Stephen Donnelly (Wicklow, Independent)

This debate must be about survival, not of any particular accident and emergency service but survival of patients. We all want equal access to safe and efficient medical services. If one has a stroke, a heart attack or a serious accident, one's chances of survival should not depend on where in Ireland you are. For this to work, our hospital system must use its resources smartly. There is no point going to Loughlinstown if the skills one requires are in St. Vincent's. There is no point going straight to St. Vincent's if one is going to spend half an hour in an ambulance in the car park waiting for a trolley.

It would be easy for me, as the only Opposition and Independent TD for Wicklow and east Carlow, to say that I will fight to retain a full, 24-hour accident and emergency department at Loughlinstown. But I do not believe this would be the safest outcome for the people of Wicklow and east Carlow. The medical experts I have spoken to also are of this view. The accident and emergency department at Loughlinstown is routinely bypassed by the ambulance services in serious cases. Loughlinstown accident and emergency department does not have sufficient patient numbers to be at the cutting edge. If one has a serious injury one is told to go to St. Vincent's Hospital because the extra seven or eight minutes travel will radically increase one's chances of survival.

In recent years I have spent a lot of time working on improving health care systems abroad and I promise to bring that experience to the Dáil. My experience tells me that Loughlinstown is being run down year after year by cutbacks and a lack of vision and leadership from politicians and the HSE. It does not stop at Loughlinstown. Wicklow and east Carlow have suffered from years of under-investment. There are not enough ambulances and the ones we have are getting old. The primary care strategy has disappeared. Where are the primary care centres? The doctor on call service is a joke; people are left waiting for hours at night for a GP to arrive.

If the Government is to change the accident and emergency service at Loughlinstown, it must not be a cost-cutting measure, but rather part of improving the entire health care system for Wicklow and east Carlow. It is not acceptable that someone in Carnew must drive more than 60 miles to have a minor injury treated. It is not acceptable for a parent in Arklow with a sick child to wait for hours at night for a GP to arrive. It is not acceptable for a heart attack victim in Blessington to have to hope that an ambulance will be ready to bring him or her to hospital.

We must have primary care centres in Arklow, Wicklow town, Blessington, Greystones and Bray, doctor on call services, a modern ambulance service and fully functional accident and emergency capacity at St. Vincent's Hospital. If the minor injury unit is to be closed at night in Loughlinstown, one should be opened in Arklow during the day. We have to invest in Loughlinstown hospital. It needs a vision. It should not cling to an outdated and potentially dangerous idea of what a hospital needs but become a truly excellent hospital serving our community as part of a comprehensive, modern and responsive health care system for Wicklow and east Carlow. That is a vision for which I will fight.

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