Mattie McGrath (Tipperary South, Fianna Fail)

I thank the Leas-Cheann Comhairle for allowing me to raise this serious matter. I believe a death notice for South Tipperary General Hospital has appeared in the form of an information document dated 29 January 2009 on the modernisation of acute services for the hospital group south-east. A short few years ago, St Joseph's County Medical and Maternity Hospital, Clonmel was renamed South Tipperary General Hospital at great expense and inconvenience to take account of the amalgamation with Our Lady's County Surgical Hospital, Cashel.

South Tipperary General Hospital under the new guise of modernisation of acute services will lose its identity and become part of a recognised, or possibly unrecognised, group — it will become a statistic in the HSE plan. Lest anyone forget or needs reminding, the HSE is about saving lives, not saving money. The situation in regard to South Tipperary General Hospital and the proposed reconfiguration of hospital services within the south-east, and its impact, is a matter of grave concern to the constituents of Tipperary South and to myself.

The implementation of the transformation programme as required by the national services plan will commence, we are told, in March 2009 with the development of a steering group for the modernisation of acute hospital services for the HSE group south-east. The steering group will have a membership initially comprised of four clinical directors — one from each hospital — and a hospital manager. The role of the steering group will be to supposedly agree and plan for a re-configuration model of acute hospital care for the hospital group south-east, make recommendations on service delivery issues and oversee the implementation of the modernisation programme. A project manager will support the planning and implementation phases of the programme and the planning phase will be completed by September 2009.

I am concerned that we have too many programme managers within the HSE and too few frontline staff. Under the HSE plan for the modernisation of services, the so-called aims of discussion are as follows: understanding and clarification of challenges, as if we did not know already; having a shared understanding of the need for change; a shared understanding of what we must do and how we should go about it; and timelines — all fancy jargon adopted by the HSE. However, what we have is no two-way dialogue, completely one-way traffic, a tunnel vision on behalf of the HSE and its management and no proper, meaningful consultations with the extremely hard-working and dedicated staff at Clonmel.

As I said, the death notice for South Tipperary General Hospital has appeared in the form of this information document, dated 29 January 2009, with its fancy title concerning the modernisation of acute services for the hospital group. I am totally opposed to these new plans to remove out-of-hours services or accident and emergency services after 7 p.m., as well as the removal of maternity services and all acute hospital services. This would mean that never again would a child be born in Tipperary, which is unacceptable, particularly when we have a top quality maternity service with large numbers of deliveries each year.

While I have no issue with centres of excellence, as with speakers on another debate today, I believe we must have centres of excellence in place before we attempt to remove services. A radical change in the direction of health care policy is needed in the Department of Health and Children and the Health Service Executive. Democratic accountability must return to the Minister and services must return to our local hospitals. There must be a health care system which truly places the patient first and which is capable of meeting the needs of our communities. I remain committed to fight might and main to keep all services in South Tipperary General Hospital.

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