Fergus O'Dowd (Louth, Fine Gael) | Oireachtas source

I thank Deputies Paudie Coffey, Ciara Conway, John Paul Phelan and John Halligan for raising this matter. I note Senator Maurice Cummins is here also. I am taking this matter on behalf of the Minister for Health, Deputy James Reilly.

A key stepping stone towards the introduction of universal health insurance will be the development of independent not-for-profit hospital trusts in which all hospitals will function as part of integrated groups. The rationale behind the establishment of hospital groups and trusts is to support increased operational autonomy and accountability for hospital services in a way that will drive service reforms and provide the maximum possible benefit for patients.

The work on hospital groups is not about downgrading hospitals, rather it is about bringing together groups of hospitals into single cohesive entities to allow maximum flexibility in management, budgets and service delivery. It is about ensuring hospital groups are broadly comparable in size and scope in order that they can attract high quality staff and trainees across all health care specialties and professions. It is about creating efficiencies by using common business processes and economies of scale and avoiding unnecessary duplication. Most importantly, it is about maximising the range of services available to deliver internationally comparable quality care services for patients, regardless of where they live.

Specifically with regard to Waterford, the hospital will retain its current suite of services - oncology, cardiology and emergency department. It will provide invasive cardiology and trauma services and continue to be an NCCP centre. It will retain the same population referral base for cancer patients. Joint consultant appointments such as general surgery shared with Wexford across the groups will continue to support the specialist cancer services provided. In addition, there has been significant capital investment in the provision of a new emergency department and neonatal unit which has been fully constructed and is being fitted out. As part of the project, the existing emergency department is being refurbished and will be completed in February.

To assist the Department in advising the Government on the formation of hospital groups, in June the Minister appointed Professor John Higgins to chair a strategic board on the establishment of hospital groups. The strategic board is composed of representatives with both national and international expertise in health service delivery, governance and linkages with academic institutions.

A project team was established to make recommendations on the composition of hospital groups, governance arrangements, current management frameworks and linkages with academic institutions for the consideration of the strategic board. The consultation process to inform the project team has been rigorous and comprehensive. It has included meetings with every acute hospital, including consultations on two separate occasions with each hospital in the south-east region. It has involved the receipt of a significant volume of formal submissions from hospitals, clinicians, regulatory bodies and citizens, all of which have been considered.

The Minister has also made clear to the project team and the board his determination to ensure that as many services as possible can be provided safely and appropriately in smaller, local hospitals. On this basis, the organisation of hospital services nationally, regionally and locally will be informed by the ongoing development of the HSE clinical programmes and the smaller hospitals framework which defines the role of smaller hospitals. It outlines the need for smaller and larger hospitals to operate together and, therefore, is intrinsically linked with the ongoing work on the development of hospital groups. The Minister expects to receive the report of the strategic board later this month and will be able to bring this matter to his Cabinet colleagues for decision shortly thereafter.

It should be remembered that the hospital groups are an interim, collaborative measure pending the legislation required to establish hospital trusts. Before these trusts are established, the composition and functioning of the groups will be reviewed and if changes prove necessary, they will be made with Government approval when the hospital trusts are being formed.

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