John Moloney (Laois-Offaly, Fianna Fail)

I am taking this Adjournment matter on behalf of the Minister for Health and Children, Deputy Harney.

The overriding aim of the transformation programme for the north-east region, which the Minister fully supports, is to improve safety and achieve better standards of care for patients in the region. This process involves widespread and fundamental change and is designed to build a health system in line with the model of care emerging internationally. The transformation programme has been informed by the teamwork report to the HSE, which demonstrated the service configuration in the region was unsustainable.

A series of focused service changes is being implemented across the region. The immediate focus is the reconfiguration of existing services by moving acute and complex care from five hospital sites, including Cavan and Monaghan, to two, including Cavan for Cavan-Monaghan. With regard to the Cavan-Monaghan hospital group, the HSE intends to complete the transfer of acute inpatient services from Monaghan to Cavan over the coming months and to develop additional services in Monaghan. The transfer of acute medical care to Cavan is due to take place during the second quarter of this year. It is also subject to several dependencies first being in place, particularly the establishment of a medical assessment unit at Cavan and the development of an enhanced ambulance and pre-hospital thrombolysis service. The Minister has been assured the transfer will not take place until two months after the medical assessment unit has opened. The existing medical wards at Monaghan will provide rehabilitation and step-down services with 26 beds, including 13 for rehabilitation and 13 beds for step-down care. This will be in addition to the day surgery, outpatient and minor injury services.

The change process in Cavan-Monaghan is being managed through a network of sub-groups. It is important that all relevant stakeholders are involved in the change process. The HSE has sought the participation of general practitioners, and several sub-groups particularly, in the development of the medical assessment unit in Cavan. It is a matter of some concern that the general practitioners in Cavan and Monaghan felt it necessary to withdraw from engagement and involvement in these groups. The HSE has indicated it will ensure communication lines are maintained with general practitioners in the area. The sub-groups are being supported by specialist risk advisers to ensure the change process is managed smoothly and any associated risks or challenges are identified and addressed in advance of any service changes.

The changes proposed by the HSE, and fully supported by the Government, are for reasons of patient safety. We are committed to providing the best possible service for patients in a manner that ensures quality and safety. It is understandable there will be concerns about change but the Government is satisfied this is the best way forward. The HSE will work with all stakeholders to bring about the improvements in a carefully planned way that puts patients first.

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