Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I will make some brief points. I raised some of my questions with the other hospital groups earlier. It is not that I have less interest in the groups that are before the committee now; it is just that the previous groups responded to my questions and I do not think the answers of the groups before us now would be very different. I would like to put my first question to Ms Day and her colleagues from the Ireland East Hospital Group. If they were given a pen and a map of Ireland, would they draw the Ireland East hospital group as it currently stands? I suggest that Our Lady's Hospital in Navan, which is north of Dublin, has just been thrown in there. It is probably more suited to the RCSI Hospital Group or the Dublin Midlands Hospital Group, but it is in the Ireland East Hospital Group.

Issues with other hospital groups arise in this context. I assume the strategic drafting and planning of the groups was done without any medical snobbery or interference or anything. Are all the hospital groups strategically drawn to ensure they are capable of delivering care at the most appropriate point? In my view, some geographical definitions that would have been considered more logical have been frayed away. I know we are not completely bound by geographical definitions, but it seems to me that there are outliers in some parts of the hospital groups. I can say honestly that the South/South West Hospital Group, which includes Cork, is a case in point. It was originally proposed that University Hospital Waterford would be a model 4 centre for the south east. That is a fact. Others then decided to plump for the Mater hospital and other hospitals. We now have University Hospital Waterford included in the South/South West Hospital Group and St. Luke's General Hospital in Kilkenny and other hospitals included in the Mater group. We have to be honest with ourselves as well. The hospital groups have to work with what they are given. I am asking about the delivery of services in the specific case of Navan. Mr. O'Callaghan might refer to Waterford as well, now that I have raised the issues there.

National plans involving the reconfiguration of services are published from time to time. Examples include the national maternity strategy and the trauma report. Do the hospital groups have the flexibility to be creative and imaginative in such circumstances? Do they always have to be prompted by the overseer of the national reconfiguration, as set out in national reports from time to time? What level of flexibility do the hospital groups have in that area?

I intend to raise the issue of recruitment and planning of personnel with Ms Hardiman in the context of the children's hospital. When a farmer ploughs a field, he knows he will sow it, tend it and reap it. In the health sector, we tend to build theatres and expand services only to realise we have no staff.

We must then run around half the world trying to find staff. Why is there not a seamless process in place for the conception, creation and delivery of the service? It is currently done in a stop-start fashion. At Cork University Hospital, for example, psychiatric services were moved without personnel being available. Why is such an irrational approach taken? Perhaps there is a logical reason for doing so but I cannot get my head around it.

What is the reason for the serious difficulties being experienced in recruiting theatre nurses? Is it that we are not producing sufficient numbers of theatre nurses, having lost many of them in recent years, or is there a global shortage of theatre nurses? What are the various hospital groups doing to expand training capacity or is this a matter exclusively for the relevant national bodies?

The Children's hospital group will clearly face major challenges in trying to bring together the three children's hospitals in the years ahead. The building of a new children's hospital is another exciting challenge. Should we be worried about the delivery of hospital services for children in the period before the new national children's hospital is completed? I refer, for example, to the issue of scoliosis. I recently met some of the families involved and some of the stories I heard were deeply troubling. Ms Hardiman is aware of these issues and I am not arguing that the Children's hospital group is not sensitive to them. Families have indicated that a theatre was commissioned but there is now a shortage of theatre nurses, which means the theatre is opened as a general theatre. What problems will the Children's hospital group face in the period before it achieves its goal of having a beautiful children's hospital on the St. James's site? Is it being squeezed a little more in terms of the delivery of services than would be the case if the new hospital were not being built?

Deputy Mick Barry referred to Waterford Regional Hospital and the fact that it is a model 4 facility. People in the area are concerned not only about the cath laboratory at the hospital but also the possibility that the hospital will lose services to the other model 4 facility in the region, Cork University Hospital. They are concerned that it may be run down as opposed to enhanced.