Joe McHugh (Donegal North East, Fine Gael)

Were Letterkenny General Hospital to be redesignated as a regional hospital to provide regional services, including oncology and cardiac services, for patients in counties Sligo and Leitrim, there would be an opportunity to save more than €2.2 million per annum. This is worth considering and I ask the Minister to examine the possibility.

Donegal is the county with the highest level of social deprivation and one of the highest levels of chronic disease in Ireland. It also has the lowest rate of private health insurance coverage at 13%. In the past five years Letterkenny General Hospital has developed its role as a major provider of acute services in the north west. In particular, it has developed its regional role in the provision of cancer, renal and cardiac services. In January the hospital initiated its undergraduate medical education programme, thereby attaining university hospital status, with its first intake of 20 undergraduate medical students who will spend one year of their clinical and academic training at the hospital. Moreover, the programme's scope will increase to 40 medical students in September.

In addition, during the first four months of the year, Letterkenny General Hospital reduced its expenditure by almost 4%, while simultaneously rising to the top of the HealthStat hospital rankings. I commend all staff at the hospital for achieving this recognition. Despite this combination of budgetary reductions which included pay reductions and difficulties in recruiting junior doctors, high consumable costs were incurred owing to the fact that 90% of the hospital's inpatient activity was non-elective. The number of emergency department presentations has risen by 5% in the year to date. Consequently, the possibility of having a deficit of €8.9 million by the end of the year remains. While the figure of €2.2 million will not be realised unless the designation for private health insurance is revisited, savings could be made in this regard.

As for the health system in general, there has been a regional campaign for radiotherapy services for a number of years at both grassroots campaign and political level. I acknowledge the personal attention the Minister has given to this agenda and his commitment to funding Altnagelvin Hospital on the basis of a commitment to admit 30% of patients from County Donegal. This has brought much welcome relief to many cancer sufferers who had been travelling to Galway or Dublin. Border geography should not be a barrier to access and I look forward to working closely with the Minister on the scheme. It also should be noted that if that type of radiotherapy service is to be provided, it augurs well for cancer services at Letterkenny General Hospital and it is important that one hospital does not detract from the services provided at another.

On the challenge faced by the Minister, while he possesses his own medical knowledge and experience, as a layman, my perception is that he must dismantle a broken bureaucratic monster and in tandem recalibrate the manner in which services are run. Obviously, this will bring pain and be a difficult time for many. I was warned about this on the canvas trail when I was told things would be tough and that people would not envy me for my task. While it is tough, the important point is that although some will harness it in an effort to use it as a political weapon, anger is not and never will be policy. I acknowledge there will be hurt, pain and anger, but to use anger as a political weapon will do no service to either the health service or the people of this country. I commend the Minister on his hard work.

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