Seán Haughey (Dublin North Central, Fianna Fail)

I am responding to the Deputy on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

The Government is committed to ensuring the delivery of the best possible quality health service in an effective and efficient way. Patient safety is of paramount importance in ensuring people have confidence in the services and that the best possible patient outcomes are achieved. It is essential that patient safety and quality are prioritised and that services are organised and managed accordingly.

In February 2007, the Health Service Executive commissioned Horwath Consultants in association with Teamwork Management Services to examine the arrangements for the provision of acute hospital services at Ennis and other hospitals in the mid-west with a view to identifying the best configuration of such services in the region, including arrangements for accident and emergency, critical care, acute medicine and surgery together with diagnostic services so that the highest quality of care can be delivered to the population of the region.

The work of the consultants will act as inputs to decisions on how best to reconfigure acute services in the mid-west region. The Government and HSE are committed to ensuring that the approach to reorganisation of services is carried out in consultation with the key stakeholders and that each element is progressed incrementally. The Minister believes that it is important to work with health professionals and other interested parties to secure an increasing set of improvements over time. This approach will, she is confident, produce the best outcome for patients.

Recent reports in regard to patient safety have raised concerns about the capacity of smaller hospitals such as Ennis General Hospital to deliver consistent high quality care for patients who present with complex care needs at accident and emergency. Smaller hospitals treating low numbers of complex cases means that medical and nursing staff often have difficulty in maintaining skills in specialised areas and delivering safe care to such patients. Concerns have also been raised in respect of the capacity to recruit permanent consultants in such hospitals with the inevitable reliance on long-term locum appointments.

Currently, the accident and emergency department at Ennis is staffed primarily by sub-consultant emergency care physicians who deal with all emergencies that present and then refer patients to the appropriate specialty or service based on their clinical assessment. The HSE in the mid-west is currently working on a detailed plan to address the future configuration of emergency services in the region so that they will be in line with best practice. This plan which will consist of an emergency care network under which designated services will be assigned to individual hospitals and service delivery will be based on clear protocols under the direction of a regional department of emergency medicine. Many of the services currently provided in local hospitals will continue under the new arrangements but in a more structured manner and with patient safety and quality of care as the determining criteria.

In regard to capital developments at Ennis, the Minister understands that installation of a CT scanner and radiology upgrade is under way and is expected to be completed in 2009. On the particular issue raised by the Deputy, the HSE has been asked to prioritise and accelerate the Ennis capital development project along with other key capital projects in the mid-west in order to support the delivery of a modernised and improved service for this area.

I assure the Deputy, on behalf of the Minister, that Ennis General Hospital will continue to play a significant part in the delivery of health care in the region.

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