James Reilly (Dublin North, Fine Gael)

I thank Deputy Patrick O'Donovan for raising this important matter which, I realise, is of particular concern to him and his constituency colleague, Deputy Dan Neville. The Government's key priority in dealing with serious budget pressures on the health services is to minimise the effect on services for patients to the greatest degree possible.

The Mid-Western Regional Orthopaedic Hospital, Croom provides elective orthopaedic services for the mid-west area. The hospital currently has 50 in-patient beds and nine day beds. I acknowledge that in excess of 1,700 inpatients were treated at the hospital last year and almost 3,000 day-case procedures were carried out. This is a hospital we value and it provides good care. Croom hospital currently performs well on waiting time targets for elective surgery and the HSE's intention is to continue to meet the waiting time threshold for access to elective surgery for public patients. I will ensure that waiting time performance in Croom, and in all other hospitals, will be monitored intensively throughout the year and bed capacity adjusted accordingly to address any change in performance.

In common with all agencies, the HSE is facing significant financial pressures. This increases the importance of delivering more within a given level of resources. In this regard, the mid-west hospital group has a requirement to operate within budget and must manage resources accordingly. A budget break-even plan is in place to ensure the group remains within its approved expenditure levels. This plan is based on achieving the overall activity targets set out in the annual service plan and the right balance between emergency and elective activity within the resources available for this year. However, I am not prepared to accept a situation where services are cut back suddenly to meet a spending target, however important it is to keep within budget. Recently, I made it clear that there should be no withdrawal or curtailment of services by the HSE without my first being briefed. In each case I am keen to satisfy myself that any change in provision of service is both appropriate and justifiable. My first priority is to protect services for patients. Accordingly, I have instructed the HSE to give me a comprehensive briefing on all aspects of the issue in Croom hospital before it makes any change to the agreed level of service.

The HSE has assured me that the measures proposed will not affect emergency or orthopaedic trauma activity and will enable savings to be made in staff overtime, agency and non-pay costs for the remainder of the year amounting to €2 million. It has also indicated that 37 inpatient beds and nine day-beds will continue to be available for elective surgery under the proposal. However, there will be no changes until I have been fully briefed about the proposals and their implications for patients.

I assure the House that I envisage Croom orthopaedic hospital as a vital part of the health services infrastructure of the mid west. I am committed to ensuring acute hospital services at national, regional and local level are provided in a clinically appropriate and efficient manner. In particular, I am keen to ensure that as many services as possible can be provided safely in smaller local hospitals, nearer to patients' homes, communities and friends. The recovery from operative procedures is influenced by having the support of one's family and friends near to hand. This is the context in which any proposals on spending and services in Croom orthopaedic hospital will be examined.

In short, there will not be any changes until we have reviewed the implications for patients, waiting lists and for the budget. The Deputies may rest assured that they will have an opportunity to return and make further representations when further deliberation is carried out and a result obtained.

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