Mr. Gerard O'Callaghan:

I am delighted to have the opportunity to speak on behalf of the South/South West hospital group. I am. Gerard O'Callaghan, and with me is my colleague Dr. Orla Healy. The South/South West hospital group delivers care for a population of approximately 895,222 people across the counties of Cork, Kerry, Waterford and south Tipperary, with gross expenditure this year of more than €927 million. It is one of seven hospital groups serving 19% of the population of the State. We provide the full suite of acute hospital services across nine hospital sites. We have model 4 hospitals in Cork and Waterford, model 3 hospitals in Cork, Kerry and Clonmel, model 2 hospitals in Mallow and Bantry and exclusively elective hospitals in Cork and Kilcreene in Kilkenny. Emergency services are provided at seven of the nine sites in compliance with acute medicine programme and emergency medicine programme requirements. Cork University Hospital is the only acute hospital in the country providing the full range of trauma specialties. We expect that will secure its status as one of two major trauma centres for the country in the upcoming report on trauma centres.

We have reconfigured the hospitals in Cork and Kerry, in particular between 2010 and 2014. That included the closure and reorganisation of a number of emergency departments, which was challenging. We are continuing with the reconfiguration process. At this point, acute and complex work has been centralised and non-complex day-case work has been decentralised. We have now moved on from Cork and Kerry and we are commencing a process of service realignment across the entire hospital group. Since the establishment of the group in the past three years, the leadership team has been embedding a new governance and management structure. One of the key actions in the past year has been to meet the 40 clinical specialties across the group to assess their current state and develop the working of cross-group specialties. To that end, we are developing a clinical directorate structure and have just appointed a group clinical director for women and children as the first directorate in the group.

We are actively integrating care delivery with our colleagues in the community. We work with two community health care organisations, CHOs. We have an unscheduled care steering group as well as access, throughput and egress subgroups established with them. We also have multilayered collaboration across all hospitals with community service, including regular meetings at senior management level.

The leadership team is co-located with the management team of the College of Medicine and Health for the primary academic partner, University College Cork, UCC. Important progress has been made in building this collaboration such as, working with UCC to attract and rotate non-consultant hospital doctors, NCHDs, to all nine hospitals through a range of joint initiatives and establishing international working relationship with the Erasmus academic health centre, Rotterdam. Achievements include establishing a master of science, MSc, programme in physiotherapy with UCC and establishing a MSc in health care leadership in UCC, which commenced in September 2016. We are also examining a postgraduate radiography programme that we hope to get off the ground in the next two years with UCC.

The overarching strategic goal of the group is to achieve independent status with the imminent appointment of a board and the establishment of an academic health centre, in partnership with UCC. The best hospitals in the world are academic health centres and this model will attract the highest calibre graduates to work in Ireland. We are actively fostering our relationship with industry, especially the multinational pharmaceutical companies based in Cork to develop our services and realise the economic benefit for our population. To that end we are working with the Health Innovation Hub, which is based in UCC.

We share many of the same challenges as other groups that the committee is already aware of, such as staff recruitment and retention and cost control. However, we as a group face a particular challenge because of the ageing infrastructure of our hospitals. We need urgent capital investment to expand services at University Hospital Waterford, UHW, and University Hospital Kerry, UHK. Major infrastructural investment at South Tipperary General Hospital, STGH, in Clonmel. Consideration will be given to the complete rebuilding of that hospital but in the interim planned capital projects must proceed with full funding if the provision of services is to be retained there. The construction of a new hospital site for Cork city is critical. This hospital would see amalgamation of the two voluntary hospitals in collaboration with UCC. The range of services and facilities to be located at this site would include services currently provided at the two voluntary hospitals; a dental hospital; mental health services; ambulatory care; expanded diagnostics, a clinical research facility; a health innovation hub; and sub-acute rehabilitation.

To conclude, the delivery of high quality sustainable health services is dependent on strategic configuration and integration of hospital and community services. At regional level this translates to the requirement for evidence-based, well-articulated plans that are consistent with national policy but tailored to local context and it is possible to deliver this objective through the development of a hospital group and academic health centre organisational structure.