Seymour Crawford (Cavan-Monaghan, Fine Gael)

I thank the Ceann Comhairle for the opportunity to raise this important issue and I thank the Minister for State, Deputy Máire Hoctor, for answering, in the absence of the Minister for Health and Children, Deputy Mary Harney.

While this has specifically to do with the services being removed from Monaghan General Hospital, it is clearly a long-term plan of this Minister, with the backing of her Fianna Fáil and Green Party colleagues, to wind down the services at all small hospitals throughout the country. The report by Mr. Stephen Mulvaney sent by Mr. Ray Mitchell to all Oireachtas Members in the north east clearly states on page 8 that the critical care unit, better known as the high care unit at Monaghan General Hospital, will be closed down this year, all acute services will be removed and that the 24 hour seven-day accident and emergency unit, previously known as the treatment room, will be wound down to a five-day 12 hour service, for minor issues only. At the same time this same Executive advises on page 2 of the report that no service will be removed until an equally good or a better service is available.

The reality is that the site of the new hospital for the north east has not even been announced. Cavan General Hospital cannot cope with its present workload and the special adviser to the former health board, Mr. Finbarr Lennon, has advised by letter that the situation in Drogheda is completely unsafe because of its present workload.

The Taoiseach in the Dáil today emphasised the fact that the distance from services will obviously mean that there can be delays in those services being delivered and to him that seemed to be acceptable. However, as one who was glad to have the services of the high care unit in Monaghan General Hospital just last year, I am not prepared to sit idly by and allow such critical services to be removed. On a continual basis I meet people whose lives have been saved by that unit and who certainly would not have survived the journey to either Cavan or Drogheda.

During the period Monaghan General Hospital was "off call", at least 17 lives were lost unnecessarily and no doubt even in the last few days others would have been lost if we were in that same position. At this late stage I urge the Minister, Deputy Harney, to consult with the senior personnel concerned in Monaghan General Hospital to explain to them how their patients will be dealt with after the proposals by the Health Service Executive are implemented. She should stop the movement now, at least until the new hospital is working.

I further ask my constituency colleagues whether they are happy that all these services should be removed at a time when general practitioners cannot get personnel to deal with all the demands within their structures. Newcomers cannot get into general practice. It is clear from a reply received from the Minister this evening that she does not understand what is happening within the sector. She is clearly unaware of the lack of trust between the HSE, her officials, and the staff implementing systems on the ground. It is even more clear that the Minister has allowed the HSE to get out of control — it simply takes its own decisions, as it likes — and she has no interest in ensuring that people's health is top priority. Taxpayers' money should be properly utilised, given the fact that Monaghan General Hospital has a prime theatre, a first-class high quality treatment room and staff that can give a high quality and economic service. However, this clearly means nothing to the Minister or this Government.

I want to emphasise to the Minister of State that I am talking about a document issued by the HSE concerning the north east transformation programme. It is not scaremongering, but rather stating simple facts. The joke, however, is that it refers to "improving the safety and quality of patient care", and states that at its core the north east transformation programme is a risk mitigation strategy.

How can a critical care unit be removed from Monaghan General Hospital, when the Minister does not even have a single bed to put patients into in Cavan or Drogheda and when the man in charge of Drogheda says the situation there is extremely serious and unsafe? Yet HSE management — not the medical staff — is going ahead with the winding down and proposed closure within 2008 of those services at Monaghan General Hospital. That situation is certainly not acceptable to me. I am simply asking for some commonsense.

Finally, I say without apology that the Minister, Deputy Harney, was able to travel to America the other day to look at new systems. She has not once visited Monaghan General Hospital, or Cavan, for that matter.

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