Jimmy Harte (Labour) | Oireachtas source

I welcome the Minister. The directive is very relevant for those living in Letterkenny and the north west, including Sligo, Monaghan, Cavan and anywhere along the Border, where people have been dealing with this issue for years. Councillor Martin Farren from Inishowen, who is in the Visitors Gallery, will be very familiar with the difficulties for people who live at the top of Inishowen and have to go to Dublin and Galway for treatment rather than to Altnagelvin and Belfast hospitals. These hospitals have the same services but people cannot access them and they drive past them, using an ambulance to go to Dublin, when, in a perfect world, it would be a 32-county health system. This directive is perhaps a step towards that.

Recently, we all became aware of the impact of flooding in Letterkenny Hospital and the work done in that regard by the HSE. Problems arose when Altnagelvin had to take the overflow of patients, and while these have been addressed, it shows the importance of having a hospital like Altnagelvin on the doorstep of Donegal to alleviate a situation, even if the exact situation may never arise again.

I met one patient recently who had to have a fistula in the arm treated and was sent to the private hospital at Ballykelly in Derry under the treatment purchase scheme. When the patient came home, the fistula was giving problems but the patient was then sent to Dublin because Ballykelly could only do the treatment but not the follow-up. This meant the patient ended up in Beaumont Hospital rather than Ballykelly, so two doctors had to deal with a simple issue. In fact, Ballykelly wanted to take the patient back but it would not be funded for it as the money was not available. Perhaps this is an issue that could be addressed.

It is important that this directive is not just put on the shelf and that it is implemented under the statutory instrument which the Minister said will be brought in. My focus is on the practicalities for people living in, for example, Letterkenny, Buncrana, Moville or Donegal town. I hope they can access treatment and that, in the future, they would feel more confident going to Altnagelvin or Belfast rather than having to go to Dublin or Galway. As part of their family connections, most people in Donegal would have connections across the Border. People living in Killea in Donegal, on the Border with Derry, would even feel more comfortable going to Altnagelvin rather than to Letterkenny Hospital, and certainly to Galway or Dublin. I believe that ten or 20 years down the road, the health system in this country will have no border. This directive will be obsolete because it will be the right thing for the two health systems in the country to operate together.

From talking to professionals, and as I am sure the Minister will be aware, there is medical politics involved between hospitals across the Border, as there is even between hospitals within the Twenty-six Counties. Between Altnagelvin and Letterkenny hospitals, there are services that should be shared, particularly the cardiac service at Letterkenny, with which I am personally familiar as I have been with the cardiologist myself. That cardiologist told me that he has been told that Donegal is out of the loop in regard to the rollout of cardiac services. What he is hearing back from the HSE is that the cardiac service will in the future be looked after by the Northern Ireland health service. However, if one looks at the map of cardiac rollout, Donegal is blank and does not come into the equation. Hopefully, a patient in Letterkenny will in the future be able to access cardiac services in Derry and vice versa, because it should be a two-way street.

I fully support the directive but the practical benefits must shine through. I believe people with private health insurance should be able to access services at the nearest hospital, for example Altnagelvin Hospital in Derry is nearer to those in Donegal than a hospital providing certain services in the South. People in Derry should be able to do the same. That is the future, whether it happens in my lifetime or the lifetime of this Government is a matter for the Governments in both jurisdictions.