Seán Sherlock (Cork East, Labour)

I wish to speak specifically on Mallow. I am not aware of any commitment that was given on Mallow General Hospital regarding accident and emergency services but I am open to correction. I am a member of the Mallow Hospital Action Committee since I entered public life. In Mallow and north Cork we have been through a very difficult and dramatic time, especially when on Tuesday, 19 April, it was announced by the Health Information and Quality Authority, HIQA, that it would investigate the services at Mallow General Hospital. At the time it was purported that the investigation was on foot of a complaint, which turned out not to be the case. When HIQA visited the hospital, it found the staff, clinicians and physicians were absolutely and utterly beyond reproach.

I note the comments of Deputy Donnelly. In parallel with the investigative process, there was a roadmap for the reconfiguration of Cork and Kerry hospitals whereby the designation of Mallow would evolve or change to reflect the concerns that arose in the HIQA report. All the stakeholders, including the hospital action committee of which I am a member, physicians, GPs and those who were referred to the hospital were part of the process. The endgame was to ensure we could maintain the capacity of the hospital to deliver in order that more services would be taken out of Cork University Hospital on an elective basis, acute surgical services could be maintained and an urgent care centre or medical assessment unit established which would allow for the vast bulk of cases that present on an emergency basis to continue to be dealt with in Mallow. We were on that route map until I discovered this week that certain forces within the HSE wanted to derail it and go way beyond the HIQA recommendations to reduce the capacity of the hospital to deliver.

I am encouraged by a meeting I had with the Minister for Health, Deputy James Reilly. He reflected a statement he made when the HIQA report was issued, namely, that he was strongly committed to the role of smaller hospitals. I can only speak for Mallow with any great authority. We now need to get the roadmap back on track so that if we have to go through change management, it will reflect HIQA. However, it must not be solely for budgetary reasons. It has to allow for a situation to arise whereby we can take more of the elective procedures that can be done in Mallow and have a short stay surgical unit in order that we can continue to have an emergency department facility and begin to facilitate the structures around CUH.

If we proceed along a pathway that seeks to excise acute surgery or the acute medicine programme from Mallow in a short space of time, I have no doubt it will contribute to the risk profile of larger hospitals like CUH. We must be cognisant and very wary of the need to ensure hospitals such as Mallow have a role. We need to consider in a more lateral way how the role can proceed. Mallow differs from other hospitals in that HIQA has examined it and provided recommendations. The issue of licensing is coming down the track. No matter what one's political hue is - I accepted this a long time ago - one has to take the view that one does not reduce the capacity. The HIQA requirements should be met, we should ensure that a hospital has a license to practice and that services can be delivered, albeit possibly in a different way.

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