Áine Brady (Kildare North, Fianna Fail)

I will reply to this Adjournment debate on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

The HSE southern area commissioned Horwath Consulting Ireland Limited and Teamwork Management Services Limited to review the current configuration of acute hospital services in the region, which encompasses counties Cork and Kerry. The HSE southern area is considering the outcome of this review and the recommendations made with the objective of securing clinically safe and sustainable acute hospital services for the region.

It is important to emphasise that the Teamwork report represents an input into decisions about the future service arrangements and it will not be the only means by which decisions about reorganisation are informed. Patient safety considerations will be paramount in determining the future configuration of services, especially where complex care is concerned. It is widely recognised that treating a low volume of cases in higher volume specialties is not conducive to optimal patient care. To ensure the best possible outcomes for patients, clinicians must be able to maintain their specialist skills by treating a sufficient number of cases. It is more difficult for specialists to maintain their skills in smaller hospitals when treating a low volume of patients. This has implications for how we organise acute services generally.

It is important to note that the total spend on health care in counties Cork and Kerry is approximately €1.4 billion. The HSE is conscious of the need to ensure that these resources are spent in the most effective and efficient way. In addition to the need to ensure patient safety, the need to ensure efficiency will also inform the reconfiguration exercise.

John Higgins, professor of obstetrics and gynaecology at University College Cork, has been appointed by the HSE as director of the reconfiguration of acute services in the Cork and Kerry region. Professor Higgins has commenced a comprehensive consultation plan with the counties' people. This process involves face-to-face meetings in various locations across both counties, with hospital staff and management, clinicians, patient groups, hospital representative and fundraiser groups and public representatives. A particular focus of the consultation process has been engagement with general practitioners across the Cork and Kerry region.

Following the consultation process, the HSE expects to be in a position by mid-June to indicate the general terms of its proposals for the future configuration of the services in the region, with the objective of putting in place a single health care system for counties Cork and Kerry and the development of a new governance structure for the hospitals and community services. The consultants' report will be published at the same time. The HSE will then commence a detailed planning process leading to the implementation phase beginning in the autumn of this year. It has emphasised that no hospital will close, but that every hospital must fundamentally change how and what services it delivers. The precise details of the changes to existing arrangements and the timetable for these will be developed in consultation with all the relevant interests in due course.

Cork and Kerry present specific demographic and geographic challenges in delivering safe health care. However, the HSE has clearly indicated with regard to Kerry General Hospital that the key current acute services, including accident and emergency, obstetrics, intensive care, acute surgery and acute medicine, will be maintained.

The Government is committed to ensuring the delivery of the best quality health services possible, in the safest, most efficient and effective way. The reconfiguration of the acute hospital services in the HSE south region which is being planned at present will be progressed in accordance with these principles.

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