James Reilly (Dublin North, Fine Gael)

There is a full capacity protocol, which has four bars to it. It has been in operation. It is not ideal but it is far safer to have patients in wards than in emergency departments. International practice and research have proven that. It is a matter of working differently and having shorter stays in hospital, more primary care and chronic illness care in the community. All these developments will take time.

The Deputy asked about small hospitals. That issue is being addressed through a small hospital framework document, which will be circulated shortly to the various interested parties for consultation. Local politicians will be included.

We are about maintaining safe services and appropriate services in the hospitals. As I stated previously, all the brouhaha about the removal of some services from the small hospitals will be nothing by comparison with the riot that will occur when we start to remove from the bigger hospitals services that more rightly belong in the smaller ones. We are determined to do so, however. Let the large type 4 hospital deal with the tertiary and regional care issues it should be dealing with. It never made sense to me that people with varicose veins and inguinal hernias should be going to big hospitals such as Beaumont, the Mater and St. Vincent's. It is like sending a ten year old Volkswagen to the Ferrari testing centre to have it serviced. It does not make sense, although it would surely do a great job.

The Deputy mentioned Portlaoise hospital. It is not in the group in question as it is a level 3 hospital.

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