James Reilly (Dublin North, Fine Gael)

I must beg to differ with the Deputy opposite, as it does add up. What is required is for appropriate services to be available in the appropriate setting and that they are safe. I have made the point previously that there has been much talk about what has gone out of small hospitals. However, one should wait for the rows that will take place when we begin to take stuff out of the bigger hospitals to put it back into the smaller hospitals. People attending major hospitals such as St. Vincent's or Beaumont for inguinal hernias or varicose veins is akin to sending one's ten year old Volkswagen up to the Ferrari testing centre. While it will do a great job, the local garage would do it just as well and a great deal more efficiently and conveniently. My point is the more complex cases will be left for the secondary and tertiary hospitals, while the smaller hospitals such as Loughlinstown and others will deal with a far wider range of problems in respect of procedures, including cataract surgery and various other day case surgery that can take place. Moreover, each small hospital is different and sits in a different place with regard to the overall hospital network in which it is located. For instance, Roscommon hospital would have a different range of procedures carried out than might the likes of Loughlinstown hospital. I again revert to Louth County Hospital, in which the footfall has greatly improved.

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