Pat Breen (Clare, Fine Gael)

I thank the Leas-Cheann Comhairle for the opportunity of raising this very important issue. It seems to be all bad news with regard to the health service. I seek a clear commitment from the Minister of State that the €39 million redevelopment of Ennis General Hospital will proceed. At least in the case of Naas General Hospital, a €75 million project was completed in 2003 but we have not seen any money like that in Ennis General Hospital.

The Ennis Hospital Development Committee has on occasions been accused of scaremongering. However, the constant downgrading and withdrawal of services from County Clare does little to dispel the fear that there is a hidden agenda to reduce Ennis hospital to little more than a first aid injury clinic. At a meeting with the Minister for Health and Children which I attended on 20 September 2007, she indicated that this development would proceed. When the Taoiseach, Deputy Bertie Ahern, visited Ennis in May, prior to the general election of course, he was happy to show up for the photocall announcing that the development had progressed to planning, saying that it "symbolises Fianna Fáil's ongoing commitment to safeguarding and developing the health services available to the people of County Clare".

I raised this matter by way of parliamentary question on 31 January 2007 and I have been advised in writing by the HSE that the review of the acute services in the mid-west is to be published shortly and that this review is likely to have significant implications for capital developments for the foreseeable future. Furthermore, I have heard from reliable sources that this review is likely to recommend that this project does not proceed or that it could be delayed. Alarm bells are ringing and I have grave concerns. The drip by drip leaking of reports and the downgrading by stealth of services in County Clare is an emergency health warning to the people of Clare that a decision has already been made with regard to Ennis General Hospital.

The population of County Clare is 103,277, with more than 44,000 of the county's population outside the golden hour travelling time away from an accident and emergency department. Over 25,000 tourists stay in County Clare overnight during the summer season and Shannon International Airport is on our doorstep, handling 3.4 million passengers. It is also the designated emergency airport for all western traffic. This seems to matter little to this Government which has presided over the downgrading of health services in our county.

The HSE's vision for 2010 as outlined in its Transformation Programme 2007-2010 of easy access, confidence and staff pride, meant nothing to the three expectant mothers living in west Clare when no ambulance was available to transfer them to Limerick Maternity Hospital. The ambulance service in County Clare is under-resourced and clearly understaffed. The staff are working in appalling conditions and must clean out their ambulances with a mop and bucket. The vision of easy access means nothing to the women of Clare who, following the closure of mammography services in County Clare may now face up to a two-year delay for a publicly funded mammogram in Limerick. It means nothing to those patients in County Clare who, following the closure of the rheumatology services at Ennis, cannot meet with a rheumatologist in Limerick because one consultant cannot possibly handle the numbers.

The lives of people who live in Clare, especially in west Clare, who suffer major traumas will be put at further unnecessary risk as they will not receive emergency treatment in time following the decision to bypass Ennis for all such cases from April next. Access to Limerick Regional Hospital at certain times of the day is a disaster. If the bypassing of Ennis hospital is not reversed then at the very least an air ambulance service should be provided for west Clare and the Kilrush ambulance station must be upgraded with extra staff and two permanent APTs in the station at all times.

Ennis General Hospital is essential for life-saving and stabilising emergency care. This is been undermined and people's lives been put at risk because there is no CAT scanner in the hospital. When a CAT scanner was approved for the hospital it was an outdated machine, not a 16 slice scanner as is required. Very little progress has been made in installing a scanner. I raised this matter in the Dáil last year.

The centre of excellence in Limerick cannot cope with the extra number of patients who are arriving on their doorstep following the closure of some services at Ennis and Nenagh. The withdrawal of acute beds from Ennis and Nenagh will add 57% to Limerick's acute bed numbers, if accident and emergency department closures proceed. With leaks emanating that accident and emergency services are also to close at St. John's Hospital in Limerick, I question how are they going to cope with the extra numbers.

A total of 5,000 people marched on the streets of Ennis last September to urge this Government to sit up and listen. The health service is a shambles in County Clare. The tactics of withdrawing by stealth services from County Clare with no alternative in place is unacceptable. In 2000, €20.9 million was promised to develop Ennis. In 2005, five years later, the Minister announced the investment. This Government is great at turning sods and showing up for photoshoots. However, eight years on, there is no sod turning ceremony for Ennis and nothing but downgrading for the hospital.

I am asking the Minister of State for a firm commitment that the €39 million promised to redevelop Ennis General Hospital will be given, no matter what the report on the acute health services recommends for the region.

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