John Perry (Sligo-North Leitrim, Fine Gael)

I am taking this matter on behalf of my colleague the Minister for Health, Deputy James Reilly.

There has been considerable debate around the issue of the role of smaller hospitals, much of which has been ill-informed. There have been many claims around lack of resources both financial and human. The real issue at stake is the need to ensure acute hospital services at national, regional and local level are provided in a safe and efficient manner. It is widely recognised that safer outcomes can only be achieved through the delivery of health services in the appropriate setting.

For certain medical specialties, particularly where complex care is required, many smaller hospitals do not have the throughput of patients which would enable doctors to maintain their skill levels. This applies no matter what resources are put in place.

The HSE, with the advice of HIQA, is taking steps to address the issues of safety. The steps being taken aim to ensure the appropriate treatment will be provided in the appropriate setting. This does not mean the closure of smaller hospitals. The Government is committed to ensuring as many services as possible can be provided safely in smaller, local hospitals. In fact this is likely to increase the volume of services delivered while ensuring their appropriateness and effectiveness. Patients should only have to travel to the larger hospitals for more complex services.

St. Columcille's Hospital, Loughlinstown, is part of a joint acute hospital service operated alongside St. Vincent's University Hospital and St. Michael's Hospital. These hospitals provide a range of services associated with acute hospital provision across three sites in a collaborative arrangement. As part of this provision, the configuration of services is constantly reviewed. From time to time, it is reorganised to improve access and quality of service and minimise risk to patients. While the range of services provided by the three sites will continue, the location of service provision will be configured in line with how best to deliver the service and maintain patient safety.

In recent years, St. Columcille's has implemented a trauma bypass protocol which allows patients suffering major trauma to be brought directly to the most appropriate site deemed necessary to treat their condition. These measures, combined with strong regional links to larger hospitals, are designed to ensure safety and are crucial to delivering the most effective outcomes for patients everywhere. The HSE is working to progress these initiatives in a collaborative framework in consultation with all stakeholders.

The Minister has made it clear that patient safety must be the overriding priority. He wants patients to be treated at the lowest level of complexity which is safe, timely, efficient and as near to home as possible. These are the factors which will inform our future decisions on the provision of acute hospital services. The Minister has assured the public that even in the difficult economic situation in which we find ourselves and which is the legacy left to us by the previous Government, no hospitals will close. St. Columcille's, Loughlinstown, has a very important role to play in the provision of acute services and this will continue into the future.

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