler. 11

MAINTENANCE: (a) Replacement of Windows: Windows on the Ground Floor were replaced as part of the Backlog of Maintenance allocation received from the Department of Health. (b) Eneq~y Mana&ement System: A grant was received from the Department of the Environment to provide an effective Energy Management System for the hospital. DIAGNOSTIC SERVICE ENHANCEMENT: Medical Laboratory Services were enhanced to provide for the introduction of an Ante-Natal Blood Group testing service and to faci litate the provision of services for Merlin Park Regional Hospital from the University College Hospital site. INFORMATION TECHNOLOGY: An integrated Laboratory Information System has been installed in each of the five Departments of the Laboratory. 12

UNIVERSI TY COLLEGE HOSPITAL. GALWAY MANAGEMENT ADVISORY STRUCTURE \...) PROGRAMME MANAGER GENERAL HOSPITAL CARE 1<------------~ I ~--------------> Hospital Management Team ----------------------- 1<------~ Chairman, H.M.A.C. Matron, Administrator Hospital Management Advisory 1< ------------------------------~ Committee ~--------------> Consultant Medical Staff Committee Single/Group Discipline Committees --- - - - - - DEPARTMENT TEAM ----------- LABORATORY DEPARTMENT DEPARTMENT DEPARTMENT DEPARTMENT TEAM TEAM TEAM TEAM ------------ ------------ ------------ ------------ RADIOLOGY SURGICAL MEDICAL OBS/GYNAE DEPARTMENT TEAM ------------ O.P.D. DEPARTMENT TEAM ------------ OTHERS

UNIVERSITY COLLEGE HOSPITAL GENERAL HOSPITAL CARE IN PATIENT STATISTICS 1992 CATEGORY BEDS I MAXIMUM I ACTUAL BED DAYS BED DAYS DISCHARGES t~li}~~~~~ J'~~,;!EJ~ ~" - ~ GENERAL MEDICINE CARDIOLOGY DERMATOLOGY HAEMATOLOGY NEUROLOGY GENERAL SURGERY UROLOGY IPLASTIC SURGERY ENT OPHTHALMOLOGY PAEDIATRICS MATERNITY GYNAECOLOGY DAY UNIT SUB-TOTAL PSYCHIATRY I 110 38,011 37,507 10 3,660 7,894 3 1,098 775 7 2,562 7,339 6 2,196 3,456 90 31,762 34,978 28 10,248 11,668 12 4,392 3,363 20 6,790 7,355 15 5,145 3,282 36 11,410 11,351 61 21,454 13,814 31 10,850 8,060 16 3,776 2,541 445 153,354 153,383 43 15,738 15,692 3,412 ':l~i 9sJ;t'* trli~' r~s9 1 1 2 ;~ ' <~:f~~:~ 'll 1 ;":~,~~~~ 688.. :::,; fa~;46 ~ ')')::;::::::::;;. 1Q,t.97.. 231 :::=~.: 157.as :' :.H::=r 14;96 ~ :m,t,~jii~ i~l, l 2,011 633 2,859 2,869 23,7 45 r=r' '':{:=rth O:q~p2!Yof ::: 'fllllii:=.n;;;. ::ft:~\;::l 661 [~;wili!e~~~1~~~~fr.fj TOTAL I 488 169,092 169,075 24.406 ~::==\:\,,,,<,,:,;:t\ : 9~~ 999~ : >===:=: q::t: tir ~4' ~9.3 :::1 WARD C LOSURES ST. MONICA'S: 496 BED DAYS ST. P A TRICKS 251 BED DAYS ST. CATHERINE'S 4 30 BED DAYS ST. CATHERJNE'S 286 BED DAYS DAY SURGICAL 2080 BED DAYS ST. ENDA'S 1666 BED DAYS PAEDIATRIC UNIT: 234 BED DAYS -------...- ""- ST. ANTHONY'S c_:r_ r. ~D..A.D n ' 434 BED DAYS --------240 BED DA.X.S

UNIVERSITY C(J LLEGE HOSP ITAL GA LWAY AVERAGE DURATION OF STAY 8 ~-----------------------------------------------------. 7 6.99 -VI >- ~ (/) LL. 0 z 0 ~ C( ::> 0 w ~ 6 5 4 3 2 0 I [)(YJ IYXJ IXXJ fxxj IXXJ rxxj fxxj I X X I I I I I I I I I I I 1986 1988 YEAR 1990 1991

UNIVERSITY COLLEGE HOSPITAL GALWAY % OCCUPANCY 110 ~------------------------------------------------------~ 100 100.02 90-0\ >- ~ (/) LL 0 z 0 ~ n::: ::> 0 w ~ 80 70 60 50 40 30 20 10 O 1 rx.x1 rx 1 x1 rx 1 x 1 rx 1 x1 r x 1 x1 r x 1 x 1 1 rx.xj rx 1 x1 1 1986 1988 YEAR 1990 1991

IUNIVERS.rTY COLLEGE. HOSPITAL GALWAY General Hospital Care IN PATIENT WAITING LIST at 31st DECEMBER 1992 CATEGORY NUMBER LONGEST WAITING TIME GENERAL SURGERY 321 3 MONTHS PLASTIC SURGERY 260 3 YEARS X UROLOGY 328 2.5 YEARS VASCULAR SURGERY 107 3 MONTHS CARDIOLOGY 215 4.5 YEARS X E.N.T. 404 1.5 YEARS OPHTHALMOLOGY 744 4.5 YEARS X. 17

UNIVERSITY COLLEGE HOSPITAL GALWAY General Hospital Care GEOGRAPHICAL DISTRIBUTION INPATIENT 1992 LOCATION NUMBER LOCATION NUMBER WESTERN HEALTH BOARD OTHER E.C. COUNTRIES GALWAY 18,688 MAYO 2,781 UNITED KINGDOM 75 ROSCOMMON 1,282 HOLLAND. 3 FRANCE 9 SUBTOTAL 22,751 GERMANY 16 ITALY 1 SPAIN 1 OTHER COUNTIES SUBTOTAL 105 CARLOW 2 CAVAN 3 CLARE 1,006 CORK 21 DONEGAL 64 DUBLIN 71 KERRY 9 OTHER COUNTRIES KILDARE 6 KILKENNY 6 LAOIS 2 CANADA 4 LEITRIM 51 POLAND 1 LIMERICK 55 U.S.A. 24 LONGFORD 27 AU STRALIA 3 LOUTH 5 SOUTH AFRICA 1 MEATH 7 MONAGHAN 5 SUBTOTAL 33 OFFALY 45 SLIGO 153 TIPPERARY 20 WATERFORD 6 WESTMEATH 116 WEXFORD 3 WICKLOW 7 SUBTOTAL 1,690 NORTHERN IRELAND ANTRIM 8 ARMAGH 6 DERRY 3 DOWN 7 FERMANAGH 1 TYRONE 2 SUBTOTAL 27 TOTAL 24,606 18

!UNIVERSITY COLLEGE HOSPITAL GALWAY OUTPATIENT ACTIVITY General Hospital Care OUT PATIENT CLINIC 1987 1988 1989 1990 1991 1992 PLASTIC SURGERY - - - 2,244 2,517 3,712 G NITOURINARY - 1,988 1,890 1,767 1,510 1,729 VASCULAR SURGERY - 1,545 1,682 1,694 3,345 1,819 GENERAL SURGERY 7,226 7,184 6,944 6,781 4,627 6,655 GENERAL MEDICAL 4,628 5,061 4,468 4,602 4,667 1,162 R SPIRA TORY 693 719 1,499 1,803 1,860 1,895 COELIAC (ADULTS) - 581 718 561 691 587 D RMATOLOG Y 1,569 1,575 1,438 1,558 1,731 1,806 GAST RO NT ROLOGY 2124 DIABETIC 348 445 481 515 600 606 NDOCRINOLOGY 1037 NEUROLOGY 1,417 1,360 1,507 1,517 1,620 1,688 MUL TIPL SCLEROSIS 27 30 19 24 33 68 EPILEPSY 58 70 88 88 66 145 HA MATOLOG Y 1,813 2,359 2,172 2,404 2,801 2,989 M DICAL+RH UMATOLOGY 628 - - - - - CARDIOLOGY 1,662 2,094 2,292 2,399 3,006 3,055 PACEMAKER CLINIC - - - 225 223 235.N. T. 2,520 3,031 3,361 3,644 4,245 4,540 OPHTHALMIC 3,647 4,325 4,280 4,529 4,303 4,237 VARICOSE VEINS 838 - - - - - PA DIA TRICS 3,166 2,977 3,254 3,559 3,797 4,101 OPHTHALMIC (PA DS) 886 857 904 869 733 866 UROLOGY (PA DS) 184 207 209 274 230 253 ORTHOPAEDIC (PA DS) 16 24 22 20 22 8 CEREBRAL PALSY 93 83 96 62 72 68 PSYCH/A TRIC 3,869 4,025 4,500 4,463 4,834 5,633 ANTENATAL 8,318 7,539 7,376 7,854 8,595 8,619 GYNAECOLOGY 3,288 3,631 3,798 4,104 3,978 4,620 POSTNATAL 198 190 202 189 161 186 ENDOSCOPIES 1,253 1,302 2,429 1,196 2,050 2,573 COAGULATION ACTIVITY 1,578 1,102 1,170 606 233 281 SUB TOTAL CLINICS 49,923 54,304 56,799 59,551 62,550 67,297 OTHER ACTIVITIES DENTAL 196 230 235 218 280 240 PHYSIOTHERAPY 12,080 14,917 15,800 2,581 2,605 3,049 X-RAYOPD 21,596 25,968 28,075 30,848 32,204 31,904..G. 807 825 1,050 683 832 914 SUB-TOTAL 84,602 96,244 101,959 93,881 98,471 103,404 ACCIDENT +EMERGENCY 30,779 34,993 40,971 40,867 42,727 43,542 TOTAL 115,381 131,237 142,930 134,748 141,198 146,946 EXTERN CLINICS PSYCH/A TRIC B 'SLO 574 507 442 377 442 445 ST. LUK S CLINIC 958 837 845 722 720 710 GROSS TOTAL 116,913 132,581 144,217 135,847 142,360 148,101 19

!UNIVERSITY COLLEGE HOSPITAL GALWAY General Hospital Care OUT PATIENT WAITING LIST at 31st DECEMBER 1992 CATEGORY NUMBER LONGEST WAITING TIME GENERAL SURGERY 1087 3 YEARS PLASTIC SURGERY 577 2.75 YEARS UROLOGY 463 3.5 YEARS VASCULAR SURGERY 900 3.5 YEARS CARDIOLOGY 120 4 MONTHS DERMATOLOGY 73 3 MONTHS ENDOCRINOLOGY 55 7.5 MONTHS GASTROENTEROLOGY 330 2 YEARS GENERAL MEDICINE & 73?.h~WEEKS RESPIRATORY NEUROLOGY 83 2.5 MONTHS E.N.T. 1440 4 YEARS OPHTHALMIC 1651 4 YEARS PAEDIATRIC 66 1.5 MONTHS PAEDIATRIC UROLOGY 23 3.5 MONTHS 20

General Hospital Care UNIVERSITY COLLEGE HOSPITAL GALWAY OPERATIONS 1992 THEATRES MAJOR MINOR EMERGENCY TOTAL MAJOR MINOR GENERAL 3,461-1,1 26-4,587 DAY WARD - 2,541 - - 2,541 E.N.T. 1,234 552 37 18 1,841 OPHTHALMIC 324 279 33 7 643 OBS & GYNAE 1,318 863 - - 2,181 CASUALTY - 504 - - 504 DENTAL (CASUAL TV) - 240 - - 240 DENTAL (DAY SURGERY) - 199 - - 199 TOTAL 6,337 5,178 1,196 25 12,736 21

General Hospital Care UNIVERSITY COLLEGE HOSPITAL GALWAY X-RAY DEPARTMENT 1992 CATEGORY NUMBER OF NUMBER OF PATIENTS PATIENTS 1991 1992 MAIN X-RAY WARDS 12,596 12,866 CASUALTY 20,906 20,631 O.P.D. 6,044 6,253 EXTERN 4,420 4,625 SUBTOTAL 43,966 44,375 C.A.T. SCAN 1,783 2,115 ULTRASOUND 2,050 2,406 NUCLEAR MEDICINE 974 1,059 MAMMOGRAPHY * 834 395 TOTAL 49,607 50,350 NUMBER OF 1991 1992 EXAMINATIONS MAIN X-RAY 54, 459 53,952 ULTRASOUND 2,733 3,200 MAMMOGRAPHY * 834 395 C.A.T. SCAN 2,120 2,515 NUCLEAR MEDICINE 974 1,059 TOTAL 61 '120 61 '121 * NO MAMMOGRAPHY SERVICE AVAI LABLE UNTIL JULY 1992 WHEN NEW EQUIPMENT CAME ON STREAM 22

General Hospital Care UNIVERSITY COLLEGE HOSPITAL GALWAY PERIPHERAL CLINICS 1992 SPECIALTY LOCATION NUMBER OF CARDIOLOGY MERLIN PARK REGIONAL HOSPITAL 4 SUBTOTAL 4 DERMATOLOGY GENERAL HOSPITAL CASTLEBAR 344 GENERAL HOSPITAL SLIGO 364 DISTRICT HOSPITAL BALLINA 355 CO. CLINIC ROSCOMMON 546 SUBTOTAL 1609 E.N.T. GENERAL HOSPITAL CASTLEBAR 2074 CO. CLINIC ROSCOMMON 821 PORTIUNCULA HOSPITAL BALLINASLOE 270 SUBTOTAL 3165 GYNAECOLOGY CO. CLINIC ROSCOMMON 229 SUBTOTAL 229 PAEDIATRICS DISTRICT HOSPITAL CLIFDEN 120 CO. CLINIC ROSCOMMON 169 SUBTOTAL 289 RESPIRATORY MERLIN PARK REGIONAL HOSPITAL 594 GENERAL HOSPITAL CASTLEBAR 120 SUBTOTAL 714 UROLOGY GENERAL HOSPITAL CASTLEBAR 282 CO. CLINIC ROSCOMMON 257 SUBTOTAL 539 TOTAL 6549 23

UNIVERSITY COLLEGE HOSPITAL GALWAY General Hospital Care CARDIOLOGY DEPARTMENT 1992 SERVICES NUMBER TOTAL PATIENTS ADMITIED 530 MYOCARDIAL INFARCTION 206 THROMBOLYSIS THERAPY 56 E.C.G 'S 7840 EXERCISE TESTING 566 ECHOCARDIOGRAM INC. COLOUR DOPPLER 1340 24 HOUR E.C.G.RECORDING 171 24 HOUR B.P. MONITOR RECORDING 97 PACEMAKER CLINIC CHECKS 232 ROUTINE CARDIAC CATHETERIZATION 434 CORONARY ANGIOPLASTY 16 VALVULOPLASTY 6 PERMANENT PACEMAKER INSERTION 74 24

General Hospital Care UNIVERSITY COLLEGE HOSPITAL GALWAY GASTROENTEROLOGY DEPARTMENT 1992 EXAMINATIONS GASTROSCOPIES UPPER POLYPECTOMIES UPPER EDER PRESTON DILATATION MALONEY DILATATIONS INJECTION OF OESOPHAGEAL VARICES E.R.C.P. PAPPILLOTOMIES BILIARY STENTS COLONOSCOPIES COLONIC POLYPECTOMIES FLEXIBLE SIGMOIDOSCOPIES ACHALASIA DILATATIONS LASER JEJUNAL BIOPSIES HYDROGEN BREATH TESTS SAVARY GILLARD DILATATIONS SUBTOTAL NUMBER 1,603 2 5 32 5 123 30 15 151 10 210 2 6 56 10 4 2,264 RESPIRATORY BRONCHOSCOPIES 449 TOTAL IN ADDITION 79 NEW PATIENTS AND 424 REVIEW PATIENTS WERE SEEN AT THE COELIAC CLINIC 2,713 25

UNIVERSITY COLLEGE HOSPITAL GALWAY General Hospital Care PHYSIOTHERAPY DEPARTMENT 1992 GENERAL: OUT-PATIENTS PATIENTS 1,386 UNITS 11,952 IN- PATIENTS MATERNITY UNIT: OUT - PATIENT PATIENTS 5,643 UNITS 40,440 PATIENTS 1,353 UNITS 989 IN- PATIENTS PAEDIATRIC UNIT: OliT -PATIENTS PATIENTS 1,598 UNITS 1,880 PATIENTS 240 UNITS 4,410 IN- PATIENTS LIFTING & HANDLING COURSES PATIENTS 256 UNITS 2,845 TRAINEES 70 UNITS 236 TOTAL OliT - PATIENTS PATIENTS,3,049 UNITS 17,587 TOTAL IN- PATIENTS PATIENTS 7,497 UNITS 45,165 GRAND TOTAL PATIENTS 10,546 UNITS 65,752 26

General Hospital Care!UNIVERSITY COLLEGE HOSPITAL GALWAY DIETETICS DEPARTMENT 1992 1990 1991 1992 IN- PATIENT 1,079 1,130 1,161 OUT-PATIENT 774 1,129 1,126 TOTAL 1,853 2,259 2,287 BIRTHS 1991 YEAR U.C.H.G. W.H.B. 1988 2,405 6,247 1989 2,320 5,694 1990 2,461 5,932 1991 2,426 5,809 1992 2,613 5,755 E.E.G. DEPARTMENT 1991 1992 IN-PATIENT 548 561 OUT -PATIENT 832 914 TOTAL 1,380 1,475 PSYCIDATRIC UNIT 1989 1990 1991 1992 ECT'S ADMINISTERED 539 368 432 315 27

UNIVERSITY COLLEGE-HOSPITAL GALWAY MEDICAL LABORATORIES DEPARTMENT TESTS N 00 1989 1990 HAEMATOLOGY 251,878 272,218 HISTOPATHOLOGY 161,786 200,392 1991 1992 295,283 319,595 206,480 199,095 MICROBIOLOGY 432,680 449,712 BIOCHEMISTRY 1,500,956 1,624,954. IMMUNOLOGY 24,028 26,088 TOTAL 2,371,328 2,573,364 -- ------- - -- 500,745 512,351 1,893,641 1,993,877 26,091 28,382 2,922,240 3,053,300

GENERAL HOSPITAL CARE UNIVERSITY COLLEGE HOSPITAL SPECIAL CARE BEDS 1992 N \Q CATEGORY BEDS AVAILABLE BED DAYS BED DAYS DISCHARGES o/o AVERAGE USED OCCUPANCY BED STAY INTENSIVE CARE 7 2562 CORONARY CARE 5 1830 PREMATURE BABY. 14 5124 1970 422 76.89% 4.67 2044 531 111.69% 3. 85 3124 273 60.970A 11.44. TOTAL 26 9516 7138 1226 75.01% 5.82

MERLIN PARK REGIONAL HOSPITAL. 30

MERLIN PARK REGIONAL HOSPITAL Expenditure at Merlin Park Regional Hospital amounted to 11.373m m 1992. accounted for 72.99% of total expenditure. Pay The Whole Time Equivalent staff complement for the Hospital was 493. Absenteeism averaged 2. 74% in 1992. Income collected by the Hospital amounted to 1.494m. FINANCIAL SUMMARY. CATEGORY ACTUAL BUDGET %VARIANCE '000 '000 PAY 8,302 8,251 0.62% NON-PAY 3,071 2,993 2.61% GROSS 11,373 11,244 1.15% INCOME 1,494 1,468 1.77% NET 9,879 9,776 1.05% 31

MERLIN PARK REGIONAL HOSPITAL DEVELOPMENTS 1992 UNIT 1: Under the Programme for Economic and Social Development, a sum of 100,000 was received from the Department of Health for the development of services for the elderly. Unit 1, which had been closed for a number of years, was upgraded and painted and the Nephology Department which was previously based in Unit 4 was transferred to Unit 1 with effect from 27th July, 1992. UNIT 2: New windows were provided in the treatment rooms of the Out-Patients Department in Unit 2. UNIT 3: New windows and doors were provided in Unit 3 from the Backlog of Maintenance Allocation received from the Department of Health. UNTT 4: New windows and doors were also provided in Unit 4 from the Backlog of Maintenance Allocation received from the Department of Health. The Unit was also upgraded and new furnishings were provided in order to faci litate the transfer of the Geriatric Assessment Unit to Unit 4 with effect from 5th Augu st, 1992, providing 10 additional Geriatric Assessment beds. The transfer of the Geriatric Assessment Unit to Unit 4 also facilitated an increase of 18 beds for long stay geriatric patients in Units 5 and 6. UNIT 5: A new entrance door and window was provided in Unit 5 and external painting of the Unit also took place. UNIT 6: A new entrance door and window was also provided in Unit 6 and this Unit was also painted on the exterior. HOSPITAL GROUND: A new Nurse-call system was installed in Hospital Ground. Hospital Two A new Nurse-call system was installed in Hospital Two. 32

THEATRE: A new Anaesthetic Monitoring Machine was purchased for the Theatre. E.C.G DEPARTMENT: A new E.C.G. M achine was purchased for this Department. KITCHEN/STORES/ PHARMACY: Major repairs were carried out to the roofs of the Kitchen, Stores and Pharmacy. Some of this work was funded from the Backlog of Maintenance Allocation received from the Department of Health and the balance was funded from our own resources. A new oven was also purchased for the Catering Department. ENTRANCE: The entrance to this hospital which also is the entrance to the Board's Headquarters was upgraded. The above works at a total cost of 335, 136. 17 have improved the services for patients and staff at Merlin Park Regional Hospital, Galway. 33

MERLIN PARK REGIONAL HOSPITAL DEVELOPMENTS 1992 w ~ Project Expenditure Unit 1 Upgrading, external painting and re-opening 168,738.78 Unit 2 Provision of new windows in Treatment Rooms of Out-Patients Department 3, 195.50 Unit 3 Provision of new windows and doors 17,000.00 Unit 4 Provision of new windows and doors 16,000.00 Upgrading of Unit and provision of new furnishings (beds, bed tables, baths, etc) 59,303.31 Unit 5 Provision of new entrance door and window 2,887.50 Date Completed July 1992 June 1992 October 1992 October 1992 July 1992 June 1992 I External Painting 4, 125.00 September 1992

MERLIN PARK REGIONAL HOSPITAL DEVELOPMENTS 1992 w U1 Project Expenditure Unit 6 Provision of new entrance door and window 2,887.50 External Painting 4,125.00 Hospital Ground Provision of new Nurse Call System 3,811.50 Hospital Two Provision of new Nurse Call System 3,809.08 Theatre Provision of Anaesthetic Monitoring Equipment 7,260.00 E.C.G Department Provision of new E.C.G. Machine 4,686. 14 Kitchen/Stores/Pharmacy Repairs to Roof 14,974.31 I! Date Completed June 1992 September 1992 July 1992 April 1992 December 1992 September 1992 October 1992 Provision of new oven in Kitchen 7,744.00 Entrance Upgrading of Entrance to Hospital and Headquarters 14,588.55 I TOTAL I 335,136.17 I February 1992 December 1992 I

MERLIN PARK REGIONAL HOSPITAL. GALWAY MANAGEMENT ADVISORY STRUCTURE PROGRAMME MANAGER GENERAL HOSPITAL CARE < 1...) "" I I I I HOSPITAL MANAGEMENT ADVISORY COMMITTEE HOSPITAL MANAGEMENT <--------------~ TEAM COMMITTEE CONSULTANT MEDICAL ~--->1 STAFF COMMITTEE I DEPARTMENT TEAM SURGERY I I I DEPARTMENT DEPARTMENT DEPARTMENT TEAM TEAM TEAM MEDICINE RADIOLOGY ANAESTHESIA

MERLIN PARK REGIONAL HOSPITAL GENERAL HOSPITAL CARE IN PATIENT STATISTICS 1992 CATEGORY BEDS I MAXIMUM I ACTUAL I DISCHARGES 1...... :. :. (] BED DAYS BED DAYS ~~-~:fi,]!: t~ '..;) --.) GENERAL MEDICINE I!NEPHROLOGY GENERAL MEDICINE/ RHEUMATOLOGY GERIATRIC SSESSMENT ORTHOPAEDIC I I I I 35 I 12597 I 9119 I 1089 41 1 15,oo6 1 10,934 1 1,072 28 1 8,118 1 5,782 I 302 109 39,894 29,384 2,931. SUB-TOTAL 213 75,615 55,219 5,394 GERIATRIC- LONGSTA Y 104 34,443 33,743 64 TOTAL I 317 110,058 88,962 5,458

MERLIN PARK REGIONAL HOSPITAL GALWAY 80 76.77 % OCCUPANCY EXC. GERIATRIC 70 '..-..) 00 ~ (f) 60 l.j... 50 0 z 0 40 ~ lr ::J 0 w ~ 30 20 10 0 I XXI l XXI IX XJ f XXJ IXX l f XXJ fxxj! XXI I 1985 1986 1987 1988 1989 1990 1991 1992 YEAR

~ 1- w 0 \0 MERLIN PARK R~GIONAL 14 13 1 12.62 POOl 12 1 1 (/) 9 10 ~- ll 0 8 z 7 ~ 0::: :::> 6 0 w 5 ~ 4 3 2 AVERAGE DURATION OF STAY EXC. GERIATRIC HOSPITAL, GALWAY 0 I [XXJ ryxj lxxj r XXJ IXX J fxxj r XXl! XX I I 1985 1986 1987 1988 1989 1990 1991 1992 YEAR

MERLIN PARK REGIONAL HOSPITAL General Hospital Care GEOGRAPHICAL DISTRIBUTION INPATIENT 1992 LOCATION NUMBER LOCATION NUMBER WESTERN HEALTH BOARD OTHER E.C. COUNTR,IES GALWAY 3,762 MAYO 1,040 UNITED KINGDOM 39 ROSCOMMON 332 ITALY 1 FRANCE 10 SUBTOTAL 5,134 GERMANY 7 HOLLAND 1 SPAIN 1 OTHER COUNTIES SUBTOTAL 59 CAVAN 2 CLARE 87 CORK 6 DONEGAL 16 DUBLIN 32 KERRY 4 OTHER COUNTRIES KILDARE 3 KILKENNY 1 U.S.A. 16 LAOIS 3 AUSTRIA 2 LEITRIM 4 AUSTRALIA 1 LIMERICK 6 LONGFORD 10 SUBTOTAL 19 LOUTH - MEATH 2 MONAGHAN 1 OFFALY 5 SLIGO 11 TIPPERARY 10 WATERFORD 2 WESTMEATH 32 WEXFORD 5 WICKLOW - SUBTOTAL 242 NORTHERN IRELAND 4 TOTAL 5,458 40

MERLIN PARK REGIONAL HOSPITAL General Hospital Care OUTPATIENT ACTIVITY OUT PATIENT CLINIC 1987 1988 1989 1990. 1991 1992 RENAL - 914 1,080 1,157 1,205 1249 RHEUMATOLOGY - 283 69 339 1,010 1114 CARDIOVASCULAR - 304 297 271 295 282 ORTHOPAEDIC - 8,138 9,150 9,434 10,505 11019 1 SUB-TOTAL 0 9,639 10,596 11,201 13,015 13,664 PLASTER ROOM 574 5,520 6,090 6,281 6,681 6606 X-RAY 958 8,334 9,309 10,009 15,476 14837 ~ PHYSIOTHERAPY 1,288 1,694 1,910 1,928 2015 DAY CASES 1,073 1,442 1,647 1,673 1370 SUB-TOTAL 1,532 16,215 18,535 19,847 25,758 24,828 U.C.H.G. CLINICS RESPIRATORY - 552 732 894 717 594 CARDIOLOGY - 160 74 15 14 4 GROSS TOTAL 1,532 26,566 29,937 31,957 39,504 39,090

General Hospital Care MERLIN PARK REGIONAL HOSPITAL OUT PATIENT WAITING LIST AT 31st DECEMBER 1992 CATEGORY NUMBER LONGEST WAITING TIME ORTHOPAEDIC GALWAY 1631 4 YEARS MAYO 795 4 YEARS ROSCOMMOt/ 303 2.5 YEARS TOTAL 2729 RHEUMATOLOGY 256 3 YEARS IN PATIENT WAITING LIST AT 31st DECEMBER 1992 CATEGORY NUMBER LONGEST WAITING TIME ORTHOPAEDIC 563 MARCH 1990 RHEUMATOLOGY 4 NOVEMBER 1992 GERIATRIC ASSESSMENT 9 I-2 WEEKS 42

jmerlin PARK REGIONAL HOSPITAL OPERATIONS 1992 THEATRES MAJOR MINOR TOTAL ORTHOPAEDIC 1379 2185 3564 PERIPHERAL CLINICS 1992 SPECIAL TV LOCATION NUMBER OF ATTENDANCES ORTHOPAEDIC GEN.HOSP. CASTLEBAR 1306 CO. CLINIC ROSCOMMON 741 DIST. HOSP. BALLINA 204 SUBTOTAL 2251 NEPHROLOGY GEN. HOSP. CASTLEBAR 89 TOTAL 2340 43

MERLIN PARK REGIONAL HOSPITAL General Hospital Care X-RAY DEPARTMENT 1992 CATEGORY NUMBER OF PATIENTS MAIN X-RAY 21,015 ULTRASOUND 343 NUCLEAR MEDICINE 355 SPECMLPROCEDURES 62 TOTAL 21,775 NUMBER OF EXAMINATIONS 25,204 NO. FILMS USED 40,100 44

I '~ General Hospital Care!MERLIN PARK REGIO NAL HOSPITAL I,~ PHYSIOTHERAPY DEPARTME NT CATEGORY OUT-PATI ENTS 1989 1990 1991 1992 ; GENERAL PATIENT s UNITS 1,694 1,910 4,114 4,028 1,92a 5,291 2,015 5,805 IN-PATIE NTS PATIENT s 20,543 17,476 15,899 15,872 UNITS 34,924 30,325 30,597 29,633 TOTAL PATIENT s 22,237 19,386 17,827 17,887 UNITS 39,038 34,353 35,888 35,438 " HAEMODIALYSIS DEPARTME NT 1989 1990 1991 1992 IN-PATIENTS TREATED 6,194 5,644 5,240 5,356 HOME TREATMENTS 156 156 144 TOTAL 6,350 5,800 5,384 5,356 DIETETICS DEPARTMENT 1990 1991 1992 IN-PATIENT 683 738 1,536 ~, OUT -PATIENT 566 554 554 TOTAL 1,249 1,292 2,090 :'~ - ~ J :., 45

GENERAL HOSPITAL CARE MERLIN PARK REGIONAL HOSPITAL SPECIAL CARE BEDS 1992 ~ 0\ CATEGORY BEDS MAXIMUM BED DAYS ACTUAL DISCHARGES % AVERAGE BED DAYS OCCUPANCY BED STAY INTENSIVE CARE. 4 1464 915 636 62.50% 1.44 TOTAL 4 1464 915 636 62.50% 1.44 - --- - -- --- - --

MAYO GENERAL HO SPIT AL. 47

MAYO GENERAL HOSPITAL, CASTLEBAR Expenditure at Mayo General Hospital, Castlebar amounted to 13.396m. Pay accounted for 74.2% of total expenditure. The Whole Time Equivalent staff complement for the Hospital was 490. Absenteeism averaged 3. 71% in 1992. Income collected by the Hospital amounted to 1.227m. FINANCIAL SUMMARY CATEGORY ACTUAL BUDGET %VARIANCE '000 '000 PAY 9,940 9,833 1.09% NON-PAY 3,456 3,050 13.31 % GROSS 13,396 12,883 3.98% INCOME 1,227 1,079 13.71% NET 12,169 11,804 3.1% 48

MAYO GENERAL HOSPITAL DEVELOPMENTS 1992. 1. A new Physiotherapy Department was provided in the area formerly used as the Kitchens. The new development includes six examir:ation cubicles, two Paediatric Room s and a Gymnasium. 2. All windows in the ward areas in the old part of the hospital were replaced as part of the Minor Capital Allocation received from the Department of Health. 3. Re-routing of the main heating system was commenced to reduce energy costs. 4. Upgrading of main corridor areas in old part of the hospital. 49

MAYO GENERAL HOSPITAL. CASTLEBAR MANAGEMENT ADVISORY STRUCTURE PROGRAMME MANAGER GENERAL HOSPITAL CARE 1<------------~ VI 0 1 r---------------> Hospital Management Team -----------------------1 <----i Chairman, H.M.A.c. Matron, Administrator Hospital Ma nage ment Advisory 1<------------------------------~ committee ~--------------> Consultant Medical St aff Committee Single/Group Discipline Committees DEPARTMENT TEAM ----------- LABORATORY DEPARTMENT DEPARTMENT DEPARTMENT DEPARTMENT TEAM TEAM TEAM TEAM ------------ ------------ ------------ ------------ RADIOLOGY SURGICAL MEDICAL OBS/GYNAE DEPARTMENT TEAM ------------ O.P.D. DEPARTMENT TEAM ------------ OTHERS

MAYO GENERAL HOSPITAL GENERAL HOSPITAL CARE IN PATIENT STATISTICS 1992 CATEGORY BEDS I MAXIMUM I ACTUAL I DISCHARGES BED DAYS BED DAYS I:_II,I{JD!I MEDICAL 73 26,645 24,807 4,436 VI - SURGICAL 65 23,406 20,072 4,485 1 obstetric 40 14,600 9,619 1,802 GYNAECOLOGY 12 3,828 2,421 924 36 13,140 8,516 2,584 226 81,619 65,435 14,231 IATRIC 44 16,060 16,213 693 TOTAL 270 97,679 81,648 14,924 * 532 of these bed days relate to day patients in m edical assessment unit WARD CLOSURES GYNAE: 12th JULY- 15th AUGUST 19th DECEMBER- 31st DECEMBER D. BLOCK: 19th DECEMBER- 31st DECEMBER

MAYO GENERAL HOSPITAL % OCCUPANCY EXC. PSYCHIATRY 100 ~----------------------------------------------------~ 90 92.81 80 Vl tv >- ~ (/) l.j.. 0 z 0 ~ er :::> 0 w ~ 70 60 50 40 30 20 10 0 I f XXI!X X I lxx I l XXJ IX XJ C XXJ f XX J lxxi I 1985 1986 1987 1988 1989 1990 1991 1992 YEAR

MAYO GENERAL HOSPITAL AVERAGE DURATION OF STAY EXC. PSYCH. 7 ~----------------------------------------------------~ 6.63 6 >- ~ (/) LL. 0 4 z VI 0 w ~ 0.:: ::> 3 0 w ~ 5 2 1 0 I!XXI lxxi lxxi!xxi!x XI!XXI lxxi!xxi I 1985 1986 1987 1988 1989 1990 1991 1992 YEAR

MAYO GENERAL HOSPITAL General Hospital Care GEOGRAPHICAL DISTRIBUTION INPATIENT 1992 LOCATION NUMBER LOCATION NUMBER WESTERN HEALTH BOARD OTHER E.C. COUNTRIES GALWAY 66 MAYO 13,695 UNITED KINGDOM 85 ROSCOMMON 132 FRANCE 11 GERMANY 6 SUBTOTAL 13,893 ITALY 3 SWEDEN 1 DENMARK 1 OTHER COUNTIES SUBTOTAL 107 CARLOW 1 CAVAN 4 CLARE 2 CORK 11 DONEGAL 4 DUBLIN 44 OTHER COUNTRIES KERRY 2 KILDARE 9 KILKENNY 3 AUSTRALIA 4 LAOIS 2 CANADA 1 LEITRIM 4 U.S.A. 17 LIMERICK 5 AUSTRIA 1 LONGFORD - LOUTH 2 MEATH 6 SUBTOTAL 23 MONAGHAN - OFFALY 2 SLIGO 77 TIPPERARY 5 TOTAL 14,233 WATERFORD 2 WESTMEATH 5 + PSYCHIATRIC ADMISSIONS 691 WEXFORD 2 WICKLOW 3 SUBTOTAL 195 NORTHERN IRELAND 15 TOTAL 14,924 54

!MAYO GENERAL HOSPITAL General Hospital Care VI V1 OUTPATIENT ACTIVITY lout PATIENT CLINIC SURGICAL GERIATRIC SIGMOIDOSCOPY VARICOSE VEINS FRACTURE MEDICAL WARFARIN E. C. G. ANTENATAL GYNAECOLOGY PAEDIATRICS ORTHOPAEDICS DERMATOLOGY NEPHROLOGY UROLOGY ST. LUKES E.N.T. RESPIRATORY SUBTOTAL CASUALTY TOTAL 1987 1988 4,028 4,819 582 728 245 204 96 89 1203 1110 1947 2071 1784 1442 56 32 3512 2940 2311 2256 1527 1601 1606 2053 315 389 95 113 208 210 886 867 1417 876 - - 21818 21800 11757 12245 33575 34045 1989 1990 1991 1992 5,211 6,217 5,991 6198 806 916 701 802 199 206 187 209 52 88 81 89 1366 356 - - 2146 2241 1409 1569 1227 1675 1225-50 7 10 1264 2447 2732 2901 2883 2145 2577 2619 2216 1786 2207 1898 1826 2469 1601 1738 1441 336 267 163 344 117 86 79 89 231 248 342 282 898 819 693 708 699 1317 1581 2074-119 161 120 22185 23679 21779 22114 12666 13111 16120 16421 34851 36790 37899 38535

MAYO GENERAL HOSPITAL General Hospital Care IN PATIENT WAITING LIST at 31st DECEMBER 1992 CATEGORY NUMBER LONGEST WAITING TIME GENERAL SURGERY 245 APRIL 1992 GYNAECOLOGY 33 DECEMBER 1992 OUT PATIENT WAITING LIST at 31st DECEMBER 1992 CATEGORY NUMBER LONGEST WAITING TIME GENERAL SURGERY 820 JUNE 1991 UROLOGY 242 DECEMBER 1989 DERMATOLOGY 140 JANUARY 1991 PAEDIATRICS 37 OCTOBER 1992 ORTHOPAEDICS 780 MAY 1989 E.N.T. 600 SEPTEMBER 1991 GYNAECOLOGY 185 JUNE 1992 RESPIRATORY 26 JULY1992 56

MAYO GENERAL HOSPITAL GENERAL HOSPITAL CARE OPERATIONS 1992 THEATRES MAJOR MINOR TOTAL GENERAL 1,055 1,759 2,814 E.N.T. - - 2 OBS!GYNAE - - 942 CASUALTY - 411 411 DENTAL - - 6 ORTHOPAEDIC - - 84 PLASTIC SURGERY - - 21 TOTAL 1,055 2,170 4,280 57

General Hospital Care MAYO GENERAL HOSPITAL I X- RAY DEPARTMENT 1992 CATEGORY NUMBER OF EXAMINATIONS MAIN X-RAY 40,453 ULTRASOUND 1,953 SPECIAL PROCEDURES 6,426 TOTAL 48,832 NUMBER OF PATIENTS EXTERNAL 21 '156 INTERNAL 10,448 TOTAL 31,604 58

lmayo GENERAL HOSPITAL General Hospital Care I PHYSIOTHERAPY DEPARTMENT CATEGORY OUT -PATIENTS 1989 1990 1991 1992 PATIENTS 887 1,049 1,600 1,989 GENERAL UNITS 4,930 5,931 10,023 13,108 IN-PATIENTS PATIENTS 2,177 2,204 1,802 2,094 UNITS 11,880 12,673 10,995 12,350 TOTAL PATIENTS 3,064 3,253 3,402 4,083 UNITS 16,810 18,604 21,018 25,458 BIRTHS YEAR NO. OF BIRTHS GEN. HOSP. W.H.B. CASTLEBAR 1988 1,583 6,247 1989 1,409 5,694 1990 1,442 5,932 1991 1,435 5,809 1992 1,318 5,755 59

GENERAL HOSPITAL CARE j.--m-a_y_o_g_e_n_e_r_a_l_h_o_s_p_it_a_l ---.~ DIETETICS DEPARTMENT 1990 1991 1992 IN- PATIENT 1,679 1,151 1,255 PSYCHIATRIC UNIT 1988 1989 1990 E.C.T'S ADMINISTERED 164 246 293 1991 1992 260 165 60

MAYO GENERAL HOSPITAL General Hospital Care MEDICAL LABORATORIES TESTS 1989 1990 HAEMATOLOGY 61,962 68,027 BLOOD TRANSFUSION * 29,045 25,127 BACTERIOLOGY 148,574 125,464 HISTOLOGY 11,178 9,935 BIOCHEMISTRY 192,766 214,102 TOTAL 443,525 442,655 1991 1992 65,932 68,939 12,479 13,536 126,666 150,412 9,453 11,273 210,917 241,153 425,447 485,313 IN 199 1 THE BLOOD TRANSFUSION SERVICE CHANGED THEIR MEASUREMENT TO CANADIAN UNITS WHICH ARE APPROXIMATELY DOUBLE THE FORMER UNITS OF MEASUREMENT. 61

ROSCOMMON COUNTY HOSPITAL. 62

ROSCOMl\10N COUNTY HOSPITAL Expenditure at Roscommon County Hospital amounted to 4.513m in 1992. Pay accounted for 76.02% of total expenditure. The Whole Time Equivalent staff complement for the Hospital was 178. Absenteeism averaged 2.78 in 1992. Income collected by the Hospital amounted to 0.398m. FINANCIAL SUMMARY. CATEGORY ACTUAL BUDGET % VARIANCE '000 '000 PAY 3,431 3,466 1.0% NON-PAY 1,082 974 11.1% GROSS 4,513 4,440 1.64% INCOME 398 303 31.35% NET 4,115 4, 137 0.53% 63

ROSCOMMON COUNTY HOSPITAL DEVELOPMENTS 1992 DEPARTMENT OF PSYCHIATRY Acute Psychiatric Unit On the loth February, 1992, the Acute Psychiatric Unit was opened with a total of 30 in-patient beds. Thirty-two Nursing Staff and five Attendant Staff, together with three Consultants, four Senior House Officers, one Psychiatric Social Worker, one Occupational Therapist, and two Clerical Staff moved from St. Patricks Hospital, Castlerea. The Acute Unit now occupies the Ground Flor of the Hospital. Addiction Treatment Unit The Addiction Treatment Uni t was also put into operation on the loth February, 1993, with two Addiction Counsellors working in this Uni t. The Addiction Treatment Unit was formerly the Gate Lodge, and is providing a 28 day Programme for patients from the Acute Unit with addiction problems. The Uni t also caters for out-patients and follow-up programmes. CONSULTANTS' OFFICES All Consultants' Offices were refurbished and relocated on the first floor of the hospital, in the former St. Agnes' Ward, thus making these offices adjacent to the Medical and Surgical Wards and Theatre. ADMINISTRATIVE AND ACCOUNTS OFFICE The new Accounts Office was relocated and refurbished and now occupies a larger space for the Administration Staff, in the old Oratory. A hatch was erected for security reasons and also to give a better and more private service to customers. CARP ARK The Carpark within the hospital grounds was extended at the Staff Residence to cater for the growing demand on space due to the increase in Staff numbers because of the opening of the Acute Psychiatric Unit, the Addiction Treatment Unit and to cater also for visitors etc. COUNTY CLINIC The County Clinic was refurbished to provide a larger Dental Clinic. Work is still in progress in relation to providing more suitable Waiting areas, Consultation Rooms, Examination Rooms etc. 64

CONFERENCE ROOM The Conference Room, which was the former Accounts Office, is now remodelled and redecorated to provide accommodation for Meetings and Interviews etc. All the above developments have greatly enhanced the image of the County Hospital, to staff, patients and visitors. It has boosted the morale of staff, and all the changes which have occurred have improved the hospital. Almost all the work done has been carried out by the Maintenance Staff of the County Hospital, and under the guidance of the Maintenance Supervisor, to a very high standard and is commented on favourably by visitors and patients alike. 65

ROSCOMMON COUNTY HOSPITAL DEVELOPMENTS 1992 Project Actual Expenditure Department of Psychiatry:- Building Contract: 269,085.88 Furnishings: 86,804.88 Date Occupied 0\ 0\ Move In:- Acute Unit and Addiction Treatment Unit 15, 178.99 loth February, 1992 Addiction Treatment Unit Buildings and Furnishings 22,429.00 Consultants' Offices 1,665.29 Administration and Accounts Office and Oratory 1,658.45 Carpark 8,538.46 County Clinic 50,000.00 Conference Room 420.00 June, 1992 May, 1992 August, 1992 December, 1992 1992

ROSCOMMON COUNT HOSPITAL MANAGEMENT ADVISORY STRUCTURE PROGRAMME MANAGER GENERAL HOSPITAL CARE Hospital Management Team 0\ -...] Hospital Management Advisory Committee I I I DEPARTMENT TEAM DEPARTMENT TEAM DEPARTMENT TEAM DEPARTMENT TEAM SURGERY MEDICINE RADIOLOGY ANAESTHESIA

ROSCOMMON COUNTY HOSPITAL GENERAL HOSPITAL CARE IN PATIENT STATISTICS 1992 CATEGORY I BEDS I MAXIMUM I ACTUAL I DISCHARGES BED DAYS BED DAYS 0\ 00 GENERAL MEDICINE 51 18666 17491 GENERAL SURGICAL 35 12810 6840 1783

ROSCOM MON COUNTY HOSPITAL % OCCUPANCY 100 ~----------------------------------------------------~ 90 89.34 89.40 89.15 80 0\ \0 ~ (/) ll 0 z 0 ~ 0::: :::J 0 w ~ 70 60 50 40 30 20 10 0 I l XXI! X XI! XXI!XXI!XX I lxxi lxxi! XXI I I I I I I I I I I 1986 1988 YEAR 1990 1991

ROSCOMMON COlJNTY HOSPITAL AVERAGE DURATI ON OF STAY 10~------------------------------------~ 9 9.11 8 -.1 0 >- ~ (/) lj.. 0 z 0 ~ 0:: :> 0 w ~ 7 6 5 4 3 2 0 I! XX I! XX I!XX I!X XI! XXI! XXI!XXI! XXI I I I I I I I I I I 1986 1988 YEAR ~ C73. C87 1990 1991

COUNTY HOSPITAL ROSCOMMON General Hospital Care GEOGRAPHICAL DISTRIBUTION INPATIENT 1992 LOCATION NUMBER LOCATION NUMBER WESTERN HEALTH BOARD OTHER E.C. COUNTRIES GALWAY 213 MAYO 21 UNITED KINGDOM 10 ROSCOMMON 3265 FRANC 5 SUBTOTAL 3499 SUBTOTAL 15 OTHER COUNTIES CAVAN 3 CLARE 2 CORK 2 DONEGAL 1 DUBLIN 7 KERRY 4 OTHER COUNTRIES KILDARE - KILKENNY - LAOIS - CANADA 2 LEITRIM 48 LIMERICK 1 SUBTOTAL 2 LONGFORD 129 LOUTH 1 MEATH - MONAGHAN 1 OFFALY 1 SLIGO 8 TIPPERARY - WATERFORD - WESTMEATH 17 WEXFORD 1 WICKLOW - SUBTOTAL 226 NORTHERN IRELAND ANTRIM 3 ARMAGH - D RRY - DOWN 3 FERMANAGH - TYRON 1 SUBTOTAL 7 TOTAL 3749 7 l

1ROSCOMMON COUNTY HOSPITAL General Hospital Care -J N OUTPATIENT ACTIVITY OUT PATIENT CLINIC MEDICAL UROLOGY SURGICAL ORTHOPAEDIC E.N.T. PAEDIATRIC GYNACOLOGY DERMATOLOGY CHILD GUIDANCE VARICOSE VEINS TRAUMA CLINIC PSYCHIATRY SUB-TOTAL. 1987 1988 2,953 2,756-133 2,136 1,811 986 1,055 229 523 234 209 271 227 387 452 87 39 112 105 8,905 7,395 16,215 1989 1990 1991 1992 3,000 3,206 3,407 3,821 196 220 242 257 1,793 1,971 1,616 1,896 1,071 906 924 741 605 560 626 821 193 195 223 169 180 208 235 229 463 488 398 546 42 47 129 224 144 220 235 ' 303 9,289 9,348 9,947 2,124 578 609 16,976 17,369 18,560 11,740 CASUALTY TOTAL 5,986 7,395 22,201 6,012 6,516 6,501 13,354 22,988 23,885 25,061-25,094

!ROSCOMMON COUNTY HOSPITAL General Hospital Care OUT PATIENT WAITING LIST at 31st DECEMBER 1992 CATEGORY NUMBER LONGEST WAITING TIME GENERAL SURGERY 164 AUGUST, 1992 UROLOGY 31 FEBRUARY, 1992 DERMATOLOGY 111 26th JANUARY, 1989 PAEDIATRICS - - ORTHOPAEDICS 320 DECEMBER, 1990 E.N.T. 148 MAY, 1992 VARICOSE VEINS 10 NOVEMBER, 1992 MEDICAL 82 AUGUST, 1992 IN PATIENT WAITING LIST AT 31st DECEMBER 1992 CATEGORY NUMBER WAITING LONGEST TIME MEDICAL SURGICAL 12 3 MONTHS 73

General Hospital Care!ROSCOMMON COUNTY HOSPITAL OPERATIONS 1992 INTER- THEATRES MAJOR MINOR MEDIATE TOTAL GENERAL 192 738 240 1170 DENTAL - 100-100 TOTAL 192 838 240 1270 PHYSIOTHERAPY DEPARTMENT CATEGORY 1989 1990 1991 1992 OUT- PATIEN PATIENTS 720 711 542 606 GENERAL UNITS 2189 2284 10406 11199 IN- PATIENT PATIENTS 479 482 419 487 UNITS 1580 1601 3800 3997 TOTAL PATIENTS 1199 1193 961 1093 UNITS 3769 3885 14206 15196 *IN 1991 THE METHOD OF CALCULATION OF UNITS WAS REVISED 74

General Hospital Care ROSCOMMON COUNTY HOSPITAL X-RAY DEPARTMENT CATEGORY NUMBER OF NUMBER' OF PATIENTS PATIENTS 1991 1992 MAIN X- RAY 8,455 9180 ULTRASOUND 304 259 SPECIAL PROCEDURE 1,123 1,118 TOTAL 9,882 10,557 TOTAL NUMBER OF EXAMINATIONS 14,698 15718 75

General Hospital Care /COUNTY HOSPITAL ROSCOMMON DIETETICS DEPARTMENT 1990 1991 1992 IN- PATIENT 342 192 298 OUT- PATIENT 223 465 TOTAL 342.41 5 763 BIRTHS YEAR NO. OF BIRTHS ROSCOMMON W.H.B. CO. HOSP. 1988 3 6,247 1989 2 5,694 1990 3 5,932 1991 0 5,809 1992 0 5,755 76

General Hospital Care COUNTY HOSPITAL ROSCOMMON MEDICAL LABORATORIES TESTS -J -..J 1989 1990 1991 1992 HAEMATOLOGY AND BLOOD TRANSFUSION 9,972 10,185 10,833 12782 BACTERIOLOGY 2,486 2,490 2,174 2367 BIOCHEMISTRY 27,043 48,698 69,016 90460 TOTAL 39,501 61,373 82,023 105,609 ---- - ----------- -- -- ----------

GENERAL HOSPITAL CARE ROSCOMMON COUNTY HOSPITAL...,J 00 SPECIAL CARE BEDS 1992 CATEGORY BEDS MAXIMUM BED DAYS ACTUAL DISCHARGES % AVERAGE BED DAYS OCCUPANCY BED STAY CORONARY CARE 4 1464 1372 320 93.72 /o 4.29 -- -- -

DISTRICT HOSPITALS. 79

SWINFORD DISTRICT IIOSPITAL Expenditure at Swinford District Hospital amounted to 0.877m. Pay accounted for 85.1% of totaj expenditure. Income collected by the Hospital amounted to 90,000. FINANCIAL SUMMARY ACTUAL BUDGET %VARIANCE CATEGORY '000 '000 PAY 746 750 0.53% NON-PAY 131 129 1.56% GROSS 877 879 0.23% INCOME 90 83 8.43% NET 787 796 1.13 % 80

BALLINA DISTRICT HOSPITAL Expenditure at Ballina District Hospital amounted to 1.134m. Pay accounted for 82.54 of total expenditure. Income collected by the Hospital amounted to 86,000. FINANCIAL SUMMARY. CATEGORY ACTUAL BUDGET % VARIANCE '000 '000 PAY 936 944 0.85% NON-PAY 198 160 23.75 % GROSS I, 134 1, 104 2.72 % INCOME 86 80 7.5 % NET 1,048 1,024 2.34 % 81

BELMULLET DISTRICT HOSPITAL Expenditure at Bel mullet District Hospital amounted to 0.848m. Pay accounted for 79.13% of total expenditure. Income collected by the Hospital amounted to 36,000. FINANCIAL SUMMARY. CATEGORY ACTUAL BUDGET % VARIANCE '000 '000 PAY 671 682 1.61 % NON-PAY 177 157 12.74% GROSS 848 839 1.07% INCOME 36 30 20.0% NET 812 809 0.04% 82

CLIFDEN DISTRICT HOSPITAL Expenditure at Clifden District Hospital amounted to 0.386m. Pay amounted to 85.49% of total expenditure. Income collected by the Hospital amounted to 55,000. FINANCIAL SUMMARY. CATEGORY ACTUAL BUDGET % VARIAt1CE '000 '000 PAY 330 325 1.54% NON-PAY 56 44 27.27 % GROSS 386 369 4.6 % INCOME 55 61 9.84 % NEIT 331 308 7.47 % 83

]!GENERAL HOSPITAL CARE u!district HOSPITALS I ACTIVITY 1992 00 ~ I HOSPITAL IBED COMPLEMENf I AVAILABLE BED DAYS BED DAYS USED PUBLIC NON TOTAL PUBLIC NON TOTAL PUBLIC NON PUBLIC PUBLIC PUBLIC I BALLINA I 55 5 60 20130 1830 21960 20416 14 BELM!JLLET I 4 1 I 6 1 471 150061 2 196 I 11202 I 13682 I 9 SWINFORD I 40 I Ol 40 I 14640 I - I 14640 I 12760 CLIFDEN I 28 I 21 30 I 10220 I 730 I 10950 I 8510

CAPITAL.ALLOCATION lgg~. Backlog of Maintenance 150,000 (All Hospitals) Replacement of Anaesthetic Equipment - 250,000 University College Hospital, Galway. Replacement of Mammography Facility, 65,000 University College Hospital, Galway. Replacement of Urgent Medical 80,000 Equipment, University College Hospital, Galway. TOTAL: 545,000 85