Áine Brady (Kildare North, Fianna Fail)

I am replying on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney. Hospital care for children is provided in Dublin at three hospitals: Our Lady's Hospital for Sick Children, Crumlin; Temple Street Children's University Hospital and the National Children's Hospital, Tallaght. Between the three, funding of over €250 million is provided for a national service for sick children.

The way to provide the best possible tertiary care most cost effectively involves the creation of one single national paediatric hospital, alongside a major teaching hospital, bringing together all the medical and nursing expertise for complex conditions. The concept of bringing together all three existing services is widely accepted. It is, therefore, entirely appropriate that we should now move towards that model of care in terms of closer integration and co-operation in the medical areas and in the most cost-effective use of resources. The Minister understands that significant cost savings are achievable if services and practices are more closely integrated, even before the building of a new paediatric hospital has been completed. For these reasons, to focus on each of these three hospitals providing paediatric services one by one, in isolation from the other two, will miss the full picture of paediatric services and the full potential for the level of services that could be provided within the resources being made available by taxpayers.

The facts relating to the budget for Our Lady's Hospital for Sick Children are as follows. The 2009 allocation to the hospital is €139.6 million. The allocation has increased by over €38 million or 39% since 2004. In line with budgetary constraints across the system, the 2009 allocation is 3% below the 2008 allocation of €143.8 million. The employment ceiling at the hospital is 1,550. At the end of March the HSE reports that the hospital employed 1,650 whole time equivalents, wtes, which is 100 above its employment ceiling, and therefore contributing to the current financial difficulties.

In terms of activity, in the first three months of this year there were 2,745 treatments for children as inpatients and 3,841 treatments as day cases at the hospital. This represents an increase of 244 over the same period in 2008. There were also 21,252 attendances in the outpatients' department, an increase of 1,041 over the same period last year. The HSE has advised that, based on the financial performance for the first quarter of 2009, the hospital should achieve a break even position at year end. This assessment takes account of cost saving measures totalling €6.5 million which have been agreed with the hospital and which are to be implemented over the remainder of the year. Much of the focus of the discussions between hospital management and the HSE has been on ensuring that all areas of non-pay expenditure are critically examined and that costs are reduced where possible.

It has proven necessary for Our Lady's Hospital for Sick Children, Crumlin, to take measures to stay within budget, including the closure of a theatre and a ward from this month. However, the hospital has confirmed that it is committed to delivering on the full level of its service plan commitments for 2009.

The funding and provision of the best standard of complex hospital care for children will continue to be a priority for the Government. Hospitals can work more effectively together, and hospitals will deliver a sustainable and constantly improving service for children by managing costs so that they stay within budget. Our strategic plan to integrate services at one new hospital is most important to achieve best outcomes for children.

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