James Reilly (Dublin North, Fine Gael)

I am committed to ensuring acute hospital services at national, regional and local level will be provided in a clinically appropriate and efficient manner. In particular, I want to ensure that as many services as possible can be provided safely in smaller hospitals. To this end, the Government will publish a framework for the development of smaller hospitals to set out how their future will be secured. The framework will give clear information on the role of smaller hospitals and address any safety issues arising from HIQA's reports. Consultation covering all the key stakeholders, including patients and public representatives, will be an integral part of the process. In addition to the framework, the organisation of hospital services will be informed by the clinical programmes being developed and implemented by the HSE. These interrelated programmes aim to improve service quality, effectiveness and patient access and ensure patient care is provided in the service setting most appropriate to people's individual needs.

In the context of the specific questions raised by the Deputy, the minor injuries unit at Monaghan General Hospital provides an eight hour service, from 9.a.m. to 5 p.m. This service came into effect on 1 November. The change in opening times is the direct result of the current budgetary and financial position facing the health system. The HSE has reviewed other possible options to save money or increase revenue but concluded that they would not generate sufficient savings in the short term. Following a detailed analysis of this issue, it has estimated that total annual savings of almost €400,000 will be generated with this alteration of opening hours.

I am favourably disposed towards the development of medical assessment units because they provide excellent service for patients. However, it is essential that such units be justified from both a service delivery and value for money point of view. The HSE has, as the Deputy is aware, established an independent feasibility study which will examine if there is a clinical need for a medical assessment unit in Monaghan General Hospital for the population of County Monaghan. It will also establish the pay and non-pay costs and internal-external support services associated with the establishment and running of an medical assessment unit in Monaghan General Hospital. The group commenced its work on 17 October and the timeframe for completion is six to eight weeks.

Additional information not given on the floor of the House

The HSE national ambulance service initially put in place a rapid response vehicle to assist with the smooth and seamless transformation within the area. This is a non-transporting vehicle, carrying advanced paramedics and an extended range of equipment to provide advanced treatment. This model is not sustainable locally because of the unavailability of appropriately qualified staff, but the matter will be kept under review, with a view to reintroduction when the National Ambulance Service is in a position to deliver it at the appropriate service level. Staff resources have been redirected to front-line ambulances to ensure there will be no change in the clinical levels available throughout the area. The region has a fully functioning emergency ambulance service.

See this speech in context