Terry Leyden (Fianna Fail)

It plays a role in regard to Roscommon because it is one of the factors involved in the future of smaller hospitals.

I welcome the Bill which we will support. On the point about Irish qualified doctors, Senator Crown has adequately pointed out the position from his experience but in the current crisis it would not be possible to put in place a requirement that they would spend at least some time here after they are qualified as the cost of qualification is very high.

I have another question on which the Minister of State and the officials might reply. There is a great emphasis on recruiting in India and Pakistan but Cuba, for instance, has tremendous medical services. Is there any recruitment of non-consultant hospital doctors taking place in countries other than India and Pakistan? Why is the concentration on those countries?

I concur with what Senator Crown said in his contribution, which was excellent and highlighted the variety of knowledge in this House. Future Governments should bear in mind that there is the potential of appointing Senators from this House as Ministers. It would have been a major move forward if somebody of Professor Crown's knowledge was made Minister for Health in this Administration. I hope he will be a Minister in some future Administration.

On the Bill, it is important to record in the Official Report of these Houses the absolute betrayal and misleading of the electorate in Roscommon prior to the general election of 2011. The Fine Gael commitment on Roscommon Hospital states:

Dear People of Roscommon,

Further to the recent public meeting addresses by Frank Feighan TD and Denis Naughten TD, I wish to confirm that Fine Gael has a very different view of the role to be played by local hospitals, like Roscommon County Hospital, than the Government, which seems intent on downgrading them through the implementation of the Hanly Report.

Yes, local hospitals must be safe, and patient safety must be our first priority. But on taking office we will immediately suspend the reconfiguration process.

While international research suggests that complex trauma and complex surgery is not appropriate in a local hospital setting, like Roscommon, nobody is looking for such a service at Roscommon County Hospital.

However, there is also a very strong argument that Roscommon & other local hospitals have the ability to deal with complex medical conditions and less complex surgery.

Safety is not simply about surgical competence, but is also about timely access. Time to treatment, particularly in remote geographical locations, is absolutely crucial.

This is key to allowing Roscommon Hospital, which does not have complex surgery, to retain the skillset required to incubate and ventilate and to have the ability to undertake less complex surgical procedures.

The big problem with our health service is that too much of the key decision-making is done at the centre. Under our plans, it would be up to each hospital to work out the best way for it to respond to a system where they are paid for what they actually do.

We will establish Roscommon County Hospital as a stand alone hospital. It will continue to be owned by the State, but will be governed and managed by a Local Hospital Board, made up of staff, management, community & patient representatives.

This will allow them to better meet the needs of our community and patients and to manage and operate the hospital to its best to meet the needs of the community it serves.

Therefore, instead of the HSE determining the future of Roscommon Hospital, its future will be in local hands.

We will reform the financing structure to ensure that Roscommon has significantly greater responsibility for financial and manpower management.It will be paid for every patient it treats, thereby allowing the hospital to develop new services which will bring in additional income, additional staff and new specialties.

These structures will provide for the development of telemedicine, which allows tests & scans to be performed locally but be read by the specialist consultant in Dublin or Galway.

I would like to confirm that Fine Gael undertakes, in accordance with the Fine Gael Policy on Local Hospitals, to retain the Emergency, Surgical, Medical and other health services at Roscommon Hospital which are present on the formation of the 31st Dáil.

Furthermore, in the event of the A&E being downgraded, we are committed to reinstating a 24/7 service, where feasible.

To this end, we are intent on addressing the current threats to the 24/7 A&E service, namely the Non-Consultant Hospital Doctors and theatre nursing staffing issues, by introducing a new structure for NCHD training which will recognise the time spent in RCH and change the legislation to facilitate National Treatment Purchase work to take place at RCH, which will enable the employment of the required theatre nurses.

To again reiterate, our core principle regarding health is that the patient be safely treated as close as possible to their home and Roscommon County Hospital is an integral part of this objective.

Yours sincerely,

Dr. James Reilly

Fine Gael Spokesperson on Health

That pledge has been broken.

In that regard, I was in a tough position in the 1980s when I stood in that area and supported and ensured the retention of Roscommon County Hospital as a general hospital. I did not walk off the pitch then. I commend whatever decisions people make politically but it is not in the best interests of Roscommon County Hospital that we would lose a Government TD and the Chairman of the Joint Committee on Health and Children. Those were crucial positions that could be of benefit to Roscommon County Hospital. I regret that a member of the Government has resigned on this issue. We have lost the influence he had, and I hope he retains his position as Chairman of the Joint Committee on Health and Children and that he will be in a position to try to assist the work in regard to Roscommon County Hospital. If I had taken the easy option in 1987 and walked off the pitch on this issue, Roscommon County Hospital would now be a district hospital but I would be a Member of Dáil Éireann.