Jimmy Devins (Sligo-North Leitrim, Fianna Fail)

I am taking this matter on behalf of my colleague, Deputy Mary Harney, Minister for Health and Children. I thank Deputy Ó Caoláin for raising this issue.

The Health Service Executive north-east transformation programme involves widespread and fundamental change and is designed to build a health system that is in line with the model of care emerging internationally. The programme is expected to deliver an integrated care system with local and regional hospitals functioning within a co-ordinated, integrated clinical network as part of the wider system of primary, community and continuing care. Its overriding aim is to improve safety and achieve better standards of care for patients in the region.

The HSE has advised that the north-east transformation programme is approaching the end of its initial phase of detailed planning and is moving towards detailed design and implementation. Operational management and transformation management arrangements in the region have now been linked in order to achieve full integration of the transformation programme with the management of operations. The HSE has emphasised its commitment that existing services in the region will remain in place until they are replaced with higher quality, safer or more appropriate services. The HSE further advises that no decisions have been taken on reducing services in the north east.

The HSE is facing a challenging year and is exploring, in the case of the north east, how best to deliver on service plan targets within the level of resources available. The Teamwork report clearly states that there is a role for all five hospital sites in the development of acute hospital services in the future. The report clearly indicates that the current service configuration is unsustainable and that there needs to be a reconfiguration of hospital services across the five hospital sites and, ultimately, the development of the new regional hospital in order to ensure the highest level of patient safety.

There are a number of factors influencing the direction of these developments, not least the need to ensure that there are fully trained teams of emergency medical and surgical staff available to deal with the most complex cases which will present in the region. In the case of Monaghan General Hospital there have been a number of significant improvements, including two newly refurbished inpatient medical wards. This project, which cost €5 million, consists of two 25 bedded in-patient wards — male and female — with each ward providing a range of multi-bedded and single rooms. The ward project builds on the investment of €1.2 million on new equipment, an upgrade of the pharmacy and general facility upgrades for the hospital.

The HSE envisages that the role of Monaghan General Hospital in the future will be to provide a range of diagnostic, outpatient, day cases and some in-patient treatment services within clinical networks. Significant developments have also taken place in the provision of surgical services across the Cavan-Monaghan Hospital interface. Emergency surgical services on a 24-hour, seven day basis are provided on the Cavan site while significant elements of diagnostic, outpatient and day case services are provided on the Monaghan hospital site. This has resulted in lower waiting times for outpatient appointments and inpatient elective services. Since the reconfiguration of Cavan-Monaghan surgical services, patients can be seen by the visiting consultant surgeon on the day of referral by the general practitioner. The HSE has indicated that the relevant clinical protocols for the development of a minor injuries treatment unit at Monaghan hospital are currently being developed by the emergency care clinical network in conjunction with Cavan-Monaghan hospital group management.

Monaghan hospital will continue to have an important role to play in the provision of health services in the north east. This view was confirmed in the Teamwork report and also in the north-east transformation programme.

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