Seymour Crawford (Cavan-Monaghan, Fine Gael)

I thank the Ceann Comhairle for providing me with the opportunity to raise this important matter regarding the uncertainty about patient care for the people of Monaghan in light of the commitment of the Minister for Health and Children, Deputy Harney, and Professor Drumm to wind down services at Monaghan General Hospital. On Saturday, at least 5,000 people met in Monaghan Church Square to protest regarding their fear for the future.

On Saturday morning, my colleague and Fine Gael health spokesperson, Deputy James Reilly, together with Senator Joe O'Reilly and myself, paid an arranged visit to Cavan General Hospital to see for ourselves what preparation, if any, has been made to cope with the downgrading of Monaghan General Hospital and the further proposals to take Monaghan General Hospital off call. It was blatantly obvious that no such structure is available or likely to be available for the foreseeable future. While some planning was explained to us, it was made clear that no additional budget has been granted and funding is already under severe pressure.

We subsequently visited Monaghan General Hospital and met with the consultants and GPs to see at first hand the facilities available in Monaghan accident and emergency treatment room. However, we were advised that no more than three patients are allowed to remain on trolleys in Monaghan under the so-called "protocol" whereas they can be transferred to the trolley system in Cavan or Drogheda, mostly against the wishes of the patients. The treatment room at Monaghan General Hospital is fabulous and equal to none.

The consultants in Monaghan have made every effort to work within the system to provide a safe and quality service to our patients. An independent survey has shown that their delivery of service is of an extraordinarily high nature and better or as good as any other in the country. I will quote a recent letter to the programme manager for the north-east transformation structure from the consultants who made it clear that "it is apparent to us following our meeting with the Cavan consultant physicians, that the availability of a critical care bed for a patient from Monaghan Hospital cannot be guaranteed. We believe therefore, that the Protocol outlined is intrinsically unsafe and we hereby formally put that on the record."

They also made it clear that:

no extra resources have or will be provided at Cavan General Hospital to provide for 3,000 extra patients from Monaghan. It is also apparent to us from our contact with our General Practitioner colleagues that no extra resources have been provided for care in the community.

They further state: "if you discontinue the coronary care/acute care facility at this hospital you are compelled to show provision of a similar quality service elsewhere to which our patients can have recourse".

I will provide the Minister of State with the full content of the letter sent to the HSE by the four Monaghan General Hospital consultants. It is clearly one of a series of letters being sent to the Department and the HSE. The situation in Monaghan General Hospital is at crisis level where the knowledge and ability of consultants is being ignored and ambulances are being advised to travel directly to Cavan by administrative staff rather than to Monaghan, in spite of the fact that the patients are almost certainly likely to finish up on trolleys.

With a clear indication that no money is available for the necessary restructuring and provision of services in Cavan or elsewhere, it is vital that the Minister for Health and Children uses her influence to stop the lunacy of withdrawing an excellent service until, as she has previously promised, a better or as good alternative services is available. This has been put on the record several times but it has been completely ignored.

At least 17 people lost their lives unnecessarily as a result of Monaghan General Hospital being off call on a previous occasion. If similar happens again, I will personally hold the Minister for Health and Children responsible along with the Taoiseach and those who support them. I do not mean this as a threat but I want to make it absolutely clear. Mr. Finbarr Lennon, a consultant at Our Lady of Lourdes Hospital, was a special adviser to the health board. Once again, he has written to the HSE explaining how unsafe the situation is and begging it to step back

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