Dr. David Hanlon:

Deputy Ó Cuív spoke about the issue of making diagnostics and services available in a cluster or in an area. Over recent years, the primary care division that Mr. Hennessy and I work with has been setting out a particular project around ultrasound access. This has been deliberately targeted at the west. It is deliberately targeted to move away from and out of the hospitals. It has moved out into the community and into more areas that are further from the hospital. This has given people quick access to ultrasound, for instance, of their abdomens and thyroids. When there are questions and concerns about whether there is something going on, these patients can get access, typically, within a couple of weeks, and a report back to their GP in a short turnaround. There has been a deliberate policy to do that outside of the hospital and make some of that diagnostic capacity available to people in the community even further out from the major urban centres. That is something that would be planned to be made available progressively to a larger part of the country. Certainly those kind of initiatives have been undertaken.

I am aware that X-ray availability is provided on an outreach basis in a number of units. X-ray is a little more difficult. With ultrasound, as was said, it is a simple computer which is reasonably portable and it is something one can move and position quickly. X-ray involves lead-lined rooms and heavier equipment. It is not as easy to install and take away or move around the way one can something like ultrasound. There are some limitations around how quickly one can deploy something like that but certainly there is planned X-ray availability around a number of areas outside of the major hospitals.

The minor surgery is another piece that the primary care division has been working on developing. Traditionally, doctors in more rural areas would have managed more emergencies, would do more stitching and would do more minor surgery anyway than a doctor in an urban area who would have more ready access to a hospital setting. What has been done over the past 12 months is effectively trying to increase that capacity and put it on a better footing. With the requirements for quality and requirements around safety, infection control and other things, the standards have increased and the expectations of people have properly increased.

Doctors want to practise to a high standard. That needs to be supported and that is what has been developed. There will be a plan to make what I describe more available. It would allow people with cuts that need to be sutured and more minor conditions, such as ingrown toenails and lumps and bumps that may need to be removed or sampled, to have them addressed by general practitioners locally without necessarily having to go to hospital. This feeds into taking the pressure from acute hospitals. It makes sense to do that.

In places such as Bantry, where 24-hour emergency department services are no longer provided, initiatives such as minor injury units have been set up locally that aim to manage many of the more minor conditions, such as minor fractures, sprains and cuts. That will manage a significant volume of the less complex emergency cases. People with serious injuries will still need to be transported to a place that has full capacity and all the staff, expertise and facilities necessary to deal with them. That is a better way of dealing with people with those kinds of more complex problems.