James Reilly (Dublin North, Fine Gael)

I propose to take Questions Nos. 7 and 26 together.

As Minister for Health, I will not stand over unsafe practice in any setting nor will I allow patients lives to be put at risk. However, it is not my policy to close small hospitals or to diminish them in any way. My priority is to ensure safe, high-quality care for patients, provided in the most appropriate location.

The circumstances in Roscommon Hospital are a cause for serious concern. It is clear that the acceptance of acutely ill patients in Roscommon as at present cannot continue and we need to find a safe solution for patients without delay. The hospital has had significant problems recruiting NCHDs, to which I referred, and relies heavily on agency staff.

Last week, I met a group from Roscommon which is concerned about the future of the hospital. I asked senior clinicians from the HSE to attend that meeting. I also asked the CEO of the Health Information and Quality Authority, Dr. Tracey Cooper, to attend to outline the authority's concerns about the hospital.

The HSE has been working with local clinicians to finalise a plan to provide a satisfactory and safe level of service in the hospital. I have asked the HSE to submit the plan to me by the end of this week.

The Government is strongly committed to developing the role of smaller hospitals in Ireland, including Roscommon Hospital, so that they will play a key part in the services provided to local communities. Local hospitals can and should be a vibrant element of local services, providing treatment and care at the appropriate level of complexity.

I assure the House that services will continue to be provided at Roscommon Hospital, as part of the Galway University Hospital group. The nature of the services will change but the hospital will always have a key role. In particular, I expect to see an increased level of less-complex activity at the hospital for the benefit of the whole local community.

With regard to Sligo General Hospital, I have confirmed it will continue to provide vital services. I am monitoring closely the NCHD vacancies around the country. As of now, the HSE has not expressed specific concerns regarding the NCHD situation in Sligo.

We must be honest and straight. What is currently available at Roscommon hospital is not safe. I referred to fractures and orthopaedic surgeons. There is no surgeon or cardiac staff to insert a stent. There is no vascular surgeon or team to deal with multiple trauma.

I want to see a vibrant 24-hour service available, through an urgent care centre, to the people who attend Roscommon hospital. This centre should be staffed and the care should be delivered by doctors. Hospital doctors should deliver the care from 8 p.m. to 8 a.m. We are in talks with the local general practitioners to provide coverage from 8 p.m. to 8 a.m. If one sprained one's ankle, one would go to the care centre to have an X-ray. However, if one's ankle were broken in two places, one would need to go to Galway. If one caught one's hand in the lawnmower and cut one's finger, one would go to the centre to get sutured but if one's hand were mangled one would clearly go to Galway. The service was to be supplemented by an additional ambulance so there would be four ambulances covering Roscommon during the day and three at night. I can guarantee that. There will be extra paramedics available with a car to provide cover if all the ambulances are out of Roscommon at any given time.

These are services that I can control and which I will deliver. I do not control the NCHDs at present because I do not know the numbers, but when they become available I commit to their inclusion. People will have an urgent care centre and a safe service. The abiding message I want to send from this House today is that I want to replace that which is not safe with something that is safe.

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