Dan Neville (Limerick West, Fine Gael)

I wish to join with Deputy Reilly and my Fine Gael colleagues this evening in expressing my deep concern about the proposed rationalisation of hospital services in the mid-west.

The HSE commissioned Horwarth Consulting Ireland and Teamwork Management Services to report on acute hospital services in the mid-west and the report was made publicly available in January of this year. While none of us can argue against best international practice that aims to maximise best clinical outcomes and improve patient safety as outlined in the report, we can argue about the way the Minister and the HSE plan to implement these changes and the potential negative impact they will have on patient care.

As the Minister, Deputy Harney, will be aware, the report clearly identifies a number of preconditions that must be met if the new plan for hospital services in the mid-west is to succeed. These preconditions include significant increases in medical manpower, further development of pre-hospital and primary care services as set out in the Primary Care Strategy 2001 and the development of critical infrastructure requirements including regional centres of excellence in Limerick city.

The purpose of this Private Members' motion is not to oppose reforms that are in the best interests of patients' safety. Its purpose is to remind the Minister of the precondition that must be met before critical hospital services are withdrawn as outlined in her report, and to remind the Minister of the over-riding principle, contained in the report, which states that no acute services will be withdrawn from the current general hospitals until the regional centre of excellence is resourced and ready to deliver that service with reference to international quality standards. Despite this clear recommendation, it seems that the Minister and the HSE plan to set ahead with the withdrawal of the accident and emergency services even though the essential upgrade of facilities in Limerick has not taken place, as well as ambulance, general practitioner and primary care provision.

We are extremely concerned about the provision of ambulance facilities from the Kilmallock area for which we have been pressing for a number of years. Currently there are three hard-working accident and emergency consultants spread across four accident and emergency services in the mid-west. This is contrary to the patient safety best international practice and is unsustainable in the long term. The report commissioned by the HSE strongly recommends that it take prompt action to reduce the current levels of clinical risk and improve patient safety.

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