Peter Power (Limerick East, Fianna Fail)

I welcome the opportunity to contribute to the debate on the hospital services in the mid-west. I will concentrate on how the proposed review relates to Limerick city. I strongly believe that the reforms set out in the report are long overdue. Ultimately, they will be good for patient outcomes in Limerick. I also believe that it will not happen overnight and that the change must be incremental. One cannot go from an imperfect system to a perfect system overnight. This means we cannot make this into a political football, and it also means involving all of the stakeholders in the process, which will take some time.

Everyone in this debate agrees on several matters. Best practice in the delivery of medical services is changing in Ireland and abroad. Technology for the delivery of those services is also changing. That means we must not do things the way we did them before and it also means not doing things in the places we did them before. It means doing them in different places with better people who are better able to produce better outcomes. We all agree that the report concludes that if those internationally recognised best practices are implemented, better outcomes will be achieved. We might disagree on how we go along with this journey, but at least that is a good starting point for all of us.

I also welcome the fact that this reform has been led by clinicians, who are the experts on this. It is not necessarily led by politicians, although it is assisted by them. It is essentially led by people such as Dr. Paul Burke and Dr. Cathal O'Donnell, who are both highly respected people. I have met these people on several occasions, and I can say that their sole motivation is the best outcomes for patients. It is not about turf wars and about keeping practices in some hospitals rather than other hospitals. Their motivation is simply the best outcome for patients. Do we accept their good faith and do we work with them in delivering their best expert advice? I say that we should do so.

St. John's Hospital has played a prominent role in recent years in the delivery of services in Limerick. I believe the hospital is well placed strategically to play a prominent role in the emerging infrastructure in the mid west, following on from this report. Consultant appointments to the hospital in recent years have been on the basis of a shared commitment with the regional hospital. In addition, the hospital has participated in joint ventures such as the development of minor injury services in Limerick, and the co-ordination of pathology and radiology services. That is very welcome. The initial discussions that began with the management of the hospital about its contribution have been productive. They are concentrated on providing increased consultant input into the accident and emergency consultant level delivery of services in St. John's Hospital, which is to be welcomed. The possibility of expanding the scope of the minor injury services in the hospital to cover the weekend period is extremely welcome.

The programme of change also includes an expansion in the range of diagnostic facilities, and an expansion of outpatient and day surgery capacity in the smaller hospitals in the region, which includes St. John's Hospital. A reference in the report has been made for a throughput in the hospital of up to 30,000 people per annum, which is very welcome. If this report is ultimately delivered, it will be good for St. John's Hospital and the regional hospital. It will mean a very significant investment in the medical infrastructure in Limerick, an emergency operating theatre in the regional hospital, an expansion of the ambulance service, and a critical new care block in the regional hospital. That is to be welcomed, but it will not happen overnight. Everybody needs to work together and we need to take the best advice from the best people with the right motivation at heart, working to deliver the sort of services that Limerick and the mid-west deserve.

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