Brendan Smith (Cavan-Monaghan, Fianna Fail)

I thank the Ceann Comhairle for giving me the opportunity to raise this important issue. I am glad that the Minister of State, Deputy Shortall, is in the Chamber as she has responsibility for the primary care sector in the Department. The proposal to end the GP service at the north-east doctor on call, NEDOC, centre in Cavan after 10 p.m each night is the cause of serious concern throughout a very large part of County Cavan. The centre is located on the grounds of Cavan General Hospital and is centrally situated to provide an out-of-hours GP service. Over the past 24 hours I have had numerous calls from the public, from people who availed of the GP services, from elderly people worried about this development and from parents who had to bring children to the centre for treatment.

NEDOC covers a huge geographical area from the outskirts of Dublin city to west Cavan, west of Bawnboy village and as far as Carraigallen, County Leitrim. It embraces counties Monaghan, Meath, Louth and that part of County Leitrim. There are four treatment centres at Cavan, Castleblayney, Drogheda and Navan. The proposed restructuring of the service from the end of this month will mean there will be no duty service at the Cavan centre after 10 p.m. Such restructuring will reduce the number of doctors working at night from four to three, with the Cavan centre alert losing this vital service.

I understand the board of directors at NEDOC has been liaising with the HSE for months and outlining the need to adequately fund the scheme and retain the current complement of doctors in order to continue the existing night service. The medical people and particularly the doctors have always stated that four doctors should work at night in order to ensure patient safety and the quality of the service. We are talking about dividing four counties into three. Cavan and Monaghan are large, rural counties. If this proposal is allowed to proceed, it will place a further burden on doctors in County Cavan to travel long distances to provide night services from the other centres on a rota basis. Doctors are busy in their practices. An inevitable consequence will be increased patient referral to accident and emergency units and the increased use of ambulances. An important consideration is the additional cost to patients getting to the treatment centres. Not every family has a car. Many elderly people depend on family members to bring them to treatment centres. If this proposal is enacted, certain parts of County Cavan will be more than one hour from the nearest treatment centre. That would be unacceptable to the people.

It is ironic that in the recent HSE report on services for 2010, the progress made in the past year in providing more services in the community was mentioned. I trust the drive to provide more services away from our hospitals, in the community, will be continued and intensified. If this proposal is allowed to proceed, it flies in the face of the policy, which has so many attributes. I implore the Minister of State to intercede with the HSE to ensure the current level of services provided at night by GPs is continued.

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