Jan O'Sullivan (Limerick East, Labour)

I concur with what Deputy Sherlock said. A Teamwork report completed in the mid-west more than a year ago has not yet been published. There are all sorts of rumours going around about accident and emergency services at hospitals in Nenagh, Ennis and Limerick being reduced. There is no evidence whatsoever that capacity in the Mid-west Regional Hospital in Limerick will be increased to cater for extra patients. People living in places like west Clare will be a considerable distance from the central hospital in Limerick should this downgrading go ahead. We are hearing rumours to the effect that this will happen in March 2009.

I have repeatedly called for the publication of the Teamwork Management Services report and have received conflicting answers, some of which indicate the report has not yet been submitted to the board of the HSE and others from the Minister and Professor Drumm who indicated in committee that they do not want to publish it because it may give rise to opposition. This is no way to democratically address the issue of how we run our hospital services in this country.

It is important to state on the record that secondary hospitals have an important role to play. They are much more cost effective in dealing with certain matters than are tertiary hospitals. We need to have a proper debate and evaluation of the role of secondary hospitals before they are downgraded in some type of secret operation, with no publication of a plan and only a vague generalised reference to reconfiguration as set out in the HSE plan launched yesterday.

While a copy of the Teamwork report is floating around in the mid-west it has not yet been published. In effect, patients, the public and public representatives are being denied an opportunity to participate in a debate on this issue and to ensure we maintain a level of service in secondary hospitals in the mid-west, south, north-east and in various other parts of the country that is appropriate to what a secondary hospital can do. An excellent service is being provided by these hospitals in a cost effective manner in comparison with larger hospitals.

It is appalling that this is happening in a type of secretive manner without any public discussion. I urge the Minister to genuinely address the issues of concern in these areas because people do not know what is happening. I have spoken about the issue to people in Clare, north Tipperary and Limerick. They are hearing rumours about what is proposed for their hospitals but there is no public announcement in this regard. It is almost as if this is being done behind closed doors with only particular people being brought on board and senior rather than regular staff at the hospitals being told about it.

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