Áine Brady (Kildare North, Fianna Fail)

I am replying to this Adjournment matter on behalf of my colleague, the Minister for Health and Children, Deputy Mary Harney.

In recent weeks, Cavan General Hospital experienced an unprecedented 40% increase in referrals to its emergency department and medical assessment unit. In addition, there was a very significant rise in medical referrals and medical admissions to the hospital from September. In order to ensure patient safety, the HSE introduced temporary curtailments, which were confined to medical outpatient services and day services. This response was solely due to the increase in activity and not due to any planned budgetary reduction. It is important to emphasise that all emergency services, oncology services, antenatal clinics and phlebotomy services were not affected and continued as normal throughout the curtailment period. A significant number of clinical procedures including endoscopy and surgical procedures also continued, based on the clinical presentation of the patients. These interventions were managed on a day to day basis by the clinicians involved.

Hospital management and clinicians are actively working to ensure that patients who had their appointments deferred this week will now be rescheduled and prioritised for appointment and-or procedures as quickly as possible. It is also important to note that the Cavan-Monaghan Hospital group has one of the shortest waiting lists for endoscopy and surgical procedures in the country. All services resumed as normal at Cavan on Monday, 18 October. Emergency activity within the hospital has decreased significantly. At 2 p.m. yesterday there was only one person waiting on a chair or trolley in Cavan emergency department compared to 11 people two weeks previously.

The Royal College of Surgeons of Ireland provided the HSE with advice regarding safety issues in relation to surgery at Navan hospital. Acting on this advice, the HSE decided to cease all emergency surgery at the hospital immediately, with effect from 1 September 2010. As the Deputy will appreciate, patient safety has to be the over riding principle in our health system. The transfer of acute and emergency surgery from Our Lady's Hospital, Navan, was always a long-term objective of the north-east transformation plan. The plan is designed to build a health system that is in line with the model of care emerging internationally.

Following on from the transfer of acute and emergency surgery, there is a decreased need for surgical and medical beds in Navan. As a result, a medical ward, which opened in Navan for a period of three months only to support the reconfiguration of medical services in Louth County Hospital, is due to close on a phased basis. The HSE is closing a number of surgical beds in Navan Hospital due to the transfer of services. The closure of these beds is managed through a combination of patient discharges, the cessation of admissions to wards and the phased relocation of patients within the hospital. The process is reviewed on a daily basis by senior hospital management team.

The hospital remains the regional centre for elective orthopaedic surgery and it expects that all of its complex joint replacement surgery procedures planned for 2010 will be completed by mid-November. From then the unit will become a five-day unit and will concentrate on completing this year's planned, less complex, minor surgery cases. An orthopaedic outpatient department initiative will also be undertaken in November and December in Navan to address the outpatient orthopaedic waiting lists in the north-east region, namely, individuals who are awaiting an assessment.

I wish again to emphasise that patient safety is central to the delivery of health services. People must have confidence in the care they receive and have the best possible outcomes. All decisions regarding the operation of health services will be taken with patient safety as the priority.

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