Brian Lenihan Jnr (Dublin West, Fianna Fail)

I am taking this matter on behalf of my colleague, Deputy Harney, the Minister for Health and Children.

The Government did not write this report or any previous report on Monaghan General Hospital. External consultants were retained to write the reports. One of the consequences of the agitation regarding this hospital is that as each complaint is made about a particular incident, a report is then compiled which does not find favour with those concerned about services in the hospital. All involved should reflect on that fact.

The Health Service Executive has recently established a steering group and a north east project group to oversee a programme designed to improve safety and standards across the acute hospital network in the north-east region. The decision was taken having regard to the issues raised in the report prepared for the HSE by Teamwork Management Services, Improving Safety and Achieving Better Standards — An Action Plan for Health Services in the North East, and taking account of the findings of the recent report into the death of Mr. Patrick J. Walsh. Led by the HSE's National Hospitals Office, the steering group has representation from key stakeholders such as clinicians and primary care providers. The project group is being led by a consultant surgeon from outside the region.

The report concluded that the present system, in which five local hospitals deliver acute care to relatively small populations in the region, is exposing patients to increased risks and creating additional professional risks for staff. The report highlights the need to develop a high quality and responsive emergency and planned service, in line with international standards, by developing local services within existing hospitals and other local centres supported by a new regional hospital.

The HSE recently published the report of the independent inquiry into the death of Mr. Walsh. The report details the difficulties that arose in trying to secure his transfer from Monaghan to either Our Lady of Lourdes Hospital, Drogheda, or Cavan General Hospital. It also exposes a failure in communications between clinicians and hospitals in the region.

Since the death of Mr. Walsh, a new protocol in respect of patient transfer has been put in place. It provides that all requests for transfer from Monaghan General Hospital to Cavan General Hospital or Our Lady of Lourdes Hospital, Drogheda, should be granted and processed immediately.

International best practice demonstrates that patients have better outcomes when treated in hospitals with appropriate numbers of specialist staff, high volumes of activity and access to the right diagnostic and treatment facilities. Patient safety and quality must be paramount and must be the key drivers in the reconfiguration of our acute hospital services. The policy of the Government is to provide safe, high quality services that achieve the best possible outcomes for patients. This will mean rebalancing service delivery so those services that can be safely delivered locally are delivered locally and that more complex services that require specialist input are concentrated at regional centres.

The HSE has assured the Minister that, in progressing the implementation of the Teamwork report and the report of the independent inquiry into the death of Mr. Walsh, there will be no discontinuation of existing services until suitable alternative arrangements have been put in place.

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