Brian Lenihan Jnr (Dublin West, Fianna Fail)

Gabhaim buíochas leis an Teachta. Tá mé ag tabhairt freagra ar son an Tánaiste agus Aire Sláinte agus Leanaí, an Teachta Harney.

Deputy Ó Caoláin has called upon the Minister to act but she would have to embark on consultations with the Health Service Executive to address the issue. The Department has not, as yet, received the report referred to by Deputy Ó Caoláin. The Minister has asked the Health Service Executive to furnish a copy and it will be examined by the chief medical officer of the Department upon receipt. However, I understand from the executive that the data used in the report referred to by the Deputy is a number of years old. I and the Health Service Executive would like to reassure the public that there is no outbreak of tuberculosis in the north inner city area of Dublin and that there are no major concerns in this regard.

The Health Act 1947 and the Infectious Diseases Regulations 1981, as amended, provide the legislative basis for the control of infectious diseases, including tuberculosis, in Ireland. The Department's strategy in the prevention and treatment of tuberculosis is guided by the recommendations of the report of the working party on tuberculosis, published in 1996, which covers a wide range of issues, including epidemiology, surveillance, screening, preventative therapy, clinical management and laboratory diagnosis. Responsibility for the implementation of the recommendations rests with the Health Service Executive.

The future organisation and delivery of respiratory and tuberculosis services was examined by Comhairle na nOspidéal in a report published in July 2000. This report found that, in line with major advances in medical treatment, the optimal inpatient care of patients with respiratory diseases, including tuberculosis, is more appropriate to acute general hospitals, staffed by consultant respiratory physicians and other consultants and supported by an array of investigative facilities. While recognising the valuable role which Peamount Hospital had played for many years in the delivery of respiratory services, Comhairle na nOspidéal did not regard it as an appropriate location for the future treatment of tuberculosis patients, especially those requiring ventilation and specialised treatment for other illnesses, for example heart disease, HIV and so forth.

Comhairle na nOspidéal subsequently appointed a committee to advise on the implementation of the 2000 report. The report of this committee endorsed the recommendations in the 2000 report and it was adopted by Comhairle na nOspidéal in April 2003. Specifically, the committee recommended that Peamount Hospital should play an active role in the provision of a range of non-acute support services, including pulmonary rehabilitation, within the Health Service Executive south-western area. For example, it recommended that patients who have been treated in the nearby St. James's Hospital and other major acute hospitals and who require ongoing rehabilitative care could be transferred to Peamount Hospital for completion of their care. In addition, three specialist tuberculosis beds for multi-resistant and complex tuberculosis patients are due to open in the coming weeks in St. James's Hospital.

The Health Service Executive eastern regional area established a working group on tuberculosis services in the eastern region and respiratory services in the Health Service Executive south-western area. The group examined the options for the future management of tuberculosis, both acute and non-acute, in the eastern region. It also addressed and identified other respiratory services that might be appropriately delivered in Peamount Hospital, taking account of best practice. The group consisted of a respiratory physician, a specialist nurse and the director of nursing from Peamount, a management representative from the hospital, general practitioners, a public health specialist and an accident and emergency representative. The group reported to the Health Service Executive eastern region in early 2005. It endorsed the recommendations of the working party report of 1996 and the subsequent Comhairle na nOspidéal report.

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