Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

Every week since the Dáil resumed at the start of this year has brought news of more cuts in our public health services as a result of the disastrous policy of this Government and disastrous management by the Health Service Executive. These cuts have come on top of the policy of over-centralisation which attacks the services provided at local hospitals. Nowhere has this been done more ruthlessly than in counties Cavan and Monaghan where our two hospitals are now facing what consultants at Monaghan have described as "a catastrophic situation."

What is the Minister for Health and Children doing about this? She is driving it. Her priority is privatisation. Next week, on 24 April, the Minister will open a private health conference in Dublin and participants will pay more than €500 each to attend this exclusive event for private health profiteers. Meanwhile, our patients are suffering and our public hospitals are being downgraded.

The latest crisis for Monaghan General Hospital has been provoked by the attempt of HSE management to discontinue the ventilation facility at Monaghan General Hospital which was due to close on 7 April. The closure has not taken place because consultants at Monaghan are refusing to operate proposed new protocols for the treatment of patients requiring acute care. The consultants say that the removal of the ventilation facility will lead to the ending of all acute medical admissions in Monaghan resulting in "mortality for patients".

Correspondence from the consultants at Monaghan General Hospital to Health Service Executive management shows that the hospital is facing, in the words of the medical professionals, "a catastrophic situation". If the HSE is allowed to proceed with its plan to end all acute medical admissions at Monaghan General Hospital, then facilities will have to be found for the treatment of the 3,000 per annum acute medical admissions to Monaghan. The main burden will fall on Cavan General Hospital which already has to cater for 5,000 such admissions per annum and which currently has 160% bed occupancy. In other words, it has 60% more patients awaiting beds than there are beds available in the hospital.

The consultants make clear that with only some 25 additional beds proposed for Cavan, the proposed downgrading of Monaghan is totally untenable. I commend the Monaghan consultants for refusing to agree and operate the protocols proposed by the HSE. As a result of their stand, the HSE has not been able to enforce the closure of the Monaghan ventilation facility.

An existing protocol, not previously known publicly, states that Monaghan is only allowed to have three patients on trolleys awaiting admission at any one time. If a fourth patient presents he or she must be moved to Cavan or another hospital. This has nothing to do with patient care. All it does is disguise the true need and demand for the services at Monaghan. In the first three months of 2008 some 78 patients were moved from Monaghan in this way. It is interesting to note that 18 patients left Monaghan untreated rather than go to another hospital. This protocol serves only to disguise the true need and demand for services at Monaghan General Hospital.

Just as significant as the strong protest from the consultants about the proposed ending of acute medical admissions is their assertion that since returning "on-call" in 2005, Monaghan General Hospital has functioned very well and provided a high standard of care to patients with acute medical illnesses. This reflects the positive experience of the overwhelming majority of people, this Deputy included, in the area served by the hospital.

All of this unquestionably gives the lie to the utterly false and misleading claims by HSE management and the Minister for Health and Children, Deputy Mary Harney, that the downgrading of Monaghan General Hospital is based on patient safety and achieving better standards of care. It is clearly no such thing. It is driven by cost-cutting and a ruthless centralisation agenda. The HSE is enforcing flawed strategic plans in the most high-handed manner, regardless of the impact on patient care. This correspondence exposes how bureaucrats have sought to enforce protocols for the care of patients against the wishes of the medical professionals who have to deliver that care.

The implications of the HSE plans are very serious for Cavan General Hospital. It will not be able to cater for 8,000 acute medical admissions per annum. Any notion that somehow Monaghan's loss is Cavan's gain is totally spurious. Patient care in both counties and in the north-east region will be adversely affected. For the sake of both hospitals and all who depend on them these plans must be resisted.

GPs in County Monaghan have written to Mr. Stephen Mulvaney, network manager of the HSE in the north-east region, and they state that patient care is not at the centre of HSE decision making. Those are the professional colleagues of the Minister of State, Deputy Devins.

Monaghan General Hospital is the victim of political decision-making on health care at Government level which takes no account of the reality of people's lives. I will conclude by making it abundantly clear that I will continue to challenge the Taoiseach, the Minister for Health and Children, Deputy Mary Harney, and all their Fianna Fáil and Green Party Government colleagues on this matter and I urge people throughout counties Cavan and Monaghan, irrespective of their political affiliation or none, and beyond both counties and that region, to challenge Government and Government-supporting Deputies on this disgraceful set of proposals which will be a template employed on hospital networks throughout the rest of the jurisdiction.

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