John Perry (Sligo-North Leitrim, Fine Gael) | Oireachtas source

I thank the Deputy for raising this issue, which I am responding to on behalf of the Minister for Health.

Small hospitals, such as St. Columcille's hospital, Loughlinstown need to be supported within a hospital group. This is necessary for the safe management of patients who present with varying levels of complexity, for education and training, continuous professional development and the sustainable recruitment of high quality clinical staff. The framework for smaller hospitals, to be published in the near future, and the hospital groups report, define the role of small hospitals. The framework outlines the need for small and large hospitals to operate together and the wide range of services that can be provided within smaller hospitals. It also sets out to address the services that should transfer from large to small hospitals and vice versa within a group. This allows services to be delivered in the most appropriate hospital and as close to the patient's home as possible.

In developing the framework for the development of small hospitals, the Government is clear on the important role that can be played by small hospitals in terms of the provision of more rather than fewer services for more patients. With this in mind, the framework will set out what services can and should be delivered safely by these hospitals in the interest of better outcomes for patients. Local hospitals may deliver services such as ambulatory care, including chronic disease management and day surgery, diagnostics and rehabilitation services and have minor injuries and medical assessment units. Local injuries units treat patients with minor injuries such as suspected broken bones, sprains and strains, facial injuries, minor scalds and burns. Patients can self-refer or can be referred by their general practitioner. Medical assessment units receive general practitioner referrals and provide access to diagnostic services. Patients will be admitted, if necessary. Those requiring interventions not available in the local hospital will be transferred to the larger hospital under appropriate protocols.

The organisation of hospital services nationally, regionally and locally will be informed by the HSE clinical programmes, including the HSE report of the national acute medicine programme, which recognises the essential role of large and small hospitals in the delivery of acute care services. Loughlinstown hospital provides joint acute hospital services with St. Vincent's and St. Michael's, Dún Laoghaire. Together, they provide a range of services for the catchment of Dublin south-east and Wicklow across three sites in a collaborative arrangement. In this context HSE Dublin-mid-Leinster is reorganising services provided at St. Columcille's in South County Dublin. This reorganisation is in the interests of patient safety and better service provision. It is planned to proceed with reorganisation on publication of the small hospitals framework, with a lead-in time of six to eight weeks. There has been ongoing communication with staff and local public representatives and a detailed communication plan has been developed for use at implementation stage.

On the Deputy's question of why he was not invited to the meeting, I imagine it would be up to the management team and clinical staff of the hospital to invite representatives to a meeting. All of the invitations which I have received to attend meetings at Sligo General Hospital were from management at the hospital.

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