Mr. Charlie Hardy:

Recent developments in the State have been moving towards the organisation of hospital groups, leading to hospital trusts. The report was written by John Higgins who happens to be a Tyrone man working in Cork. He is well aware of the North-South dimension. Built into the report was the need to ensure that in strategic plans for the bigger groups there would be North-South co-operation and networking of hospitals across the Border. I do not think there will be cross-Border groups or trusts at this stage but networking across the Border is a very important element of the strategic plans the groups are being asked to draw up in the next few months. A strategic advisory group is meeting as we speak. John Higgins is part of it and it will look at the services generally. That is something will be kept on the agenda. We will build on the work of Co-operation and Working Together, CAWT. In the past there were very good examples of cross-Border co-operation and they will be built into the strategic plans of the groups, in particular those groups relating to the north east and west north-west, which are conjoined with the Border. As well as that, there is a proposal to draw up a steering group between the two Departments to deal with hospital co-operation in particular. We will work with colleagues in Northern Ireland to set that up in the future. That will give some element to the co-ordination to which reference was made.

As regards the emergency ambulance situation, I know that calls have been made across the Border to the North and the South for ambulance transfers in emergency situations. There are developing links and good communication in many areas on that and the National Ambulance Service is anxious to improve on the links and will work to do that as much as it can.

The aeromedical service has been very successful, as Deputy Feighan acknowledged. It is being reviewed at the moment. We hope to enable it to continue in the best way alongside the proposal that has emerged for a northern aeromedical service that will be complementary, exactly as has been described. The discussions are at an early stage at this point. The policy in the North was not to have an aeromedical service but the view on that has changed and we are working together to see whether we can have a joint aeromedical service to complement the service being established in the State as well. That will be very positive, in particular for Cavan, Monaghan and Donegal.

Again, in the north west we have heard about Altnagelvin but there are also proposals on the table for north west cardiology. When Bill Maher, the CEO of the west north-west group, and his chair, Noel Daly, went to Altnagelvin to thank them for all the good work they did to assist when the flood took place in Letterkenny they raised the issue again. While resources are very tight and it is very difficult to carve out resources to make progress in many of those areas at the moment, they are working with colleagues in Altnagelvin to see how that could be advanced as well. There will be no change in any service in that area until it has been put in place and piloted and we can see what the results are on a broader front. Again, that would apply to the group plans that have been put in place there too.

Reference was made to congenital cardiac surgery and paediatric cardiology. That has been worked on for a long time and there has been good co-operation. Up to 29 cases involving children from Northern Ireland were treated last year in Crumlin hospital in Dublin. They are working on a new service level agreement as an interim measure to deal with the service west. An internationally-led expert assessment is to take place, which is due to finish at the end of June. The assessment will describe the existing hospital services in both jurisdictions, outlining options for service configuration and governance arrangements. The experts will report to both Ministers jointly and recommend an approach to an appropriate model that meets the population needs and other requirements in both jurisdictions. We can expect a report from the internationally-led group, which is well supported in terms of the requirements it needs to bring the report forward.

In addition, we have looked at the situation in Enniskillen. We think there is great potential for cross-Border co-operation with that hospital. There will be two-way traffic. We are determined to try to ensure that two-way traffic takes place and that everybody gains the maximum from the situation.

I will take back the ideas that were spoken about in terms of obesity services, the paediatric surgeon and other ideas. I can feed them back into the system in terms of considering the strategic options and the group strategic plans that will be brought into play in the next few months. That generally covers the issues. I will come back if anyone wants me to follow up on any issue.