Brian Hayes (Dublin South West, Fine Gael)

I thank Deputies Boyd Barrett and Ferris for raising this issue, which is very important to the people of Dún Laoghaire, Wicklow and Wexford. Its importance is recognised throughout the House.

.St. Columcille's Hospital, Loughlinstown, is an important, integral part of the joint acute hospital service operated between St. Vincent's University Hospital, St. Michael's Hospital and St. Columcille's Hospital. The three sites provide a very wide range of acute services to the local population in a collaborative arrangement. There is no need to cease any of the current services at St. Columcille's Hospital. However, the configuration of services is constantly reviewed and, from time to time, rearranged to improve access and quality of service and minimise risk to patients. For instance, in regard to accident and emergency services, a trauma bypass arrangement was introduced in recent years that allows for patients to be brought directly to St. Vincent's University Hospital to ensure the most appropriate treatment. This programme of realignment of services has received recent impetus from HIQA in regard to the need to implement the recommendations from the Ennis and Mallow reports. The conclusions of these reports were a very important contribution to driving further improvement in the quality and safety of acute hospital services. The reports deal, in particular, with the types of services that can safely be provided in smaller hospitals, and with the structures required for good governance and accountability. The HSE must ensure that this happens and the Minister will be monitoring the situation closely in conjunction with HIQA.

The Minister is strongly committed to developing the role of smaller hospitals so they can play a key part in the services provided to local communities. Local hospitals can and should be a vibrant element of local health services, providing treatment and care at the appropriate level of complexity to the patients in their area. The restructuring of services will also be closely aligned with the programme of care set out in the HSE's Report of the National Acute Medicine Programme, which recognises the essential role of large and small hospitals in the delivery of acute services. The HSE is working to make progress on these initiatives in a collaborative framework in consultation with all stakeholders.

The Minister has made it clear that he expects to be briefed by the HSE where there are any proposals to withdraw services from individual hospitals. He has also made it clear that patient safety must be the overriding priority and wants patients to be treated at the lowest level of complexity that is safe, timely, efficient and as near to home as possible. These are the factors which will inform our future decisions on the provision of acute hospital services.

The Minister has clearly assured the public that, even in the difficult economic situation we find ourselves in, no hospitals will close. However, ongoing reform of the system may result in some changes in how care is delivered across our health system.

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