Enda Kenny (Mayo, Fine Gael)

That is why the changes are being made to improve patient safety. We are a small country and a small State with a population less than half the city of London. Our philosophy is that we should have health services available to people at the lowest unit cost and as close to them as possible. This means that we cannot have everything at every crossroads. In this case, the changes are being brought about for the people of Roscommon who attend Roscommon hospital. They will still have access to the vast majority of the types of treatment that they have always had, except in the outlined cases where small numbers will have an opportunity for better treatment due to the range of medical personnel in a bigger hospital. It is for that reason that extra transport facilities, extra trained paramedic staff and a rapid response vehicle are being made available. That applies from this weekend.

I understand that GPs have agreed to base their drop-in centre in the outpatient department of Roscommon hospital. That facility will be available to the people as it always was, and the GPs will continue their roster at weekend as they have done heretofore. The service in the urgent care centre in the hospital will be provided by the non-consultant hospital doctors for the people of Roscommon on a daily basis, as they would expect. In the interests of those who suffer from serious attacks, the facility and best opportunity for them will be provided elsewhere.

It is a case of anxiety and concern. I know many of the people involved. It is not an easy situation to say we must change this, but it is in the better interests of the patient and the services being provided. As the Minister for Health proceeds to change the structures, the problems associated with bigger hospitals, including Galway, will also be dealt with. His setting up of the special delivery unit will begin to deal with the backlog of waiting lists, with consequent problems for everyone when there are patients lying on trolleys and so on.

This is not an isolated issue. This is a leviathan structure that did not deliver what it was supposed to deliver and which has to change direction, its structure and the way it does its business. That is not easy task for the Minister, but that is what the Government will do in the interests of patients and the quality of services provided.

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