Timmy Dooley (Clare, Fianna Fail)

I welcome this opportunity to discuss the issue of reconfiguration of medical services in the mid-west region. Health is an emotive issue and the advent of change generates fear and uncertainty in the minds of the public at large. While that fear may be well-founded in some cases, the efforts by some vested interests to mislead and misguide is unfortunate and unnecessary.

The current position on the delivery of health services in the mid-west, and Clare in particular, is unacceptable. Patients are confronted with unnecessary risk on a daily basis. A number of cases have been highlighted in the media which have created a bad impression of Ennis. That has been difficult for those people and their families and the outcome was not acceptable. Notwithstanding that, it is my understanding that similar cases happen throughout the smaller hospital network and there is a requirement to address that.

According to Dr. Cathal O'Donnell, an accident and emergency consultant in the region, the chance of a better outcome for the patient can be increased by up to 25%, based on existing case data. He has staked his reputation on this claim. He has also stated on record that mortality rates in the region will reduce as this reconfiguration is implemented.

The Minister already quoted Professor Frank Keane, president of the Royal College of Surgeons in Ireland. In a letter to The Irish Times in January this year, he stated:

I would like to reaffirm that the Royal College of Surgeons in Ireland is convinced that the reform should continue in the mid-west and elsewhere where these changes are necessary and, in many cases, long overdue. The Royal College of Surgeons in Ireland's motive is first and foremost to achieve better and safer patient care. We want critically ill surgical patients to be brought to the centres that are appropriately equipped and staffed and where there is sufficient volume of this kind of activity to sustain the necessary levels of skills to manage these patients. Timing is often an issue and therefore patient transfer from hospital to hospital should be kept to a minimum.

That complies with international best practice which seems to suggest, as the Minister stated, that stabilisation should take place at the earliest possible time in the case of a road traffic accident on the roadside and, in the case of another trauma, at the particular site of that event.

These are just two of the many clinicians who have called for, and who support, the proposals contained in the programme of service delivery reconfiguration in the region.

As a public representative with no medical training, other than being the son of a well-qualified but retired nurse, it is incumbent on me to listen and heed the advice of such eminent medics. Regardless of my hunches or any desire to be politically expedient, I cannot, in good conscience, ignore the advice of these professionals who have taken an oath which places upon them a burden to protect their patients. Patient safety, reduced mortality and better outcomes are the cornerstones of this reconfiguration.

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