Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)

The House should note that at last week's meeting of the Oireachtas Joint Committee on Health and Children the Minister put on record that she had the authority to halt the closure of hospitals and the removal of acute services from hospitals such as Mallow General Hospital, Monaghan General Hospital, Nenagh General Hospital, Ennis General Hospital and Roscommon County Hospital, to name but five. There will be others too. Has the Minister ever given consideration to the substantial body of work which argues, contrary to her long held view, that centralisation is the best way to proceed, and that strongly contradicts the notion that high volumes means best outcomes in all cases? Has the Minister noted or re-read the York Health Economics review, often cited as one of the key reports supporting the notion of centralisation? Has the Minister taken heed of the fact that in its conclusion the review makes clear that there is no casual link between high volumes and best outcomes?

Does the Minister not accept that, as in Mallow General Hospital and each of the other hospital locations I cited, there is a very strong expression of opposition throughout the range of service providers, both in terms of in-hospital services providers, namely, consultants, doctors and nurses, and the general practitioners within the community, who strongly and vehemently oppose what she proposes to do? This is replicated throughout each of the sites I have instanced. When, if at all, will the Minister listen to the contrary view and give due regard to the opinions of those entrusted with the coal face delivery of acute hospital services at each of these sites, given that the model she proposes to introduce is based on the experiences of other jurisdictions which are now being revisited?

The Minister is taking no cognisance whatsoever of the unique make up of the Irish health care delivery system, especially in respect of acute hospital services. When will she desist in her plan, or will she allow the opportunity for others to revisit the damage that she has already inflicted on the hospital system throughout the State?

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