Seymour Crawford (Cavan-Monaghan, Fine Gael)

I thank the Leas-Cheann Comhairle for the opportunity to raise the difficulties regarding Monaghan General Hospital. It was with absolute shock that I and my constituents read of the HSE proposals for the winding down of services at Monaghan General Hospital, in spite of the fact that no alternatives are available. We were assured by the Minister for Health and Children, Deputy Harney, and by Professor Drumm on many occasions that no services would be removed until as good, if not better, alternative services were available. The proposal to take Monaghan General Hospital off call, that is, to close the medical and treatment casualty room, the precise date for which is to be confirmed, is totally unacceptable and unjustified, in light of the fact that the new high-quality treatment room, together with two refurbished wards, are capable of giving excellent results. This was particularly true up until such time as the HSE removed two consultants from the hospital. That was done at a time when the Minister was advising that we need 400 extra consultants, rather than junior doctors. There appears to be one law for the Minister's hospitals and another for Monaghan.

I ask the Minister and the general public to examine what has happened in Monaghan General Hospital. A high quality, well equipped treatment casualty room was built four years ago, at a cost of approximately €1.5 million. It was opened for service less than 18 months ago and is now being wound down. The female medical ward was completely refurbished four years ago, to the highest specifications and contains approximately 30 beds. That ward is now completely closed, with high-quality beds in private storage, while patients lie on trolleys in Cavan and Drogheda. The coronary care ward in Monaghan General Hospital has five to six beds constantly in use. That ward has been proven by independent surveys to have a higher record of safety and service than any other similar facility in the country, yet the Minister for Health and Children, who is not here tonight, together with the HSE, is suggesting that one bed in either Drogheda or Cavan will cover the needs of the people of Monaghan. So much for patient care and patient safety.

Just before Christmas the hospital alliance met senior HSE personnel but were not even advised that two consultants had been given their notice. They were further told that the maternity ward was to be restructured into a high-care unit. Even when I visited the hospital a few weeks ago to discuss the situation regarding the two consultants, I was assured that the high-care unit would be restructured in the former maternity unit. I subsequently found out that the unit was already being used for other purposes.

The absent Minister was entrusted with the management of approximately €16 billion of taxpayers' money. Can she advise how it is that when the country was literally broke, 30 years ago, a small number of administrators could employ sufficient nurses, consultants, doctors and so forth, to provide a satisfactory service for the area without any mass administration structures, outside consultants or committees? Does the Minister or her Department have any interest in or say on patient care? Do they understand that while home care and home help is only available, in the main, for a few hours a day, sufficient quality home carers are not being employed to do the necessary work?

I urge the Minister to meet personnel from the Cavan, Monaghan hospital group which is interested in saving lives and avoiding hardship. During the last period that Monaghan General Hospital was taken off-call, at least 17 lives were lost, without justification. Today I received a copy of a letter from Mr. Finbar Lennon, former medical adviser to the North Eastern Health Board, which clearly states:

. . . the present Teamwork transformation projects have and will inevitably fail. This is due to the fact that the medium term plan is unrealistic, but also because many vital front line staff have been excluded, by design, from the so-called consultation process. Their medical and nursing experience and advice has been largely disregarded by the planners and decision makers.

I humbly suggest that the Minister feels that she has no role regarding patient care and safety on behalf of the people of Monaghan. In the interest of similar hospitals nationally, she should do the honourable thing and resign.

I wish to read into the record a very quick statement from the same doctor: "The situation in Drogheda was very unsafe and I call for a fundamental appraisal." That is how serious the situation is within the health services in the north east.

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