Mary Wallace (Meath East, Fianna Fail)

I will take this Adjournment matter on behalf of my colleague, Deputy Mary Harney, the Minister for Health and Children.

The Government is committed to ensuring the delivery of the best quality health services possible and to doing so effectively and efficiently. Ensuring patient safety is of paramount importance so that people can have confidence in the service and the best possible patient outcomes can be achieved.

The Health Information and Quality Authority was established on a statutory basis in 2007 and is responsible for driving quality and safety in the health and social care services. In 2007 a new Medical Practitioners Act — the first major overhaul in 30 years of the law regulating the medical profession — was enacted. Also in 2007, the Minister for Health and Children established the Commission on Patient Safety and Quality Assurance to develop proposals for a service-wide system of governance based on corporate accountability for the quality and safety of all health services. In this context it is essential that every health care provider and facility is fully cognisant of patient safety and quality issues and takes account of these in the organisation, management and delivery of services. The priority is to provide safe services as close as possible to where people live.

The HSE has conducted a review of surgical and anaesthetic services at Roscommon County Hospital and Portiuncula Hospital, Ballinasloe. The difficulties faced by Roscommon and Portiuncula in maintaining surgical services independently, and the need for closer co-operation between them, was highlighted by the former Comhairle na nOspidéal in March 2006. The best way of retaining and developing services at Roscommon and Portiuncula hospitals is for both hospitals to work together. In the past, these two hospitals operated independently, with two consultant general surgeons in each hospital. Advances in clinical care and ever-increasing levels of specialisation mean this model of care is no longer sustainable. Small stand-alone hospital services will not be able to offer their doctors the opportunity to treat a sufficient volume and variety of patients to maintain their skills. Nor will they be able to provide the range of experience required for training new doctors. As a result, it will prove increasingly difficult, and perhaps impossible, to fill consultant posts on a permanent basis.

The development of joint departments of surgery and anaesthesia will provide a better service for patients of both hospitals. The plan is to combine the staffing and workload of the existing small service units in Roscommon County Hospital and Portiuncula Hospital into joint departments of surgery and anaesthesia serving both hospitals. This will involve joint consultant surgical and anaesthetic posts. While the more complex surgical cases will be treated in Portiuncula, this represents only about three cases per week on average. Roscommon Hospital will continue to provide surgical services for the rest of its patients. It is likely that more Roscommon patients than heretofore will be able to have surgery performed at the hospital because most surgery can be carried out on a day basis, which is also more convenient for patients.

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