Margaret Conlon (Cavan-Monaghan, Fianna Fail)

I welcome the opportunity to contribute to the debate. In setting the context for this debate it is important to state again that the budget for the HSE for this year is €14.6 billion. That is a huge amount of money in terms of what was spent on health care 20 years ago. The HSE must ensure that the services it delivers are delivered in the most cost effective and efficient manner.

At the end of August the HSE had a deficit in the hospital sector of €108 million. That is a huge amount of money. The HSE, no more than any other statutory body in the country or people in their own homes, must live within its budget because in a time when we are spending €5 for every €3 we take in in revenue, it is unsustainable. It cannot continue into the future.

I agree that people who are sick deserve the very best treatment in a dignified setting where patient safety is central. The patient must be the number one priority. He or she must have confidence in the care they receive and get the best possible outcome.

There are many good people working in the HSE delivering front-line services and good outcomes for patients on a daily basis but they are truly demoralised due to the large amount of negative publicity they receive. Those people must be recognised and affirmed. For example, the HSE published its hospital league tables for July and Cavan hospital was only one of two hospitals in the country to achieve green light status, having scored highly in many areas. That would not be possible without the hard work, dedication and commitment of the staff and the board. It is often the case that negative news hits the headlines but we must highlight the positive news. For most people the experience in hospital is positive and I would argue that only our sickest people need to be in hospital. Hospital should be the last place one ends up.

I am aware from a friend who works in an accident and emergency department that the weekends are very busy. In some cases people are bypassing the out-of-call service and going straight to the hospital. This is unnecessary and unfair and increases pressure on the services.

Medicine is not an exact science. There will always be challenges and there will never be enough money. Therefore, we must use what we have to achieve the maximum benefit for patients. I have witnessed first hand in my constituency the difficulties faced when reconfiguration takes place. I do not have medical expertise but I am guided by the experience of those who do. I understand that if we had a blank canvas in the north east, we would not have five hospitals but change is difficult. I spoke to a doctor a few months ago who told me that in his country change was something to be embraced, but that in this country it was something that was feared.

Since the changes came into effect in July last year there have been many positives. The minor injuries unit is working well and there is room for expansion. The medical assessment unit, MAU, in Cavan is excellent and the CT scanner is ready to run in Monaghan. We are waiting for the application specialist to provide the training. The ear, nose and throat, ENT, service is also working very well and there is scope for cross-Border development. We must all show leadership and courage in dealing with these sensitive issues to ensure better outcomes for patients.

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