The Galway Workhouse
The Galway Workhouse on Newcastle Road, on a site in front of and partly occupied by the present University Hospital Galway, included an infirmary intended for sick paupers but which, in practice, became the hospital for the city's poor. The layout conformed with the standardised plan laid down by Wilkinson. At the roadside there was a large cut-stone Entrance Lodge, which contained a Boardroom, clerk’s office, porters’ room, waiting areas and probationary wards for paupers, males on one side, females on the other. Between the Entrance Lodge and the main block were two separate yards, one for boys and one for girls.
The main block was in the form of an H. The front and larger limb of the H, parallel to the road, was of three storeys with an attic floor overhead. There was a Master’s House, Matron’s Quarters and children’s rooms in the centre, with dormitories for the paupers in each wing. The old and inform were accommodated on the ground floor with dormitories for active adults in the upper storeys. To the rear of each wing were kitchen, wash-house and privies. The smaller parallel wing of two storeys to the rear contained the infirmary, lying-in ward and wards for idiots and lunatics. The connecting link of only one storey housed the chapel and dining room. There were recreational yards on each side of the connecting link, for men and boys on one side and for women and girls on the other. There were rooms specified for boys on the male side and for girls on the female side. The grounds, about 8 acres in extent, were completely enclosed by high stone walls.
Only the hospital section was supplied with beds. Along the walls of dormitories, and raised about 12 inches above the floor, were wooden platforms on which the paupers slept on straw palliases. Blankets were provided and the inmates were required to wear workhouse dress, which consisted of rough gray frieze suits for the men and calico gowns and petticoats for the women. There were no closets in the dormitories and the inmates had to make do with night buckets, which frequently overflowed and soiled the floors.
On 2nd March, 1842, the Workhouse opened for the reception of paupers and, on 16th March, Dr. Browne, the Medical Officer, reported that the first pauper, admitted on 3rd March, had died from old age and destitution. The number of inmates gradually increased to 313, including 13 fever cases, by May 1845 and, from the following year, the impact of the Famine on the number of admissions was dramatically evident.
The Workhouse was originally intended to hold up to 800 destitute persons but this was subsequently increased to over 1,000. There was strict segregation of the sexes in all parts of the institution, even though that meant breaking up families. All members of a family had to be admitted and, if by any chance the father absconded, the mother and children were likely to be thrown out of the workhouse.
Although the regulations forbade the acceptance of children under 3 years of age unaccompanied by a parent, foundlings and young orphans were usually accepted and placed in the care of female pauper inmates. The registration of the religion of such children was a persistent cause of contention. The Law required that they should be baptised in the Church of Ireland, unless they had been baptised outside the workhouse before admission. Father Peter Daly, Catholic Chaplain, was not worried about legal niceties and frequently baptised foundlings admitted to the Workhouse.
In December, 1858, one of the Guardians reported him to the Commissioners, citing a case in which Fr. Daly baptised a foundling after its admission and registered it as a Catholic. The Commissioners directed that the child should be registered as a Protestant and the controversy became so heated and vituperative that Fr. Daly was forced to withdraw from the chaplaincy, despite his having the support of the majority of the Guardians.
As the name of the institution implies, the inmates, who were fit to do so, were required to work, the able-bodied men worked in the fields or at tasks such as breaking stones, the women did housework, helped in the kitchen or looked after the orphan children or the patients in the infirmary. Even the old and infirm were required to mend clothes, pick oakum or card and spin wool. Girls were supposed to be trained for domestic service but conditions within the workhouse were far different from any they might find in the homes in which they might be placed. A school master and mistress were employed but there were many criticisms of the standard of teaching.
The regime in the workhouses was deliberately harsh and intended to discourage people from seeking admission. The diet was not good and unvaried.
The Famine began to have an impact on the Galway Workhouse from mid 1846 the number of inmates progressively increased from 460 in June 1846 to 1,302 in November 1847. In December 1847 it was reported that 313 paupers were seeking admission but the Workhouse was already overcrowded. Captain Hilliard, then Assistant Poor Law Commissioner, took over a store in Newtownsmyth to accommodate between 300 and 400 children, though he appreciated that it was far from suitable. There were also auxiliary workhouses at Merchant’s Road and St. Helen’s Street, Galway and Barna. Auxilliay Workhouses for children were established at Parkavera and Dangan in Galway and the Fever Hospital in Moycullen was converted into an Auxiliary Workhouse especially for children.
There were Workhouses in the following locations Ballinasloe, Clifden, Galway, Glenamaddy, Gort, Loughrea, Mountbellew, Oughterard, Portumna and Tuam.
While the Workhouses offered shelter to the destitute and homeless and undoubtedly saved many from death by starvation and exposure, it must be admitted that they contributed to the death toll from epidemic diseases such as fever, dysentery and cholera.
‘Galway: A Medico-Social History’ by Dr. James P Murray
Permission to use granted by Publishers
The County Infirmary, Prospect Hill, Galway
The County Infirmary, now the site of the County Buildings, was opened in June 1802. In accordance with the Act of 1765, "for erecting and establishing Public Infirmaries and Hospitals in this Kingdom" a meeting of the Corporation of Galway was held on 17th April, 1766, when it was ordered in council, "that a committee consisting of the principal gentlemen of the town, be, and are accordingly appointed to inquire and find out a proper place within the county of the town of Galway for erecting a public infirmary or hospital for the reception of the poor, sick and disabled persons."
This Committee having selected the site on Prospect Hill, the Governors of the Erasmus Smith School granted two acres of ground gratis for ever, on which it was erected. Previous to the erection of the County Infirmary a small building at Woodquay was from about 1688 used as an infirmary. Having been in use for some years it was removed to a house in Abbeygate Street where it continued in use until 1802.
Hardiman quotes: "The following extract from the reports of the celebrated Howard, who visited this institution in the year 1788 will give the reader an idea of this superior accommodation: 'The County Infirmary at Galway', says that indefatigable promoter of universal benevolence, 'is an old house with two rooms on a floor. Those on the second floor are for patients, in one of which there were three men, and in the other old bedsteads, without bedding, all very dirty; allowance to each three pints of new milk and two pennyworth of bread. A very large house, not finished, is said to be intended for an infirmary.'
Robert Ffrench of Monivea Castle was the Treasurer, and Dr. James Veitch was the Superintendent of the new infirmary. Dr. Veitch was a native of Scotland and was the first Catholic appointed to such a position in Ireland.
County Infirmary, Prospect Hill.
An original drawing of the County Infirmary done in 1820. This drawing is part of the Hardiman collection.
Rules and Regulations
The rules and regulations, "to be strictly adhered to", make interesting reading:
- No person can be admitted as (an intern) patient of the hospital, who does not produce a letter of recommendation from a governor or governess of the infirmary.
- The hours of general attendance at the hospital are from 11 to 12 o'clock every day. All out-patients to attend at those hours. No out-patient to proceed farther than the hall of the hospital, without orders from the surgeon.
- The days of admission (only) on Mondays and Thursdays, except in cases of accident.
- The patient, upon his or her appearance in the hall of the hospital, at the hours and days above mentioned, and producing of recommendation, will be immediately inserted upon the books of the hospital.
- Each patient, after being inserted on the books, to be taken to the bathroom to be well washed and cleaned by the person appointed for that purpose, and the barber directed to attend; afterwards to be taken to the vesting room, and dressed in the hospital clothing, and directed to the ward and bed appointed by the surgeon; and on his or her dismissal their own clothing to be given them, and the hospital clothing delivered up to the proper person appointed, to be well washed and fumigated, and put upon the proper number in the vesting room.
- The nurses to count over the bed clothes and clothing, etc., to the patient; and are to be responsible that he or she leaves every thing in the same state, allowing for necessary tear and wear; and no patient (except allowed by the surgeon) to visit the other wards; if found in any but their own, to be immediately dismissed the hospital.
- No patient to be allowed to spit or dirty the walls or floor of the house, as spitting boxes and bed pots are provided for the purpose; and no smoking of pipes allowed on any account in the wards.
- Immediately on the bell ringing, every patient that is able (or who is ordered by the surgeon) are to attend in the dressing room.
- Any patient who acts impertinent to the housekeeper or nurses, to be immediately dismissed, and to be reported to the governor or governess who recommended him or her.
- All medicine to be given by the surgeon or nurses; and they are immediately to report, should they refuse either medicine or diet as directed.
- The wards of the hospital to be washed and fumigated twice a week, and oftener if necessary.
- The housekeeper to visit the wards twice a day, and to report any deviation from the above rules, as she is responsible for the cleanliness of the whole hospital; and no filth or excrement of any kind to remain one minute in the patients ward.
- The nurses or housekeepers are to see the patients take their meals, according to the dietary annexed; and the patients to report any neglect or deficiency in their diet; first to the nurses, then to the housekeeper, and if immediate redress is not granted, to the surgeon.
- The rules and regulations to be read to each patient on admission to the house; and their name, age, and disease, posted up on the head of their bed.
By Samuel J. Maguire
The old Infirmary, on Prospect Hill, closed in December 1924. There was an orderly transfer of services from the Infirmary to the site of the new Central Hospital on Newcastle Road (site of the old Workhouse).
1922 – 1956
The transfer in 1922 of the Galway Hospital (Infirmary) on Prospect Hill to the old Workhouse site on Newcastle Road was made in an orderly fashion. The general medical and tuberculosis patients moved first and the surgical services retained on Prospect Hill until last. The old Infirmary closed in December 1924.
The main block of the Workhouse was virtually re-constructed with new roof and floors; the large dormitory, on each side of the three floors, was divided into a long ward and two side wards with kitchen, bathroom and lavatories, making a total of six large wards and 12 small wards on three floors. The division into male and female sides was continued, with males on the north side and females on the south. Surgical cases were nursed on the top floor with the operating suite in the middle, consisting of two theatres with a complete glass roof, anaesthetic and sterilising rooms. A small ward on each side of the middle floor was designated for pulmonary TB cases. A small casualty department, a combined X ray and physiotherapy department, offices and staff room were provided on the ground floor. Accommodation was allocated for resident medical staff on the first floor and for students in the attic. A lift was installed.
Fortunately, about £4,000 was available from the Annual Bazaar Fund to purchase equipment and furniture, without the delays inevitable if formal County Council approval was required, the hospitals were under the remit of the County Council prior to the setting up of the Health Board in 1970. For instance, at a Medical Staff meeting on 29th September, 1924, it was decided that the X ray equipment in the Infirmary was not worth transferring and Drs. Conor O’Malley and R. Bodkin Mahon were authorised to purchase a complete new X ray unit at not more than £700. The unit was purchased and installed on the ground floor in January 1925 at the total cost of £794, paid for out of the Bazaar Fund. This Electrotherapeutic Department was described as containing a large X ray Apparatus, Bergonie Chair, Diathermy Outfit and Pantostat Lamp, all under the supervision of a Radiologist and Masseuse.
Three single storey buildings between the main block and the gate lodge were refurbished and equipped as Pathology Laboratories, again mainly out of the Bazaar Fund, to provide a broad range of histological, biochemical and bacteriological investigations. One of the buildings was used as an animal house for guinea pigs and rabbits, which were used extensively in those days to confirm the diagnosis of tuberculosis and other infectious diseases. A mortuary was provided at the rear between the main block and the Fever Hospital.
The Hospital’s Committee and Medical Staff decided that the two story Dispensary Building in the Workhouse grounds facing Newcastle Road should be converted to a Maternity Hospital with 18 beds, and operating theatre and labour ward. This Maternity Hospital opened in 1924 and continued as such until the new maternity wing of the Regional Hospital opened in 1942. A wooden and galvanised building was constructed nearby facing Newcastle Road to serve as the Dispensary for the city and continued as such until the new County Clinic in Shantalla was opened in 1955. The Fever Hospital, which was purpose-built in 1909/11, required no alteration; it had suitable accommodation for 72 patients with acute infectious diseases and was divided into 6 male and 6 female wards with isolation facilities for some individual cases.
By 1931, the capacity of the Central Hospital was 221 acute beds in the main block, 38 long-stay beds in the rear extension, 18 in the Maternity and 72 in the Fever Hospital, a total of 349 beds. In the year ending 31st march,1931, there were 4,248 intern patients treated in the Central Hospital, as well as 828 extern patients treated for minor accidents and ailments. In the same year, 4,300 patients attended the City Dispensary located in the hospital grounds and over 3,000 specimens were examined in the Pathology Department. There was a progressive increase in the number of patients having diagnostic X rays, from 381 in 1925 to 1,007 in 1931.
The medical staff of the new Central Hospital consisted of R. Bodkin Mahon and Michael O’Malley, Surgeons, Seaghan McEnri, Ophthalmologist, Conor O’Malley, ENT Surgeon and Radiologist, Michael Davitt, Physician, Thomas Walsh, Pathologist and Richard Kinkead, Obstetrician/Gynaecologist with Dennis Morris as his assistant. William Brereton, who was Surgeon to the Infirmary, died in 1924 before surgery was transferred and Nicholas W. Colohan, who had a formal appointment as Surgeon to the Infirmary, did not become active in the new hospital because of poor health. The senior medical staff proved a broad range of expertise and the Central Hospital was able to function as a regional referral centre for adjoining counties, where hospital services were particularly poor at that time. There were two resident medical officers initially, later increased to 4 by 1942 and in 1946 the junior staff was increased to 6 RMOs, reflecting the increased workload in the hospital, especially in the new Maternity Department. Residential accommodation was provided for 4 medical students initially, later increased to 6 when the old Nurses’ Home became available in 1938.
Conor O’Malley, although primarily an Ophthalmic and ENT Surgeon, acted as Radiologist for the installation of the X ray equipment in January 1925. He was formally appointed Radiologist through the Local Appointments Commission (LAC) in 1928, the first such appointment to a local authority in Ireland. As well as diagnosis, Conor O’Malley also carried out superficial radiotherapy and radon implantations, with the needles supplied by the Dublin Radium Institute. In 1925, he treated 114 patients with X ray for warts, rodent ulcers, epitheliomas, enlarged glands, goitre and other conditions; he was treating malignant tumours of the mouth and naso-pharynx with radon implantations from the mid 1920s. When Seaghain McEnri died in 1930, the post of Ophthalmologist and Otologist to the Central Hospital was advertised by the Local Appointments Commission and Conor O’Malley was appointed. He also carried out all the Eye and ENT Surgery for the Schools’ Medical Service and, in 1939, stated an Orthoptic Clinic at the Central, the first such clinic in Ireland, staffed by Nurse Mary O’Shaughnessy who had been specially trained in London.
Dr. Sarah (Sal) O’Malley (nee Joyce), wife of Conor O’Malley, was formally appointed part-time Anaesthetist through the Local Appointments Commission (L.A.C.) in 1929, though she had been acting as Anaesthetist for many years before that. Dr. Mai Costello also served as Anaesthetist on a sessional basis.
Although Bodkin Mahon retired as Professor of Medicine in 1932, he continued as Senior Surgeon in the hospital until May 1941 and afterwards as Honorary Consultant Dermatologist until his death in 1943. Mahon was quite elderly and Micheal O’Malley carried virtually all the surgical load until the return of Neil McDermott and later ‘Gerry’ Little.
Professor Richard Kinkead died in 1928 and was succeeded as Obstetrician by Dennis Morris, who immediately started to campaign for a new maternity hospital which was obviously badly needed. Dr. Michael Davitt, son of the founder of the Land League, died suddenly in December, 1928. He had come as Physician to the Central Hospital in July, 1922 and had played an active and constructive part in building up the services in the new and expanding hospital. As well as being a fine physician, he took an active part in social and political life in Galway. He was succeeded by Walter (‘Wat’) Fallon.
Regional Hospital Galway
At the end of the war, planning for completion of the Regional Hospital complex was renewed. The development plans which had been sanctioned in 1941 were revised in the light of altered requirements. The proposed facilities at Merlin Park Regional Sanatorium meant that the Chest Block would not be required, but there was an obvious need for a large Paediatric Department and this was planned as a separate unit.
The main hospital block was to be five stories, not three as in the 1941 plan and the architectural plan followed the model of the large hospitals in Sweden which were then recognised as the most advanced in Europe. The new hospital complex was planned to have 594 beds, including 38 beds in the existing Maternity Section and 63 beds in the Fever Hospital. The Hospital Trust Fund made grants totalling £2,640,683 for the construction of the new hospital, including money spent on site preparation during the war years.
The name of the hospital was changed to University College Hospital in June, 1989, to reflect its close association with University College Galway (UCG).
The foundation stone of the new Regional Hospital was laid by the Minister of Health, Dr. Noel Browne, in 1949. The main block of the new hospital was located to the rear of the old Central and involved the demolition of the rear wing of the old hospital. The long-stay patients from this rear section were accommodated in temporary huts erected at the front of the Central. This arrangement allowed the Central to function, more or less, normally during the construction.
The first patients were admitted to the Paediatric section, which had accommodation for 50 infants and children, in mid 1955. The patients in the Central Hospital were transferred into the Main Block on 3rd April, 1956, a logistical exercise greatly helped by the local unit of the Knights of Malta Ambulance Corps. Soon afterwards the Eye and ENT patients from the old two storey building facing Newcastle Road were also transferred into the Main Block.
But hospital overcrowding was not to disappear with the old Central, much to the dismay and annoyance of the Minister for Health, as indicated in correspondence between the Minister’s Secretary and the Honorary Secretary of the Medical Staff in the Connacht Tribune newspaper during June, 1958. The Department of Health had insisted on the orthopaedic cases being transferred from the temporary St. Joseph’s Unit into the main block of the new Regional Hospital, so reducing the accommodation available for acute medical and surgical patients. Consequently, over 100 additional beds had to be proved over and above the number for which the hospital was designed. This reduced the floor space per bed in the acute general wards to an unacceptably low level, - worse than in the old Workhouse, according to the Medical Staff! Contributing to the problem were the chronic long-stay cases which had to be kept in the Regional because there was no other accommodation available for them. At the same time, Woodlands was vacant and the Medical Staff and local representatives were urging that it should be made available for chronic and convalescent cases. The transfer of the bulk of the Orthopaedic Service to Merlin Park partly relieved the situation and the accommodation for additional geriatric cases in Merlin Park and other homes after 1960 also helped.
The beds in the Regional were reduced from over 700 to a more acceptable level of 625 by 1971. But pressure on beds and out-patient clinics and long waiting lists remain a feature of the hospital to this day though, of course, it is far from unique in Ireland in this respect.
Merlin Park Regional Hospital
The planning of major regional sanatoria at Dublin, Waterford, Cork and Galway had commenced in 1945, before streptomycin and the other anti-tubercular drugs could have been anticipated. The Tuberculosis (Establishment of Sanatoria) Act in 1945 enabled the Government to acquire compulsorily any property suitable for construction of a sanatorium. But there was no question of compulsion being necessary in the acquisition of the 80 acre estate at Merlin Park: Mr. and Mrs. Wyndham-Waithman were conscious of the terrible problem of tuberculosis at that time and felt it their civic duty to cooperate fully in transferring the property to the Government. Consequently there was no administrative delay in proceeding with the project, funded by a grant of £1,955,407 from the Sweepstakes Fund.
The foundation stone for the Western Regional Sanatorium (as it was then called) was laid by the Minister for Heath, Dr. Noel Browne, in 1948 and, in view of the urgency of the tuberculosis patients from Woodlands in July, 1952. The transfer was greatly helped by the local unit of the Knights of Malta Ambulance Corps. By March, 1953, six ward blocks were occupied by adult respiratory TB cases, and Woodlands was converted for the treatment of tubercular orthopaedic cases from the Western region. Though it was evident by now that the new drugs had dramatically shortened the duration of in patient treatment for all forms of tuberculosis and there were already empty beds in the ward blocks completed, administrative inertia permitted the construction to continue. On completion in 1954, a total of 550 beds were available, later increased to 636 by 1971. Dr. J.V. Cussen, who had been Resident Medical Superintendent of the Chest Hospital in Castlerea, and Drs. Harry Hitchcock and Maureen Keyes, who had been Chest Physicians there, transferred to corresponding positions at Merlin Park. They were not replaced when they retired, because of the changed pattern of respiratory diseases.
Fortunately the layout in 40 bed units with a central hospital block facilitated its subsequent adaptation for other purposes such as Cardio-Thoracic Surgery and Orthopaedics. In 1961 accommodation was proved for 120 geriatric patients on transfer from St. Brendan’s Home in Loughrea, later increased to 290 by 1971. In later years 60 beds were provided for non-tubercular respiratory conditions and by 1970 over 800 such patients were being treated in the Respiratory Unit each year. At the same time the number of TB patients showed a progressive reduction until, by 1971, there were only 105 beds being utilised for TB patients and the number treated that year was down to 246.
A small Renal Dialysis Centre was established in Merlin Park in 1968 under the supervision of Dr. Des O’Moore. It operated as a sub-centre of the National Renal Service in Jervis Street Hospital in Dublin with one machine supplied from Jervis Street and a second purchased by Galway County Council.
University College Hospital
An acute Psychiatric Unit with 43 beds was opened in May 1977 to serve the western part of County Galway in collaboration with St. Brigid’s Hospital in Ballinasloe. It serves as the headquarters for Community based Psychiatric Services and operates in close co-operation with the long term rehabilitation and training facilities for psychiatric patients in Merlin Park and elsewhere. There is close co-operation with the Child and Adolescent Psychiatric Service based at St. Anne’s Children’s Centre, which was opened on Taylor’s Hill in 1975 and provides treatment and education for disturbed children up to 16 years of age.
A major extension of the Maternity Department was opened in 1983, which provided, inter alia, a larger better equipped Special Care Babies Unit and improved Operating Theatre, Labour Ward and Antenatal facilities. The births in the Hospital increased from 1,940 in 1971 to 3,133 in 1982, but, in line with the national trend, decreased to 2,426 in 1991. Two additional Consultant Obstetrician/Gynaecologists were appointed in 1972 and 1981.
A Cardiac Investigational Unit was opened in the Hospital in 1987, funded jointly by the Western Health Board and the West of Ireland Cardiology Foundation. The Foundation (CROí), which is a voluntary organisation, was set up in 1985 and is completely dependent on voluntary subscriptions and fund raising activities. Its aims are to educate the public about heart disease, promote research, to provide cardiac investigational facilities locally and, ultimately, to help establish a Cardiac Surgical Unit in Galway. The response to its fund-raising activities has been phenomenal. Without its support the Cardiac Investigational Unit would not have been provided and already over 2,000 patients, who otherwise would have been referred to Dublin have had their investigations carried out in Galway. The Foundation also supports important research work in the Cardiology Department.
Specialisation in Medicine, begun in the last 1960s, has further developed with the appointment of consultants in Neurology and Dermatology and additional physicians with special interests in Endocrinology, Gastroenterology and Respiratory Medicine. A Pulmonary Function Laboratory was commissioned in 1989.
Since 1971, two additional consultant posts in ENT and one in Ophthalmic Surgery have been filled and new surgeons have been appointed in Urology, Plastic Surgery, Accident & Emergency and Vascular Surgery, all of which increases the pressure on beds and operating facilities. Indeed the establishment of a new specialised unit usually opens a ‘Pandora’s Box’ of need, not previously perceived, as with the Plastic Surgical Unit which is already overwhelmed by the workload required. In October,1990, a new Day Surgical Unit was opened, with 18 beds and its own theatre and endoscopy suite, which helped to relieved pressure on existing facilities. In its first full year in operation, 2,075 patients were treated in the unit.
The Department of Anaesthesia and Intensive Care has been expanded and re-organised in recent years. The increasing specialisation in Surgery, the commissioning of a Day Surgical Unit and the provision of an epidural service for maternity patients have all contributed to the increased workload on the Anaesthesia Department. Additional appointments have been made at all levels, bringing the staff complement at UCH to 6 consultant and 13 trainee anaesthetists. A Recovery/Intensive Care Unit was opened in January 1972 and this was replaced in March 1978 by a larger and better equipped ICU of 7 beds, which accepts a broad range of patients requiring intensive medical and nursing care. Admissions to this Unit have averaged over 550 per annum.
The last Peter O’Beirn was especially interested in underwater medicine and was in charge of the Hyperbaric Oxygen Unit since 1976. The Unit is used, not just for diving accidents, but also for patients having badly traumatised limbs, multiple sclerosis and a variety of other medical conditions. The 2-man Hyperbaric Chamber was purchased by the W.H.B. in 1975 on the recommendation of Prof. Kennedy and Dr. Padraic Keane; it is the only such chamber in Ireland and accepts patients from all parts of the country. Members of the Galway Sub-acqu Club are available to help care for patients being treated in the chamber.
The annual expenditure on University College Hospital has increased from £1,694,427 in 1971 to £32,163,000 in 1991, which, allowing for inflation, represents just over a three-fold increase in real money terms. But the work load and pressure on the hospital has also increased: in 1971 a total of 16,991 in-patients were treated with an average duration of stay of 12.10 days and in 1991 the in-patients increased to 23,132 with an average stay of only 7.27 days; the out-patients increased from 56,584 in 1971 to 108,994 in 1991. All departments showed an increased workload, despite a reduction in the beds available and, in recent years, temporary ward closures due to financial constraints. The overall bed complement was reduced from 625 in 1971 to 504 in 1991, despite the establishment of new departments, such as Psychiatry and Plastic Surgery and the transfer of Urology and Respiratory Medicine from Merlin Park. The Consultant Medical Staff of the Hospital increased from 23 in 1971 to 51 in 1991, but is still not adequate to cope with the expanding needs and increasing complexity of modern practice. The Non-Consultant Medical Staff numbered 128 in 1991.
The doubling of attendances at the Out-patient Departments resulted in unsatisfactory conditions for patients, but the completion of a new Out-patient Department and Admissions Unit in early 1992 relieved the congestion, and provided more appropriate conditions to cope with the workload. Peripheral Clinics at many centres in the Western Health Board area are served by consultants from UCH, and this helps to relieve the pressure on the hospital clinics, but there are still long waiting lists for non-urgent cases.
There is unrelenting pressure on the acute beds, as evidenced by an overall average occupancy approaching 100%. Indeed some Departments have occupancy rates considerably above 100% and can cope only by overflowing into other departments: Cardiology had a bed occupancy rate of 195% in 1991 and Clinical Haematology a rate of 210%; the Coronary Care Unit has a bed occupancy averaging 110%, though the average bed stay was reduced from 4.17 days in 1978 to 3.4 by 1985. Average bed occupancy in General Surgery, Urology and ENT also exceeded 100%, despite the commissioning of a Day Surgical Unit. Consequently overcrowding is a problem and long waiting lists for non-urgent cases are a harsh reality, ultimately due to inadequate funding of the Health Services, as in most parts of the country.
Merlin Park Regional Hospital
In contrast with University College Hospital, there has been reduced pressure on beds in Merlin Park Regional Hospital for a number of reasons, including the transfer of some acute department to UCH, the discontinuance of Thoracic Surgery in 1985 and the changing pattern of disease in the patients being accommodated in Merlin Park. The bed complement has been reduced from 636 in 1971 to 319 in 1991 but, in the same period, the number of in-patients treated each year has increased from 2,262 to 5,281. The increase in the number of in-patients treated has been most marked in Orthopaedics, from 855 in 1971 to 2,954 in 1991, despite a reduction in Orthopaedic beds from 169 to 109 in the same period. Three additional Consultant Orthopaedic Surgeons were appointed between 1972 and 1978. The demand for orthopaedic procedures, such as hip replacements, continues to grow and waiting lists for non-urgent procedures are a matter for concern. This again is a national-wide problem due to lack of funding for adequate staff and facilities. Sadly, Roman Gorczak, who had come in 1977 as a consultant Orthopaedic Surgeon, died suddenly in May 1992.
The appointment of a Consultant Physician, Dr. Brendan Duffy, with a special commitment to Nephrology, in 1973 was a significant development, and the Renal Dialysis Unit has been expanded from 3 to 9 beds. There is also a Home Dialysis Service since 1974, catering for up to 10 patients at a time. There were 1,087 in-patients and 1,205 out-patients treated in the Unit in 1991. The Dialysis Unit is actively supported by the Galway Branch of the Irish Kidney Association. The General Medicine/Rheumatology Unit was transferred from the Regional to Merlin Park in 1975 and has a bed complement of 41. In 1991, there were 1,118 in-patients treated in the Unit, with an average stay of 9 days, and 1,010 out-patients. Pulmonary Tuberculosis no longer needs a special department and is treated by the Department of Respiratory Medicine, which is not based at UCH, but also conducts clinics at Merlin Park and Castlebar. A Geriatric Assessment Unit of 28 beds was set up following the appointment of a Consultant Geriatric Physician in 1975 and long-term geriatric beds have been reduced from 290 in 1971 to 87 in 1991. A medium-stay Psychiatric Unit of 30 beds opened in Merlin Park in 1991.
The cost of running Merlin Park increased from £715,392 in 1971 to £10,310,000 in 1991, a five-fold increase allowing for inflation, but there was a corresponding increase in the workload: the in-patients treated increased from 2,262 to 5,381 and the out-patients from 1,826 to 13,746. The Consultant Medical Staff increased from 7 in 1971 to 10 in 1991. The Non-Consultant Medical Staff was 26 in 1991.
In June 1991 it was decided by the Western Health Board that surplus land at Merlin Park should be sold to partly fund badly needed facilities at University College Hospital, such as extra beds, new operating theatres and diagnostic facilities, upgrading of the intensive care units and replacement of ageing equipment. A similar proposal had been discussed in 1979 by a Project Team, set up to formulate a planning brief for the further development of UCH. The Development Plan was submitted in 1982, but is still awaiting approval from the Department of Health. In May 1991, the Minister for Health proposed that a Working Party, consisting of officer of the Department and of the Health Board, should be set up to consider and advise on the requirements of both Merlin Park and University College Hospitals. The first meeting of the Working Party was on 14th October, 1991.
‘Galway: A Medico-Social History’ by Dr. James P Murray
Permission to use granted by Publishers
The result of the findings of the working party has given us the services and departments that are the Galway University Hospitals
(incorporating University Hospital Galway and Merlin Park University Hospital, Galway)